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