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Vitamin D for Children

HIGHLIGHTS:

Vitamin D (Calciferol) is a fat-soluble vitamin of which there are two types:

  • Vitamin D2 (ergocalciferol), which the body receives in very small quantities by eating plant-based foods, mushrooms, and yeast.
  • Vitamin D3 (cholecalciferol), which the body receives in large quantities from 2 different sources. Firstly, eating meat, liver, egg yolks, oily fish (salmon, mackerel, and tuna), fish liver oils, milk and milk-based products. Several food sources of vitamin D are listed in Table 1 below.

Secondly, Vitamin D3 is produced by the body itself. This can be achieved by going out in the sun for 15 minutes, 2-4 times per week, such as in the morning from 6 to 8 am and in the afternoon from 4 to 6 am. The UV rays in sunlight can help the body to convert cholesterol to vitamin D.

The benefits of Vitamin D

  • Helps the body absorb calcium and phosphorus, which are essential to strengthen bones and teeth
  • Helps treat conjunctivitis
  • Helps absorb Vitamin A
  • Indirectly, Vitamin D plays an important part in the functioning of the nervous system, maintaining heart rhythm, and strengthening the immune system

Conditions caused by Vitamin D deficiency

  • Rickets
  • Severe tooth decay
  • Muscle weakness

Children who are at risk of Vitamin D deficiency include those who are rarely exposed to sunlight or who wear sunscreen, infants, children who do not eat much food containing Vitamin D, and children who are overweight.

Recommended amount of vitamin D for children of different ages:

  • Breastfed babies should receive a vitamin D supplement of 200-400 IU a day as breast milk usually contains 25 IU per liter; therefore, breastfed babies should receive vitamin D drops or multivitamins with vitamin D. For more information, please consult your child’s doctor.
  • Formula-fed babies drinking 1 liter of milk containing vitamin D (400 IU per liter) daily usually get sufficient vitamin D. However, babies drinking less than 1 liter of formula milk daily should receive a vitamin D supplement of 200-400 IU a day.
  • Older children drinking less than 1 liter of milk containing vitamin D or standard formula milk daily should also consume foods high in vitamin D or multivitamins with vitamin D of at least 400 IU a day.

Consuming over 2,000 IU per day may lead to excess vitamin D in children. Symptoms indicative of this excess include urinating frequently, being abnormally thirsty, severe dehydration, conjunctivitis, itchiness, stomachaches, vomiting, and constipation. The condition can also result in calcium deposits accumulating on blood vessel walls, the heart, lungs, liver, and stomach, and can cause kidney stones.

All children should receive the right amounts of Vitamin D to ensure their optimum strength and growth.

Food

Breast milk vitamin D3 ~ 25 IU/ litre
Cod liver oil vitamin D3 ~ 400–1,000 IU/tea spoon
Salmon vitamin D3 ~ 300–600 IU/100 grams
Sardines vitamin D3 ~ 300 IU/100 grams
Mackerel vitamin D3 ~ 250 IU/100 grams
Tuna vitamin D3 ~ 236 IU/100 grams
Fresh shiitake vitamin D2 ~ 100 IU/100 grams
Dried shiitake vitamin D2 ~ 1,600 IU/100 grams
Egg yolk vitamin D3 or D2 ~ 20 IU/egg

Sun exposure for 15 minutes

On legs and arms vitamin D3 ~ 3,000 IU
Milk, fortified with vitamin D vitamin D3   100 IU/8 ounce
Yogurt, fortified with vitamin D vitamin D3   100 IU/8 ounce
Butter, fortified with vitamin D vitamin D3   56 IU/8 ounce
Margarine, fortified with vitamin D vitamin D3   429 IU/8 ounce
Cheese, fortified with vitamin D vitamin D3   100 IU/8 ounce

Medicine

Ergocalciferol vitamin D2 50,000 IU/capsule
Drisdol liquid vitamin D2 8,000 IU/cc.

Dietary supplements

Multivitamin vitamin D3 or vitamin D2 400, 500 and 1,000 IU
Vitamin D3 400, 800, 1,000, 2,000, 5,000, 10,000 and 50,000 IU

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Reference

  1. Heike A. Bischoff-Ferrari Catherine M. Gordon David A. Hanley Robert P. Heaney M. Hassan Murad Connie M. Weaver Evaluation, Treatment, and Prevention of Vitamin D Deficiency: an Endocrine Society Clinical Practice Guideline. The Journal of Clinical Endocrinology & Metabolism, Volume 96, Issue 7, 1 July 2011, Pages 1911–1930
  2. U.S. Department of Health & Human Services: Vitamin D-Fact Sheet for Health Professionals. Accessed from: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Accessed September 1, 2017.

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Rapeepun Chai-udom, M.D. Summary: Pediatrics Pediatric Endocrinology And Metabolism