Saturday, January 31, 2009

Vitamin D: Recommendations for Children


In 2008, the American Academy of Pediatrics (AAP) recommended that vitamin D be increased from 200 IU to 400 IU per day for children. Vitamin D is required for calcium absorption and promoting bone mineralization. Vitamin D deficiency in children can cause rickets, a disease that affects the developing bones of children. According to the AAP, children 1 year of age and older should consume vitamin D from vitamin D-fortified milk and other fortified foods and take a supplement if needed, under guidance by a pediatrician.

Milk is one of the most important sources of vitamin D (and calcium) in pre- and school aged- children. If your child consumes three 8-ounce glasses of low-fat vitamin D-fortified milk a day, they will get 75% of their daily value (DV) for vitamin D. However as many parents know, it is difficult to get a child to consume one glass of milk, let alone three!

A couple of years ago my son stopped drinking milk (once I took away his sippy cup) and I was faced with the reality that I was a parent (with degrees in nutrition) whose son did not drink milk ! I hadn't expected this dilemma because my son loved his milk (but obviously it was the sippy cup he loved more). So I broke my first preconceived nutrition notion which was "no chocolate milk allowed" and proceeded to give him low-fat chocolate flavored milk a couple of times a week. It contains more calories and twice the amount of sugar as white low-fat milk (even now the makes me cringe!) but it also contains the same amount of vitamin D. The way I view this is as follows: imagine your child is learning to drive, you let them practice in your new car but you purchase an old car for them, different vehicle but it gets them from point A to point B. Thats how I see chocolate milk - as a different vehicle, not ideal, but hopefully they'll upgrade soon !! I kept offering my son white milk and eventually he did try it again and I soon weaned him off the chocolate milk (once its not in the fridge the battle stops!). As a nutritionist I encourage you to give your children low fat white milk, but as a parent I know sometimes this is an impossible battle, and we have to approach the battle field from a different angle!

With respect to supplements, I think giving your child a multivitamin supplement that contains 200 IU of vitamin D, particularly in the winter months, is a good idea. My advice is aim to get at least half your childs vitamin D requirements (i.e. 200 IU) from dietary sources - milk, fortified orange juice, breakfast cereals and fish, and the other half from supplements. Alternatively, try your ancestors remedy - a teaspoon of cod liver oil ! This contains 400 IU of vitamin D. Perhaps the new flavors of cod liver oil disguise the taste - let me know how you get on with that one!

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