What should I say to parents about vitamin D supplementation from infancy to adolescence?
Part A: Evidence-based answer and summary
The apparent re-emergence of nutritional rickets (1) and reported bone (2) and extraskeletal (3) benefits of vitamin D supplementation in adults are leading Canadian physicians to face frequent questions about vitamin D. Therefore, it is instructive to review the evidence base that guides nutritional recommendations regarding vitamin D supplementation from infancy to adolescence.
Part B: Clinical commentary
Which infants should receive vitamin D supplements
and how much should they be given?
Consistent with the evidence (Part A), Health Canada (8)
and the American Academy of Pediatrics (AAP) (9) advise
that breastfed infants receive a daily supplement containing
400 IU of vitamin D3. There is no low-risk group in which
vitamin D supplementation is not recommended, because
rickets has been reported in fair-skinned Canadian infants
(10). Factors such as season of birth, maternal diet or location
of residence should not deter parents from adhering to
Health Canada recommendations. Caregivers should be
reassured of the safety of the recommended vitamin D dose,
regardless of exposure to sunlight. Preterm infants do not
require a different dose of vitamin D (11,12).