Vitamin D Deficiency in Young Children

Suboptimal vitamin D levels are common in healthy infants and toddlers.
From: Arch Pediatr Adolesc Med. 2008;162(6):505-512.

Recent research suggests that vitamin D deficiency is more common than we once thought. To examine vitamin D status in young children, Boston investigators determined vitamin D levels (25-hydroxyvitamin D) in 247 infants (age, birth to 1 year) and 133 toddlers (age, 1–2 years) during routine visits at an urban primary care clinic.

The prevalence of vitamin D deficiency (<20 ng/mL) was 12%, and 40% of children had suboptimal vitamin D levels (<30 ng/mL). Prevalences were similar in infants and toddlers. Among children with vitamin D deficiency, wrist and knee radiography revealed that 8% had rachitic changes, and 33% had evidence of demineralization. The only factors independently associated with vitamin D deficiency were breast-feeding without supplementation in infants and low milk intake in toddlers.

Comment: As noted by an editorialist, the level of vitamin D that truly represents deficiency in asymptomatic children is uncertain. However, because demineralization of bone during childhood can have lifelong consequences, ensuring adequate intake of vitamin D is important. The American Academy of Pediatrics recommends 200 IU of supplemental vitamin D for all breast-fed infants, unless they are receiving 500 mL daily of vitamin D–fortified formula or milk. They also recommend that toddlers consume 500 mg of calcium in their diet daily to assure adequate stores.