AAP Recommends Doubled Vitamin D Amounts for Children

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The pediatrics academy has raised its earlier recommendation to 400 IU per day.

The American Academy of Pediatrics (AAP) today announced that it has doubled the amount of vitamin D recommended for infants, children and adolescents. The increase, from 200 international units (IU) to 400 IU per day, starting in the first few days of life, was detailed at the group's annual meeting in Boston. The new advice replaces an academy recommendation issued in 2003.

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"We are doubling the recommended amount of vitamin D children need each day because evidence has shown this could have life-long health benefits," said Frank Greer, M.D., FAAP, chair of the AAP Committee on Nutrition and co-author of the report. "Supplementation is important because most children will not get enough vitamin D through diet alone."

"Breastfeeding is the best source of nutrition for infants. However, because of vitamin D deficiencies in the maternal diet, which affect the vitamin D in a mother's milk, it is important that breastfed infants receive supplements of vitamin D," said Carol Wagner, M.D., FAAP, member of the AAP Section on Breastfeeding Executive Committee and co-author of the report.

The new advice is based on mounting research about potential benefits from vitamin D besides keeping bones strong, including suggestions that it might reduce risks for cancer, diabetes and heart disease. But the evidence isn't conclusive and there is no consensus on how much of the vitamin would be needed for disease prevention.

"We know 400 IU a day is safe and prevents rickets," Greer said. "We don't have any idea if that amount of vitamin D is enough for other diseases. We also don't know if anything over 400 is safe."

The AAP also made these recommendations:

• Infants who are breast-fed or partially breast-fed receive 400 IU a day of vitamin D in supplements, beginning in the first few days of life, continuing unless the infant starts taking at least one quart a day of vitamin D-fortified formula or whole milk, although whole milk should not be introduced until the child has turned 1.
  
  
• Non-breast-fed children and older children should also receive a vitamin D supplement of 400 IU per day.
  
  
• Adolescents who do not obtain 400 IU of vitamin D per day through foods should receive a supplement containing that amount.
  
  
• Children at increased risk of vitamin D deficiency (for example, those taking anti-seizure medications) may need higher doses, but this should only be done in consultation with a health-care professional.

The new recommendations were expected to be published in the November issue of the Journal Pediatrics.

October 13, 2008

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