Vitamin D and Your Child

Vitamin D is an important nutrient that works with calcium to help build bones and keep them strong. Vitamin D also plays a role in preventing health problems like heart disease, diabetes, osteoporosis, and thinning bones.

Our bodies naturally produce vitamin D when we’re outside in the sun. So, many kids get enough vitamin D naturally from being outdoors during daily activities, such as walking, biking, or playing sports.

But sometimes the body doesn’t make enough vitamin D. While sunscreen helps protect kids from the sun’s harmful rays, it also blocks some of the sun the body uses to make vitamin D. And it can be hard to get enough of this nutrient from our diets because few foods contain it naturally.

Luckily, many foods are fortified (have vitamin D added), and supplements are available for kids who still need more vitamin D.

Learn how much vitamin D your child needs, and how to get it.

Who’s at Risk for Vitamin D Deficiency?

Things like a lack of direct sunlight and insufficient vitamin D in the diet put these groups at risk for vitamin D deficiency:

• People living where exposure to sunshine is limited. Because of limited skin exposure to sunlight from November to February, kids who live in northern areas like New England and the Pacific Northwest may not get enough sun to meet their vitamin D needs.
• People with dark skin. Because the pigment, or melanin, in darker skin blocks the sun, vitamin D is not effectively produced. When a kid with darker skin is in the sun for the same amount of time as a kid with lighter skin, the one with darker skin makes less vitamin D. This puts kids with African, Latino, Asian, and Middle Eastern backgrounds at risk.
• Babies who are only breastfed. Breastfeeding is wonderful for babies. But one thing that breast milk does not have enough of is vitamin D. Babies who are mostly drinking breast milk should be given a vitamin D supplement.
• People with certain health conditions. Some health conditions, like cystic fibrosis and inflammatory bowel disease (IBD), affect how well the body absorbs nutrients, including vitamin D. Also, studies have shown that obesity increases a person’s risk for vitamin D deficiency.

How Much Do Kids Need?

The Institute of Medicine (IOM) recommends that in the first year of life, babies get at least 400 IU (international units) of vitamin D per day. Kids older than 1 year and teens should get at least 600 IU of vitamin D each day.

For Babies

Babies who are exclusively breastfed (and some who are breastfed but also receive formula) may need supplements to get the recommended amount of vitamin D. Look for vitamin D-only liquid supplements that supply 400 IU. Follow your doctor’s instructions to make sure your child gets the right amount.

Formulas sold in the United States have at least 400 IU per liter, so most formula-fed babies will get the required amount. If your baby gets less than 1 liter of formula a day, use a vitamin D supplement to make up the difference. Talk to your doctor about how much your baby needs.

As babies are weaned off of breast milk, it’s important that they get enough vitamin D-fortified formula (or, if they’re older than 1 year, milk) to reach the recommended daily 400 or 600 IU.

For Kids & Teens

Many kids and teens don’t get the recommended 600 IU of vitamin D each day. Most commonly, vitamin D deficiency affects kids with darker skin and those who live in northern regions with limited sunlight.

Vitamin D-fortified milk can help — 1 quart, or 32 ounces, has about 400 to 460 IU. But most kids and teens drink much less milk than that each day. In that case, they should take a daily multivitamin or vitamin D-only supplement with 600 IU of vitamin D.

Teens might not think that they need that much vitamin D if they’re done growing. But they still need it just as much as younger kids. And it’s especially important for them to maintain a healthy weight, since being overweight seems to keep vitamin D from working properly.

Some kids and teens might need even more than 600 IU, especially if they live in areas with limited sun exposure, have a chronic disease, or have darker skin. Check with your doctor about higher doses.

Getting Vitamin D From Food

Vitamin D can be found in foods, but doesn’t occur naturally in many. The best natural sources are fatty fishes and fish oils. Excellent sources that provide lots of vitamin D include:

• cod liver oil, 1 tablespoon: 1,360 IU
• cooked fatty fishes (trout, swordfish, salmon), 3 ounces: 450-650 IU
• portobello mushrooms, per mushroom: 375 IU

The amount of vitamin D in other foods drops off after those. But the foods below can help make up the difference. Keep them in mind when planning meals and packing lunches:

• tuna packed in water, 3 ounces: 154 IU
• vitamin D-fortified milk, including skim and reduced-fat, 1 cup: 115-124 IU
• vitamin D-fortified orange juice, 1 cup: 137 IU
• vitamin D-fortified yogurt, 6 ounces: 80 IU
• vitamin D-fortified margarine, 1 tablespoon: 60 IU
• vitamin D-fortified cereal, ¾ to 1 cup: 40 IU
• 1 egg (vitamin D is in the yolk): 41 IU
• products made from vitamin D-fortified milk (amount varies)
• vitamin D-fortified fruit juices and drinks (amount varies)

What About Too Much Vitamin D?

Too much vitamin D in the body can be toxic and raise blood calcium levels, which can lead to kidney stones and heart rhythm problems, among other problems. Signs of too much vitamin D include:

• vomiting
• poor appetite
• constipation
• weakness
• weight loss

Talk to your doctor or a dietician about how much vitamin D your child needs. And remember, as kids grow, their diets change. Check with your doctor regularly to make sure your child is getting enough of what’s needed to grow and maintain strong bones.