What is the target level of vitamin D (Vitamin D) in children?

From the Guidelines

The target level of vitamin D in children should be above 50 nmol/L, with a daily intake of 400 IU for infants under 12 months and 600 IU for children 1-18 years of age. According to the ESPGHAN Committee on Nutrition 1, a serum 25(OH) vitamin D concentration > 50 nmol/L indicates sufficiency. This is essential for calcium absorption and bone development in growing children, with deficiency potentially leading to rickets, poor bone mineralization, and impaired immune function.

Key Points

• The daily vitamin D intake recommendation is 400 IU for infants under 12 months and 600 IU for children 1-18 years of age 1
• Children at risk for deficiency may require higher supplementation, typically under medical supervision
• Blood testing (25-hydroxyvitamin D) can determine a child's vitamin D status, and supplementation should be adjusted accordingly
• Natural sources of vitamin D include sunlight exposure, fortified milk, fatty fish, and egg yolks
• Parents should consult healthcare providers before starting supplements, especially at higher doses, as excessive vitamin D can cause hypercalcemia and other adverse effects

Considerations

• The optimum vitamin D requirements of preterm infants on parenteral nutrition are not known, but current recommendations vary to a great extent 1
• Prolonged daily intake up to 10,000 IU or up to serum concentrations of 25(OH)D of 240 nmol/L appears to be safe, while serum concentrations >375 nmol/L are associated with acute hypercalcaemia and hyperphosphataemia 1

From the Research

Vitamin D Target Level in Children

The target level of vitamin D in children is a crucial aspect of their overall health, with various studies suggesting optimal levels for maintaining strong bones and preventing diseases.

• The American Academy of Pediatrics recommends a daily intake of 400 IU (10 µg) of vitamin D for all infants, children, and adolescents 2.
• Vitamin D levels are categorized as deficiency (< 12 ng/ml), insufficiency (12-20 ng/ml), and sufficiency (> 20 ng/ml) 3.
• A circulating level of 25-hydroxyvitamin D of > 75 nmol/L, or 30 ng/mL, is required to maximize vitamin D's beneficial effects for health 4.
• Serum 25(OH)D levels should be maintained above 20 ng/mL to obtain optimal health benefits 5.

Factors Affecting Vitamin D Levels

Several factors can affect vitamin D levels in children, including:

• Season (winter), insufficient time spent outdoors, ethnicity (non-white), older age, more advanced stage of puberty, obesity, low milk consumption, and low socioeconomic status 2, 3.
• Adolescent girls are at a higher risk of vitamin D deficiency 3.
• Living in the north of the 40th parallel is also a risk factor for vitamin D deficiency 3.

Recommendations

• Prophylactic vitamin D supplementation and adequate sunlight exposure should be provided for all children, particularly healthy adolescents 3.
• The World Health Organization recommends lifelong, regular vitamin D prophylaxis 3.
• Medical advice for vitamin D supplementation should be individualized accordingly 6.