From Our 2010 Archives
Too Many Infants Short on Vitamin D
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In 2008, the American Academy of Pediatrics raised the recommended daily requirement of vitamin D for infants from 200 International Units (IU) a day to 400 IU, the researchers noted. However, too few infants are getting these new levels.
"Vitamin D receptors are present in almost every type of cell in the body," said lead researcher Cria G. Perrine, from the U.S. Centers for Disease Control and Prevention Epidemic Intelligence Service in the Office of Workforce and Career Development, and Division of Nutrition, Physical Activity, and Obesity.
Vitamin D is also essential for bone development, Perrine said. Although there is no national estimate, many kids are still getting rickets, which is a softening of the bones that can lead to fractures and deformities.
"Most infants, starting at birth, will need a vitamin D supplement," Perrine said.
To make sure your baby is getting enough vitamin D, Perrine said there are vitamin D drops and liquid multivitamins for infants. "Pretty much all the drops are single doses for 400 IUs," the researcher noted.
The report is published in the March 22 online edition of Pediatrics.
For the study, Perrine's team collected data on infants included in the Infant Feeding Practices Study II, which was done from 2005 to 2007. Using these data, the researchers estimated how many infants were getting the recommended levels of vitamin D. They estimated these levels for babies from 1 month to 10.5 months.
The researchers found that among infants who were exclusively breast-fed, only 5 percent to 13 percent, depending on age, were getting enough vitamin D. For infants who were breast-fed but also got formula, 28 percent to 35 percent were getting 200 IUs of vitamin D a day, but only 9 percent to 14 percent were getting 400 IUs a day.
For infants fed exclusively with formula, 81 percent to 98 percent were getting 200 IUs a day, but only 20 percent to 37 percent were getting the recommended 400 IUs.
"In the past, it was assumed that children receiving formula didn't need a vitamin D supplement, because they were getting it from the formula," Perrine said.
Although they were getting enough formula to meet the 200 IU recommendation, most formula-fed infants won't get enough vitamin D to meet the 400 IU recommendation, Perrine noted.
In addition, the investigators found that only 1 percent to 13 percent of infants were being given a vitamin D supplement.
"Most infants need a vitamin D supplement, and we are not only talking about only breast-fed children," Perrine said.
Samantha Heller, a dietitian, nutritionist and exercise physiologist, said that "low levels of vitamin D may not seem like a big deal but we are finding out it is. Research is suggesting that low vitamin D levels are linked to autoimmune diseases such as multiple sclerosis, psoriasis, as well as cardiovascular disease, hypertension, osteoporosis, mood dysregulation, muscle problems, certain cancers and more."
Heller added: "Sun exposure is one of the best ways to get vitamin D since it is not found in many foods. However, for people living in northern latitudes the sun is not strong enough to generate vitamin D production many months of the year. In addition, we encourage people to use sunscreen to protect against skin cancers, which also minimizes skin's ability to produce vitamin D."
Supplements are the next best option, Heller said. "Experts now recommend a minimum of 800 to 1,000 IU per day for adults and children year round. In July 2008, the American Academy of Pediatrics recommended that infants who are exclusively or partially breast-fed receive 400 IU of supplemental vitamin D daily, beginning in the first few days of life," she said.
"This study suggests that parents are unaware of the need for vitamin D supplementation in infants and other studies show the same for older children. Health professionals need to get the word out to the public that infants, children, adolescents and adults need to get appropriate amounts of vitamin D all year," she added.
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SOURCES: Cria G. Perrine, Ph.D., Epidemic Intelligence Service, Office of Workforce and Career Development, and Division of Nutrition, Physical Activity, and Obesity, U.S. Centers for Disease Control and Prevention, Atlanta; Samantha Heller, M.S., R.D., dietitian, nutritionist and exercise physiologist, Fairfield, Conn.; March 22, 2010, Pediatrics, online