Recommended Vitamin D Supplementation Dosages for Pediatric Patients
The American Academy of Pediatrics recommends 400 IU/day of vitamin D for all infants 0-12 months of age, and 600 IU/day for children 1-18 years of age. 1
Standard Dosing Recommendations
The most recent guidelines provide clear dosage recommendations based on age:
- Infants 0-12 months: 400 IU/day
- Children 1-18 years: 600 IU/day 1
These recommendations align with the goal of maintaining serum 25(OH) vitamin D concentrations above 50 nmol/L (20 ng/mL), which is considered adequate for bone health and overall development. 1
Special Considerations for Infant Feeding
- Exclusively or partially breastfed infants: Require supplementation of 400 IU/day
- Formula-fed infants consuming <28 ounces daily: Require supplementation of 400 IU/day
- Formula-fed infants consuming ≥28 ounces daily: Typically receive adequate vitamin D from formula alone 1
Higher Dosage Requirements for Special Populations
Certain pediatric populations may require higher vitamin D doses:
- Children with malabsorption syndromes: May need 1000-2000 IU/day 1
- Preterm infants: May require 200-1000 IU/day or 80-400 IU/kg/day 1
- Children with chronic kidney disease: Require individualized dosing based on their specific condition 1
- Infants with limited sun exposure or darker skin pigmentation: Require careful monitoring due to higher risk of deficiency 1
Safety Considerations and Upper Limits
The tolerable upper intake levels should not be exceeded without medical supervision:
- Infants 0-6 months: 1000 IU/day
- Infants 7-12 months: 1500 IU/day
- Children 1-3 years: 2500 IU/day 1
Monitoring Recommendations
- Healthy term infants: Routine monitoring is not necessary when receiving appropriate supplementation
- High-risk infants or those on long-term supplementation: Periodic monitoring of serum 25(OH) vitamin D concentration is recommended
- Patients with vitamin D deficiency: Monitoring of serum calcium, phosphorus, and parathyroid hormone levels is necessary to assess treatment response 1
Clinical Perspective
While the American Academy of Pediatrics recommends 400-600 IU/day based on age, the US Endocrine Society suggests slightly higher doses: 400-1000 IU/day for infants under 1 year and 600-1000 IU/day for children 1 year or older. 2, 3 This difference reflects varying goals and interpretations of the evidence, with the Endocrine Society aiming for higher serum levels (>30 ng/mL) compared to the AAP's target (>20 ng/mL). 2
Daily administration is preferred over intermittent dosing for maintaining consistent vitamin D levels. 1