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Prevention
By Mayo Clinic staffAlthough most adolescents and adults receive much of their necessary vitamin D from exposure to sunlight, infants and young children need to avoid direct sun entirely or be especially careful by always wearing sunscreen.
Vitamin D supplements
In light of these factors, and because human milk contains only a small amount of vitamin D, the American Academy of Pediatrics (AAP) recommends that all breast-fed infants receive 400 international units (IU) of oral vitamin D daily beginning during the first two months of life and continuing until the daily consumption of vitamin D-fortified formula or milk is two to three glasses, or 500 milliliters (mL). AAP also recommends that all children and adolescents should receive 400 IU a day of vitamin D.
Vitamin D supplements for infants generally come in droplet form. Use only supplements that contain up to 400 IU of vitamin D per mL or tablet. Avoid supplements containing a higher concentration of vitamin D (some forms come in levels of up to 8,000 IU/mL), because they're unsafe for children.
For adults, the Institute of Medicine (IOM) recommends that adults up to age 50 consume 200 IU daily. For people between ages 50 and 70, the IOM recommends 400 IU every day, and people over age 70 are advised to consume 600 IU daily.
Getting enough calcium
Calcium and phosphorus consumption are also important for bone formation in childhood. Breast milk is a good source of calcium, as are most commercially available formulas.
Recommended daily intake of calcium is as follows (serving sizes vary with age):
- 1 to 3 years of age. 500 milligrams (mg) (two servings of dairy products a day)
- 4 to 8 years of age. 800 mg (two to three servings of dairy products a day)
- 9 to 18 years of age. 1,300 mg (four servings of dairy products a day)
- 19 to 50 years of age. 1,000 mg a day (three servings of dairy products a day)
- Older than 50. 1,200 mg a day (nearly four servings of dairy products daily)
Milk and dairy products are common sources of calcium. Other sources of calcium include leafy green vegetables (for example, spinach), fortified orange juices, fortified breakfast cereals and calcium supplements.
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- Holick MF. Vitamin D deficiency. New England Journal of Medicine. 2007;357(3):266-81.
- Rauch F. Etiology and treatment of hypocalcemic rickets in children. http://www.uptodate.com/home/index.html. Accessed Aug. 19, 2008.
- Gilchrest BA. Sun exposure and vitamin D sufficiency. American Journal of Clinical Nutrition. 2008;88(2)(suppl):570S-577S.
- Rauch F. Overview of rickets in children. http://www.uptodate.com/home/index.html. Accessed Aug. 19, 2008.
- Dietary reference intakes: Vitamins. Institute of Medicine. http://www.iom.edu/Object.File/Master/54/411/DRIs.Vitamins.pdf. Accessed Aug. 19, 2008.
- Gartner LM, et al. Prevention of rickets and vitamin D deficiency: New guidelines for Vitamin D intake. American Academy of Pediatrics. http://pediatrics.aappublications.org/cgi/content/full/111/4/908. Accessed Aug. 19, 2008.
- Dietary reference intakes: Elements. Institute of Medicine. http://www.iom.edu/Object.File/Master/54/395/DRIs.Elements.pdf. Accessed Aug. 19, 2008.
- Hoecker JL (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 21, 2008.
