Watching for Vitamin D Deficiency in Children

7 of 12 in Series: The Essentials of Vitamin D Basics and Dosage

Adequate levels of vitamin D are essential for children before birth, after birth, and throughout childhood to ensure the proper development of bones and teeth. If they get enough vitamin D throughout childhood, they may avoid problems in adulthood, such as osteoporosis.

The recommended optimal level of 25-hydroxyvitamin D in children is the same as in adults — 20 ng/ml (50 nmol/L). The best way to check children for vitamin D deficiency is with a blood test for 25-hydroxyvitamin D.

Risk factors for low vitamin D in children include:

  • If their skin is naturally dark, such as people who are of African, Hispanic, or Southeast Asian descent

  • If their skin is regularly covered, such as due to religious or cultural reasons

  • If they are being breastfed exclusively

  • If they drink milk less than once a week

  • If they are obese

  • If they live a sedentary lifestyle that limits outdoor activities

  • If they live in a place with a long winter

Delivering the proper dose of vitamin D for kids

The Institute of Medicine vitamin D recommendations for kids range from 400 to 600 IU daily. This is consistent with the American Academy of Pediatrics Guidelines for infants, children, and adolescents. That organization suggests that the following groups receive a daily supplement of vitamin D:

  • Breastfed and partially breastfed infants

  • Nonbreastfed infants and older children drinking less than a quart per day of vitamin D-fortified milk

  • Children with an increased risk for vitamin D deficiency, such as those taking certain prescription medications including anticonvulsants that reduce vitamin D activity

  • Adolescents who don’t obtain enough vitamin D daily through food

Many kids have a good vitamin D status because of the sun exposure they get as part of an active lifestyle.

Children who have fat malabsorption, including cystic fibrosis and inflammatory bowel disease patients, should receive their vitamin D by injection subcutaneously or intramuscularly.

Treating children for vitamin D deficiency

Actual treatment of vitamin D deficiency in infants and adolescents requires much higher doses for a period of time. Doctors give patients 2,000 to 4,000 IU daily for three to six months, monitoring their blood 25-hydroxyvitamin D levels regularly to prevent toxicity.

After sufficient vitamin D is given, the abnormalities rapidly reverse. The following improvements occur:

  • The serum 25-hydroxyitamin D level rises to 20 ng/ml (50 nmol/L) or higher.

  • Low serum calcium and phosphorus levels rapidly correct within six to ten days.

  • Parathyroid hormone level, which had risen because of the low serum calcium, falls to normal within one to two months.

  • Healing of rickets occurs in three to six months, depending on the severity of the disease.

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The Essentials of Vitamin D Basics and Dosage

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