Jul 19, 10 | Posted by: Michelle Linsmeier, M.D.

Finding the Right Dose of Vitamin D

Vitamin D has become a hot topic over the last year.  More than ever, people are aware of vitamin D deficiency, and its possible consequences.  We now know that vitamin D is important not only for bone health, but also immune and brain function. 

For many years, pediatricians have been recommending vitamin D supplementation for breastfed infants during the first year of life.  Studies have shown that vitamin D levels are low in breast-milk, likely because of poor transfer from mom to breast-milk, and our relative deficiency as adults.   Pediatricians, including myself, have also started to encourage more supplementation in children over 1 year who have limited milk consumption (of any type – breast, cow, goat or soy).  Ultimately, we no longer acquire significant amounts from the sun, due to our indoor lifestyle and the increased (necessary) use of sunscreens. 

With the increased awareness of vitamin D, more preparations are available over the counter.  A new problem – overdosing of vitamin D in infants and small children.  Why? Not all preparations have the same concentration of vitamin D.  In infants and toddlers, we often recommend the brands D-vi-sol and Tri-vi-sol.  They both contain 400 IU (international units) of vitamin D in one dropperful of liquid (1 ml).  However, many health food stores, as well as online suppliers, offer liquid vitamin D in other concentrations (often for teens and adults who can’t swallow pills).  Be careful – some of the liquids have up to 5000 IU (or more) of vitamin D in one ml dropper.  The Institute of Medicine has set the upper limit of safe levels of vitamin D for infants and young children at 1000 IU per day.   Also, some companies sell products for infant vitamin D supplementation that have 100-400 IU of the vitamin in every DROP not dropper (1 ml).  So, in those situations, one full dropper can give up to 150,000 IU of vitamin D.  Scary!  Very high doses of vitamin D can lead to hypercalcemia.  Symptoms of hypercalcemia include poor or decreased appetite, nausea and vomiting.  With prolonged exposure to very high levels of vitamin D, renal (kidney) failure can develop.

So, the take home message: vitamin D supplementation is important for all breastfed and partially breastfed infants as well as older children who don’t consume enough of the milk products.  The recommended dose for that age group is 400 IU per day.  Look for products which supply the dose as 400 IU per 1 ml of liquid – Tri-vi-sol and D-vi-sol are easy products that meet that need over the counter.  If you have questions, talk with your doctor.  And as always, read labels.  It makes a huge difference in the health of your child.

No Comments »