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Babies and Vitamin D Deficiency: Is supplementation necessary?

How much vitamin D does your baby really need?

If you’ve been following the story of vitamin D over the last several years, you know that’s a tough question to answer. While various studies credit the vitamin with strengthening bones, guarding against respiratory infections, and maintaining a healthy immune system, there’s also been a lot of mixed information lately about how much adults need, which makes determining how much to give your baby even harder.

Up through 2008, experts and doctors told us we’re all likely to be vitamin-D deficient, and babies are especially vulnerable. Since then, the vitamin-D supplement industry has soared: between 2008 and 2009 sales jumped 82 percent. Then in December of 2010, the Institutes of Medicine (IOM) made new recommendations stating that most of us do in fact have sufficient levels of vitamin D, which we get from a combination of diet and sun exposure. The panel of doctors also deflated the often-floated idea that vitamin is a cure-all supplement. Yes, it’s important to bone health, the committee said, but science did not support the claims that vitamin D offers cancer and heart disease protection or a lower risk of diabetes and other chronic health problems, as had been suggested by many researchers. To make things even more complicated, the new IOM recommendations don’t mention babies; they apply only to adults.

So where does that leave you – and your baby? Here’s what you need to know about vitamin D and what infants, especially, are up against when it comes to getting sufficient amounts:

  • It’s not that easy for infants to get the vitamin D they need from the sun or their diets. Sun exposure is supposed to be our number one source of D, but when we (rightly) hide our new babies from the sun’s harmful rays, we’re cutting off their main supply. In terms of diet, breastfed babies are the most vulnerable to vitamin-D deficiency because breast milk doesn’t contain enough, especially if mom is also deficient. Formula-fed babies get a healthy dose of vitamin D if they are drinking roughly 30 ounces of formula a day, but the recent Pediatrics study found that only one in five formula-fed infants actually have adequate levels of vitamin D, suggesting that they could also benefit from supplements.
  • 58 percent of newborns and 36 percent of new moms are deficient in vitamin D, according to a 2010 study using samples of cord blood, and 38 percent of just-born babies were considered severely deficient. Babies whose moms took vitamin-D supplements (included in many prenatal vitamins) in the second and third trimester were less likely to be low on D. The new IOM guidelines suggest that adults have 600 IU of vitamin D per day, which may be especially important for an expecting or nursing mom.
  • Babies born in the winter and babies with dark skin are even more likely to have a deficiency as well as those born in geographical areas with less sun exposure. Meanwhile, the study of newborns and mothers (that showed roughly half being deficient) was pulled from a population of mom-baby duos in Boston, where sun exposure is low during many months of the year.

The daily dose of vitamin D for all infants, children, and adolescents, as recommended by the American Academy of Pediatrics (AAP) in 2008, is from 200 to 400 International Units (IU) a day. Here’s how to administer it:

  • A few days after a baby’s birth, parents should start giving a daily supplement of 400 IUs. Before 2008 few doctors passed this advice on to patients – last winter, a study in the journal Pediatrics suggested that only 5-13 percent of breastfed babies were given vitamin-D supplements between 2005 and 2007 – but since 2008, the AAP has been encouraging pediatricians to suggest supplementation to parents.
  • Vitamin-D supplements for babies come in droppers (with a strong taste) or in the form of tasteless, single-dose drops. You can also get it in a baby multivitamin.
  • When baby turns 1 year old, she can drink cow’s milk (fortified with vitamin D), so supplements will be less critical. But the AAP suggests that little kids need to drink approximately one quart of milk per day to bump vitamin D levels to the right range. Fatty fish and eggs also have vitamin D, but most toddlers still don’t get enough in their diets.

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