Vitamin D Supplements for Infants

Do infants require vitamin D supplementation?

Formula fed infants require no vitamins, as all products are fortified with vitamins. Breast fed infants may need vitamin D. According to the Canadian Pediatric society, "breast milk contains adequate amounts of all vitamins except vitamin D, which may need to be supplemented". Sunlight helps the body to use vitamin D and in northern climates, however during the fall and winter months, many infants are not exposed to adequate amounts of ultraviolet light. The consequence of vitamin D deficiency is the development of rickets, which although extremely rare, still occurs from time to time. For this reason many pediatricians recommend vitamin D supplementation for infants who are breast fed. The American Academy of Pediatrics qualifies it's position on vitamin D supplementation by stating that only infants who are unlikely to get adequate ultraviolet exposure need supplementation, rather than all infants. There are other authorities who feel that breast fed infants do not need Vitamin D at all if they get even very limited outside exposure during the fall and winter months. Evidence used to support this argument suggest that even 30 minutes of ultraviolet exposure a week in the summer and 90 minutes a week in winter months is sufficient for most infants. The only reason to use supplementation would be in the unusual situation of a baby who almost never goes outside or is fully covered from head to toe or is born in the fall and lives north of the Arctic circle. In essence physicians need to explain these facts to parents of breast fed infants, while emphasizing that supplementation does not imply that breast milk is "imperfect" because it lacks sufficient vitamin D. Physicians need to acknowledge that vitamin D may be expensive for some families. Given the information outlined above, parents ought to be able to decide whether their child would benefit from vitamin D supplements or not.

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