A new Canadian study recommends giving vitamin D supplementation to children who are still nursing after their first birthday, in an effort to prevent health problems.
This is important for exclusively breastfed infants who are not supplemented with vitamin D because they are at increased risk for developing rickets due to the limited transfer of vitamin D in breast milk.
The American Academy of Pediatrics recommends “any breastfeeding infant, regardless of whether he or she is being supplemented with formula, should be supplemented with 400 IU of vitamin D.” The Committee on Nutrition of the French Society of Pediatrics also suggests continuous vitamin D supplementation beyond the first year of life, irrespective of breastfeeding status, and the Canadian Pediatric Society recommends, “400 IU/day for all infants during the first year.”
There is no important downside to supplementation, as long as it is limited to the recommended doses of vitamin D. Mothers may also be able to enrich their milk with adequate vitamin D for an infant if they take high enough doses themselves.
Vitamin D promotes the absorption of calcium and phosphorus from the gastrointestinal tract. A deficiency of vitamin D makes it difficult to maintain proper calcium and phosphorus levels in bones, which can cause rickets. Children 3 to 36 months old are most at risk for rickets because their skeletons are growing so rapidly.
Researchers in the Canadian study found children who were nursed up to 36 months and did not take supplements were more likely to develop vitamin D deficiency even though they had started eating solid foods.
“Sometimes vitamin D levels are low or insufficient but not in the extremely low range that can cause rickets,” cautions Mayo Clinic pediatrician Dr. Phil Fischer, who is not part of the research. “This new study shows vitamin D levels are higher in supplemented children after the first year of life, but it is not clear there is any clinical significance to these variations in vitamin D level.”
Fischer recommends seeking input about vitamin D supplementation from a health care provider, noting too much of the vitamin is also bad. “We occasionally see children who are very sick due to over-supplementation with vitamin D, so parents giving supplements must be very careful to give the appropriate amount.”
Note to pregnant women: higher intake of foods containing vitamin D during pregnancy – but not supplemental vitamin D intake – has been associated with reduced risk of development of allergies in children, according to a recent study led by an investigator from the Icahn School of Medicine at Mount Sinai. Foods that contain vitamin D include fish, eggs, dairy products, mushrooms and cereals.
