What is the name of a pediatric vitamin D3 (cholecalciferol) supplement appropriate for a 6‑year‑old child with a serum 25‑hydroxyvitamin D level of 28 ng/mL?

Vitamin D3 Supplement Name

The generic name is cholecalciferol, which is vitamin D3. For a 6-year-old child with a serum 25-hydroxyvitamin D level of 28 ng/mL (which represents insufficiency, not deficiency), the appropriate supplement is cholecalciferol in a pediatric-appropriate formulation 1.

Recommended Dosing for This Clinical Scenario

For children over 12 months of age, the recommended daily intake is at least 600 IU (15 mcg) of vitamin D3 to maintain adequate levels 2. Given that this child has a level of 28 ng/mL (just below the 30 ng/mL threshold for sufficiency), standard supplementation rather than treatment dosing is appropriate.

Key Considerations:

• The child's current level (28 ng/mL) is in the insufficient range (defined as 12-20 ng/mL by some guidelines, though this child is just above 20 ng/mL) 3
• Standard maintenance dosing of 600 IU daily is recommended for children over 12 months to meet nutritional requirements 2
• Higher doses (1500 IU daily) have been shown effective in northern latitudes for achieving optimal levels above 30 ng/mL 4

Available Formulations

Cholecalciferol comes in multiple formulations:

• Daily low-dose preparations: 400-1000 IU tablets, drops, or gummies suitable for children
• High-dose preparations: 50,000 IU capsules (containing 1.25 mg cholecalciferol) are available but not recommended for children 1

The 50,000 IU formulation explicitly states "Not recommended for children" on its FDA label 1. This high-potency preparation is designed for weekly dosing in adults with severe deficiency, not for pediatric maintenance supplementation.

Practical Approach

For this 6-year-old with borderline insufficient vitamin D:

• Start with 600-1000 IU daily of pediatric cholecalciferol (vitamin D3)
• Consider 1500 IU daily if in northern latitudes or during winter months 4
• Recheck 25-hydroxyvitamin D levels after 3 months of supplementation to ensure adequacy
• Routine screening is not recommended in healthy children, but this child has a documented level requiring correction 2

Important Caveats:

• Non-white children may require higher doses to achieve optimal levels 4
• Adolescents may need higher or more prolonged supplementation compared to younger children 4
• Vitamin D toxicity is defined as 25(OH)D >100 ng/mL with hypercalcemia, which is extremely unlikely with standard dosing 2, 3
• Always administer with food to enhance absorption 1