Vitamin D is being hailed as the new 'wonder vitamin' - Is your baby getting enough?

Bone growth depends mainly on the absorption from the intestine of two minerals, calcium and phosphorus.  Vitamin D is the agent that promotes this process. Without it, bones do not grow normally, causing deformities of the skeleton that in turn can lead to poor growth, anemia and potential complications such as pneumonia and tuberculosis.

Other Benefits:

• Adequate vitamin D throughout childhood may reduce the risk of osteoporosis.  
• New evidence suggests that vitamin D plays a role in the immune system and may help prevent infections, autoimmune diseases, cancer and diabetes.

Symptoms of Vitamin D Deficiency:

• Rickets – A clinical disease caused by a lack of vitamin D that has recently been on the increase. Classic signs include a potbelly, “knobby” ribs, and curved legs and arms. It can be treated with an adequate amount of vitamin D.
• Anemia.
• Increased susceptibility to serious infections such as pneumonia.

Recommended Dose of Vitamin D:

The American Academy of Pediatrics recommended that all infants and children have a minimum daily intake of 400 IU of vitamin D beginning soon after birth.

• Breastfed and partially breastfed infants consuming less than 1 liter (just under 1 quart, or 33.8 ounces) of infant formula per day should be supplemented with 400 IU a day of vitamin D beginning in the first few days of life because vitamin D requirements cannot be met by human milk alone (which provides only about 25 IU/L).
• All non-breastfed infants, as well as older children, who are consuming less than one quart per day of vitamin D-fortified formula or milk should receive a vitamin D supplement of 400 IU a day.
• Children with increased risk of vitamin D deficiency, such as those taking certain medications and those with darker skin, may need higher doses of vitamin D.

Sources of Vitamin D:

• Sunlight - Ultraviolet light causes substances that are normally in the skin to be converted to vitamin D. However, it is strongly advised that infants younger than 6 months be kept out of direct sunlight. Additionally, children’s activities that minimize sunlight exposure are preferred, and when outdoors, protective clothing as well as sunscreens should be used. These measures protect children from skin damage, but block out vitamin D. 
• Milk is the leading source of vitamin D in the diet, providing about 100 IU per cup. One quart of milk (non-fat, reduced fat or whole), fortified with vitamin D, contains the daily requirements of vitamin D.
• Infant formula - All formulas sold in the U.S. must meet vitamin D requirements, but younger babies will not be able to consume enough to get the recommended daily dose, and therefore will require a supplement.  
• Breast milk - Human milk contains a small amount Vitamin D - around 25 IU per liter. Some studies have shown that mothers can increase the Vitamin D in their breast milk, by adding a vitamin D supplement to their diet or ensuring some sunlight exposure each week.
• Fish - Salmon, mackerel, tuna, sardines.
• Fish oil, especially cod liver oil.
• Eggs - Vitamin D is in the yolk.
• Orange juice fortified with vitamin D.
• Yogurt fortified with vitamin D.
• Supplements - Most infants and growing children require supplements of vitamin D. 

What is in Vitamin D supplements?

There are 2 forms of vitamin D that have been used as supplements: vitamin D2 (ergocalciferol, which is plant derived) and vitamin D3 (cholecalciferol, which is fish derived). Vitamin D3 has been shown to be more effective. Most fortified milk products and vitamin supplements now contain vitamin D3. They are available in drop form for younger children and in a chewable multivitamins for older children.

Food	Vitamin D (IU)
Salmon (3.5 ounces)	360
Sardines, canned (1.75 ounces)	250
Tuna, canned (3 ounces)	200
Cow's milk fortified with Vitamin D (1 cup)	100
Soy milk fortified with Vitamin D (1 cup)	100
Orange juice fortified with Vitamin D (1cup)	100
Cereal fortified with Vitamin D (3/4 cup)	40 + check the label
Yogurt fortified with Vitamin D (1/2 cup)	40
Egg (1 whole - vitamin D is in the yolk)	20

From this table, you can see how it could be difficult for babies to get enough Vitamin D each day. Is your baby getting enough?

By Sandi Schwartz - Science writer and mom

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