Recently, the Academy of Pediatrics has changed its recommendations about the amount of vitamin D to be taken daily for all infants.

It is now recommended all infants, children and adolescents take 400 IU daily. Low levels of vitamin D are associated with rickets, which is a condition of weakened deformed bones.

New information now suggests that vitamin D has a role in immunity and reduces the risk for certain chronic diseases such as cancer and diabetes.

The primary natural source of vitamin D is from cholesterol being changed in the skin with exposure to UVB light (sunshine). Natural sources from the diet are limited.

It is not easy to determine how much exposure to sunshine is needed for a given individual, and too much exposure increases the risk of skin cancer.

Mothers who are vitamin D deficient might expose their unborn babies to a higher risk of vitamin D deficiency. Therefore, the Academy of Pediatrics is recommending the following:

1. Beginning in the first few days of life, breast-fed and partially breast-fed infants should be given 400 IU of vitamin D daily.

This should continue until the infant is taking at least one quart of vitamin D-fortified formula or whole milk. Whole milk should not be given until the infant is at least 1 year old.

Use of reduced-fat milk in children age 12 months to 2 years should be discussed with a health care provider and only with concern about a family history of obesity, dyslipidemia or heart disease.

2. Vitamin D supplementation should be continued for children who are not taking a quart of vitamin D-fortified milk daily. Some cereals are also fortified.

3. The same recommendations are indicated for adolescents. Adolescents should be encouraged to drink four 8-ounce glasses of fortified milk daily.

4. Children who have chronic fat malabsorption and those children taking medication for seizures might be vitamin D deficient despite taking 400 IU daily and might require higher doses.

5. There are recommended blood levels of vitamin D (20-50 ng/mL) which can help determine if you think you or your child might be deficient.

It is important that along with adequate intake of vitamin D, adequate calcium must also be taken to assure the best bone formation.

Too much vitamin D can cause toxicity secondary to increased calcium in the blood and in the urine.

Don’t give more than what is recommended unless your doctor has said it is safe.

Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital, and Keith Bly is an associate professor of pediatrics and director of the UTMB Pediatric Urgent Care Clinics. This column isn’t intended to replace the advice of your child’s physician.

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