Double the dose of Vitamin D to give infants, children and adolescents strong bones and immune systems.

That's the recent recommendation of the country’s leading pediatrics organization.

The American Academy of Pediatrics now recommends that children of all ages receive 400 IU (international units) of vitamin D each day to improve immunity and prevent bone-weakening illnesses such as rickets.  This new standard may be sending many parents to the pharmacy for supplements.

Vitamin D is a relatively difficult vitamin to obtain naturally. Unlike most vitamins, vitamin D comes from sun exposure, as well as a limited number of foods, such as fatty fish, fish oils and eggs from chickens fed vitamin D. 

Children often don’t like the food items that are natural sources of vitamin D.  Luckily, milk, soymilk, rice milk and some cereals and orange juices are fortified with vitamin D. 

Traditionally, the main source of vitamin D has been sun exposure. But the time needed to absorb the necessary dose from the sun would vary widely. People with darker skin will capture less of the UV-B rays needed to make vitamin D compared to those with lighter skin. Weight, location, season, cloud cover, smog, apparel and sun screen usage all make a difference in the amount of vitamin D a person can soak up.  

Dr. Jennifer Bryan, of Glenbrook Pediatrics in Glenview, doesn’t recommend sun exposure as a primary source of vitamin D because of the risk of skin cancer, however. “There is no definite safe amount of sun that we know of,” said Bryan.
    
Excess sun exposure is also discouraged by the Centers for Disease Control and Prevention and the American Cancer Society.

This new vitamin D recommendation is an update from the 2003 recommended level that called for infants (beginning at 2 months after birth), children and adolescents to receive 200 IU of the vitamin each day. 

In order to receive the recommended 400 IU of vitamin D a day, a child would have to drink four 8-ounce ounce cups of milk - a whole quart - every day. 

“Most children are probably not getting enough in their diet,” said Bryan about the amount of vitamin D needed.

Many children will need to take supplements in order to receive the 400 IUs recommended, including infants who are breast-fed.  Although many pediatricians and leading health organizations recommend breast-feeding until the age of one, babies won't receive the amount of vitamin D needed from their mother’s milk. 

Bryan urges the parents of breast-fed infants to give their babies vitamin D supplements.  Children who do not receive supplemental vitamin D have a higher risk of developing rickets, according to the pediatrics academy, based in Elk Grove Village. 

Rickets is a softening or weakening of the bones caused by a vitamin D deficiency. Vitamin D can prevent as well as treat rickets.  Rickets occurs most often in children between 3 and 18 months of age and is more likely in breast-fed infants who are not receiving 400 IU of vitamin D a day, according to the American Academy of Pediatrics. 

All infant formulas sold in the United States are fortified with the newly recommended dose of vitamin D if an infant consumes about a quart of formula a day. 

Many physicians and medical organizations maintain that vitamin D plays a role in maintaining general immunity and preventing diseases.