New vitamin D recommendations

The American Academy of Pediatrics (AAP) today announced a doubling of the amount of vitamin D it recommends for infants. The new clinical report, Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents, recommends all children receive 400 international units (IU) a day of vitamin D, beginning in the first few days of life. The previous recommendation, issued in 2003, called for 200 IU per day beginning in the first 2 months of life. According to the chair of the AAP Committee on Nutrition, the dose of the recommended amount of vitamin D children need each day needs to be doubled because evidence has shown this could have life-long health benefits. Supplementation is important because most children do not get enough vitamin D through diet alone.Breastfeeding is the best source of nutrition for infants. However, because of vitamin D deficiencies in the maternal diet, which affect the vitamin D in a mother's milk, it is important that breastfed infants receive supplements of vitamin D.The new recommendation is based on a review of new clinical trials on vitamin D and the historical precedence of safely giving 400 IU per day to the children. Studies show that 400 units of vitamin D a day will not only prevent the bone-softening disease rickets, but treat it. Adequate vitamin D throughout childhood may also reduce the risk of the bone-thinning disease osteoporosis and in adults, new evidence suggests that vitamin D plays a role in the immune system and may help prevent infections, autoimmune diseases, cancer and diabetes. The new AAP recommendations on vitamin D specifically call for all breastfed and partially breastfed infants to be supplemented with 400 IU a day of vitamin D beginning in the first few days of life; all infants who aren't breastfed, as well as older children who consume less than one quart per day of vitamin D-fortified formula or milk, should receive a vitamin D supplement of 400 IU a day; and adolescents who do not obtain 400 IU of vitamin D per day through foods should receive a supplement containing that amount.Children with an increased risk of vitamin D deficiency, such as those taking certain medications, may need higher doses of vitamin D. Given the growing evidence that adequate vitamin D status during pregnancy is important for fetal development, the AAP encourages providers who care for pregnant women to consider measuring vitamin D levels in this population.

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