Vitamin D helps to ensure that our bodies absorb and retain calcium and phosphorous, which are both needed for building strong bones. The need for vitamin D begins even before a baby is born; insufficient intake can put an infant’s bone development at risk.
Why is Vitamin D so Essential?
Severe vitamin D deficiency can lead to nutritional rickets, which can cause softened and weakened bones. This disease is most often seen in children younger than 2 years of age. Because recent studies have shown that most infants in the United States have not been consuming enough vitamin D, the American Academy of Pediatrics (AAP) now recommends that all infants have a minimum intake of 400 International Units (IU) of vitamin D per day beginning soon after birth.
How Does the Body Get Vitamin D?
Vitamin D can be obtained in two ways: first, from the foods we eat; and second, made in the skin after exposure to ultraviolet (UV) light.
Vitamin D from the Sun
Despite the ability to absorb Vitamin D from the sun, we have learned over the past few decades that the sun’s rays are harmful to our skin. The AAP recommends that children six months of age and younger be kept out of the sun altogether. Infants six months and older should wear protective clothing and sunscreen to minimize their exposure to sunlight. Short periods of sun exposure are sometimes recommended as a way to obtain vitamin D, but sun exposure must be handled safely, since its impact on skin cancer in the future is not well known. Sun exposure can also be an unreliable source of vitamin D because of latitude, season, sunscreen use, skin pigmentation, and pollution. Because of this, infants need to obtain the majority of the vitamin D they need from their diets.
Vitamin D from Food
According to the AAP, the primary source of nutrition for infants should be breast milk or, if breast milk is not available, infant formula. Because breast milk does not contain enough vitamin D, breastfed or partially breastfed infants should be supplemented with 400 IU of vitamin D per day beginning in the first few days of life. If a baby is on an infant formula, they still may need a vitamin D supplement. All infant formulas are made to provide 400 IU of vitamin D in 32 ounces (about 1 liter). But if an infant is drinking less than 32 ounces of formula each day, then vitamin D supplementation is needed.
Liquid supplements are the best option for breast- or formula-fed infants. Some preparations provide the recommended amount of 400 IU in ½ mL, 1 mL, or a one-drop dose. Supplementation should continue until a baby is weaned to at least 24 ounces of vitamin D-fortified whole milk per day. It’s important to remember, though, that whole milk should not be started until an infant is 12 months of age. When solid foods are introduced, babies can get vitamin D from foods like oily fish (such as salmon), egg yolks, and fortified foods like yogurt, cheese, and ready-to-eat cereals.
Pregnant Moms Need Vitamin D, Too
Pregnant women must also be sure to get enough vitamin D, since their intake directly affects their baby’s vitamin D levesl at birth and during the first 2-3 months of life. Unfortunately, research has shown that most infants will not meet their goal intake of vitamin D during their first year of life. Pregnant moms should speak with their obstetricians to have their vitamin D levels checked. Your pediatrician can also help to determine if your baby needs to have their vitamin D levels checked.