From the Guidelines
All infants should receive 400 IU (10 micrograms) of vitamin D supplementation daily, beginning within the first few days of life, as recommended by the American Academy of Pediatrics 1. This applies to both breastfed and formula-fed babies, though formula-fed infants who consume at least 32 ounces (1 liter) of formula daily may not need supplementation since formula is already fortified with vitamin D. The supplement should be given in liquid drop form, which is available over-the-counter as vitamin D3 (cholecalciferol). Parents should continue this supplementation until the child is consuming adequate vitamin D through diet, typically around 12 months of age. Vitamin D is essential for calcium absorption and bone development in growing infants, and deficiency can lead to rickets, a condition causing soft, weak bones. Natural vitamin D production through sun exposure is not recommended for infants due to skin cancer risks, making supplementation particularly important, especially for breastfed babies since breast milk alone contains insufficient vitamin D levels. According to the most recent guidelines, the recommended dose of vitamin D for infants is 400 IU/day, which is supported by studies such as 1 and 1. It's worth noting that some studies suggest that preterm infants may require a higher dose of vitamin D, up to 1000 IU/day 1, but for term infants, 400 IU/day is the recommended dose. Overall, vitamin D supplementation is crucial for infants to prevent deficiency and promote healthy bone development, and parents should consult with their pediatrician to determine the best course of supplementation for their child.
From the Research
Recommended Vitamin D Supplementation for Infants
The American Academy of Pediatrics recommends a supplement of 200 IU per day of vitamin D to all breastfed and nonbreastfed infants unless they consume at least 500 ml per day of vitamin-D-fortified formula or milk 2. However, more recent studies suggest that a daily dose of 400 international units of vitamin D in infants is effective for improving bone health and preventing rickets 3, 4.
Benefits of Vitamin D Supplementation
Vitamin D supplementation is well tolerated and not associated with toxicity 4. It may also reduce the risk of certain infections and chronic diseases 3. Additionally, adequate levels of vitamin D might not be achieved with lower daily doses, and higher doses have not shown to add benefit while potentially causing toxic blood levels and hypercalcemia 4.
Guidelines for Vitamin D Supplementation
Universal vitamin D supplementation starting shortly after birth, regardless of the mode of feeding, and until 12 months of age is strongly recommended 4. Beyond 12 months of age, vitamin D supplementation is recommended only in groups of children at risk 4. The Endocrine Society recommends that pregnant women who are unable to obtain an adequate amount of vitamin D from sunlight exposure and natural and fortified diets should take a vitamin D supplement of 1500-2000 IUs daily 5.
Key Points to Consider
- The American Academy of Pediatrics recommends 200 IU per day of vitamin D for infants 2
- A daily dose of 400 IU of vitamin D is effective for improving bone health and preventing rickets 3, 4
- Vitamin D supplementation is well tolerated and not associated with toxicity 4
- Universal vitamin D supplementation is recommended until 12 months of age 4
- Pregnant women may need to take a vitamin D supplement of 1500-2000 IUs daily 5