Babies and children with thin brittle bones
In children, insufficient vitamin D can lead a bone disease called rickets. Rickets, which first became problematic in the 18th century, is characterized by thin, brittle bones (at risk for
fracture), skeletal deformity, muscle weakness, dental problems, and even misshapening of the head. The disease has a peak incidence between three and 18 months and can lead to life-long skeletal
The incidence of rickets was brought down in the 18th century through improved nutrition. However, experts suspect the incidence of rickets may be on the rise again, due to insufficient vitamin D
intake and lack of sun exposure. Babies who are exclusively breast-fed, particularly by mothers who also have a vitamin D deficiency, as well as children who are not exposed to sunlight and do not
consume vitamin D fortified foods are especially at risk for the bone-damaging disease.
New vitamin D recommendations
Up until now, the vitamin D recommendation for children was 200 international units (IU) per day starting at two months and continuing into adolescence. Based on evidence from more recent
research, the AAP has updated the vitamin D recommendation to 400 IU per day starting shortly after birth.
Infants who are exclusively breastfed should receive supplements until they are weaned and consuming at least one liter - or about four cups - of vitamin D-fortified formula or whole
milk per day. Likewise, children who are not getting 400 IU per day through food and drink should also take a 400 IU vitamin D supplement daily.
According to the Office of Dietary Supplements, a division of the National Institutes of Health, all formulas sold in the United States provide at least 400 IU vitamin D per liter, and the majority
of vitamin D-only and multivitamin liquid supplements provide 400 IU per serving (be sure to read the labels).
Kid-friendly tips to get enough vitamin D
Even though very few foods naturally contain vitamin D, the following tips can help ensure your kids are getting enough of the bone-boosting vitamin.
1. Eat fish
Salmon, tuna, sardines and mackerel are good sources of vitamin D. Make it a point to serve fish two to three times per week. Broiled salmon for dinner (a 3.5-ounce serving contains over 350 IU) or
tuna salad sandwiches for lunch (a 3-ounce serving of tuna packed in oil provides 200 IU) are easy kid-friendly meals. You can also try the following:
Other natural sources of vitamin D are beef liver, cheese, egg yolks and mushrooms. Be sure to include these foods in your family's daily diet, too.
2. Got milk?
One 8-ounce glass of vitamin D-fortified milk can provide nearly 100 IU of vitamin D. Expecting your kids to drink four glasses of milk per day is likely unrealistic – and may interfere with
them getting their recommended intake of other vitamins and minerals if they are replacing meals with milk. Also, if they start swigging down milk in addition to their regular daily meals, they risk
taking in too many calories. The best bet is to have them consume milk with their morning cold cereal – another fortified source of vitamin D – and to replace soft drinks or sugar-filled,
low-juice drinks with a glass of milk. You can also use milk to cook hot cereal, mash into potatoes, or make low-fat Alfredo sauce for pasta.
3. Serve cereal for breakfast
Ready to eat cereal is a convenient way to increase your children's vitamin D intake. Though not all cereals are fortified with vitamin D, many provide at least 10 percent of the recommended
intake. For example, Total and every variety of Cheerios provides 40 IU of vitamin D per serving (the Multi-Grain variety also provides 100 percent of 10 other vitamins and minerals). If you prefer
organic cereals, try Cascadian Farms' Raisin Bran or O's, which also provide 40 IU per serving. However, before you buy any cereal, read the label to make sure it's fortified with
In addition to breakfast, your kids can snack on vitamin D-fortified cereals in place of junk food, and you can use crushed cereal in place of breadcrumbs for chicken fingers or meatballs. (Try these
family-friendly recipes using cereal
4. Get some sun
One of the reasons rickets became a problem in the 18th century was because the smoke from factories blocked the sun, preventing people from getting the sun exposure necessary for their bodies to
produce vitamin D. Nowadays, more kids are indoors on the computer or in front of video games – or in daycare facilities that don't offer outdoor play – resulting in a lack of sun
exposure and vitamin D. Make a rule that your kids need to get at least 15 to 20 minutes of sunshine daily, weather permitting of course. Sunshine time is good for you, too – take your kids to
the park or simply venture into your own backyard and play some fun outdoor games (here are 10 kid-friendly outdoor activities
5. Take a supplement
The best way to ensure your kids are getting enough vitamin D is to give them a supplement that provides 400 IU. Since adults are also at risk for vitamin D deficiency, be a good role model and take
6. Talk to your pediatrician
If you have questions about vitamin D and the new guidelines, talk to your family doctor. He or she may also have additional tips to ensure your kids – as well as the adults in the household
– are getting enough vitamin D.
More reasons to get adequate D
In addition to preventing rickets and other bone disease, research suggests that sufficient vitamin D can offer protection against colon, prostate, and breast cancers as well as prevention and
treatment of type 1 and type 2 diabetes, glucose intolerance, and high blood pressure. Vitamin D may also help boost immunity.
The need for vitamin D and the increased recommendation for children does not mean more vitamin D is better. Since vitamin D is a fat-soluble vitamin – meaning that it is stored in your
body's fat tissues – it can result in toxicity when taken in excess. Stick to the 400 IU per day recommendation for your kids.