The American Academy of Pediatrics recommends vitamin D supplementation for all babies

All infants, particularly those who are breastfed, should be given vitamin D to help prevent rickets, a potentially crippling condition in which the bones fail to grow straight and strong, the American Academy of Pediatrics (AAP) announced Monday.

NEW YORK (Reuters Health / April 7, 2003) -- While breast milk is the best nutrition for babies, it may not contain enough vitamin D to meet babies' needs, particularly when youngsters are protected from sunlight, a natural source of the vitamin.

All infant formula sold in the U.S. contains added vitamin D, but if a baby drinks less than 500 milliliters (17 ounces) of formula each day they should also receive supplements, according to the AAP.

Vitamin D supplements are also recommended in children and teens who do not drink at least 500 milliliters each day of milk fortified with vitamin D, according to the guidelines published in Monday's issue of the journal Pediatrics.

Supplements of vitamin D come in liquid form, and just a few drops in the baby's mouth before nursing will give a child all the vitamin D he or she needs, Dr. Lawrence M. Gartner of the AAP and the University of Chicago told Reuters Health. Supplementation should begin within the first two months of life, and achieve an intake of 200 International Units (IU) of vitamin D per day.

Gartner added that certain shifts in society have likely contributed to this apparent paradox, in which the milk that nature produces specifically for babies does not provide them with enough of a needed vitamin.

Sunlight is a major source of vitamin D, he noted, and early humans likely had skin that was better suited to their environment, which enabled them to spend enough time in the sunlight to make lots of vitamin D without worrying about skin cancer.

Today, however, the picture is quite different, Gartner said.

Nowadays, he explained, humans have moved all over the world, often to places where their skin no longer matches their environment.

Furthermore, the depletion of the ozone has forced humans to use sunscreen to protect themselves from sunlight's ultraviolet rays, Gartner said, and sunscreen also prevents the skin from using sunlight to make vitamin D.

Vitamin D supplementation for infants "is a fairly simple, and quite safe, adaptation," Gartner noted.

"Just give the babies a little bit of vitamin D, and they won't get rickets," he added.

Breastfeeding, although imperfect, is still best for babies, Gartner noted. Numerous studies have linked nursing to a host of health benefits, such as higher IQ and a lower risk of sudden infant death syndrome, diabetes and chronic digestive diseases.

"We want to encourage breastfeeding, not discourage it," he said.

He explained that he and his colleagues decided to issue recommendations about vitamin D supplements after hearing reports of rickets among breastfeeding infants.

Those cases occurred more frequently in African-American children because melanin, the pigment that darkens skin, may act as a natural sunscreen. Infants who are both dark-skinned and breastfed are at greater risk of developing vitamin D deficiency than other babies.

Asking mothers to take extra vitamin D will not solve the problem, Gartner noted, for the amount needed to satisfy nursing infants is "close to the toxic level" in mothers.

"Yes, it can be done, but it's not really recommended," Gartner said.

Rickets, a condition in which a deficiency in vitamin D leads to abnormal bone formation, can result in bow legs, knock knees and spinal curvature.