Vitamin D, the Sunlight Vitamin
It is common knowledge that Vitamin D and calcium promote strong bones, but new evidence reveals additional
benefits, such as boosting the immune system, preventing childhood diabetes, multiple sclerosis, rheumatoid
arthritis, cancers, diabetes, high cholesterol and infections.
Vitamin D deficiency causes RICKETS, a disease resulting in soft, deformed and easily fractured bones. Due to
recent cases of rickets, the American Academy of Pediatrics revised the recommendations for Vitamin D
supplementation. Breastfed infants with dark skin and very little sun exposure are at greatest risk. Most of us do
not get enough exposure to the sun, the natural source of vitamin D. This handout will explain how children of all
ages can get enough vitamin D intake from food and vitamins.
Who needs vitamin D supplements?
o Give vitamin D to breastfed infants (even if Mom takes vitamin D herself and even if they get some formula)
Give 1mL per day (400 IU) Enfamil D-Vi-Sol (sold over the counter at most drug stores)
Start giving it at around 1 month of age when breastfeeding is well established.
Stop giving it if baby drinks 32oz/day of formula (under 1 year old) or cow’s milk.
o Give vitamin D to non-breastfed infants, children, teens and adults drinking less than 32oz/day of vitamin
D–fortified milk or formula. If vitamin D fortified foods are eaten daily, give less vitamin D supplement.
o Give vitamin D to people at increased risk of vitamin D deficiency, such as those with chronic fat malabsorption
(cystic fibrosis and those taking anti-seizure medications.
Food Sources of Vitamin D
Office of Dietary Supplements National Institutes of Health, 12/08
Food
IUs1/serving
Cod liver oil, 1 tablespoon 1,360
Salmon, cooked, 3.5 ounces 360
Mackerel, cooked, 3.5 ounces 345
Tuna fish, canned in oil, 3 ounces 200
Sardines, 1.75 ounces (canned in oil, drained) 250
Some orange juices and yogurt --Milk, vitamin D-fortified, 1 cup (nonfat, low fat, and whole) 98
Margarine, fortified, 1 tablespoon 60
Ready-to-eat cereal, 0.75-1 cup
40
(fortified with 10% of the DV2 for vit D
Egg yolk, 1 whole 20
Liver, beef, cooked, 3.5 ounces 15
Cheese, Swiss, 1 ounce 12
1. IUs = International Units
2. DV = Daily Value
Vitamin D fortification in foods:
o A milk fortification program virtually eliminated rickets in
the USA in the 1930s.
o In today’s American diet, fortified foods provide most
of our vitamin D.
o Almost all of the U.S. milk supply is fortified with
100 IU vitamin D per 8 oz.
o U.S. laws dictate how much vitamin D can be added to foods
and also which foods can be fortified.
How much sun exposure is necessary to get enough vitamin D?
The amount of sun exposure needed to get adequate vitamin D depends on skin pigmentation, body mass, distance
from the equator, season, cloud cover, air pollution, amount of skin exposed, and sunscreen use. Light skinned
adults need full-body exposure for 10-15 minutes during the summer (dark skin requires 5-10 times more) to get
about 10-20,000 IU of vitamin D within 24 hours. The average American adult spends 93% of their time indoors
and it is apparent that kids and adolescents spend more time indoors than ever before. It is difficult to determine
how much sun exposure is adequate, and the risk of skin cancer prompts us to minimize sun exposure even more.
Research has shown that as little as 5-10 minutes of sun exposure on arms and legs, or face and arms, 3 times
weekly between 11am and 2pm during the spring, summer, and fall at 42 degrees latitude (Lincoln, Nebraska) should
provide a light-skinned person with adequate vitamin D and allow for storage of excess for use during the winter,
with minimal risk of skin damage. Holick MF. Vitamin D deficiency: what a pain it is. Mayo Clin Proc. 2003;78(12):1457-1459
Infant and Children’s Vitamins
Healthy breastfed infants get all the vitamins they need via breastmilk, except for vitamin D, which is provided as
Enfamil D-Vi-Sol 1mL daily (400 IUA) as described previously. Healthy children who eat foods from all food groups
which contain a variety of vitamins and minerals generally do not require additional vitamins in pill form. For those
who do need vitamins, there are a variety of them available in chewable and liquid forms, most of which contain
400 IU vitamin D per dose. Common preparations contain vitamins A,D,C (“Tri”-vitamins) and others contain those
plus others (“Poly” or “Multi”–vitamins). Some have added iron (for anemia) and/r added fluoride (requires a
prescription). Ask your doctor if your child needs any such supplements.
LincolnPedsGroup.com
402-489-3834
8/13