Nurturing life Your reference in perinatal nutrition, from pregnancy to childhood

Should we stop vitamin D supplements for children over one year who eat everything?

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By : Nurturing Life's Nutrition Team | Montreal Diet Dispensary
vitamine D-supplément-enfant

Yes and no. Children aged one year and older need 600 international units (IU) of vitamin D daily. Health Canada recommends a supplement of 400 IU per day for children who do not consume cow’s milk.

Because it facilitates the absorption of calcium, vitamin D is essential for healthy bones and teeth. For this reason, it is essential to meet the vitamin D needs of the developing child. A deficiency in this vitamin can lead to rickets, a disease that affects bone growth and can cause muscle weakness and fractures.

Food sources of vitamin D are scarce. It is added to milk, margarine, vegetable drinks and some orange and apple juices. While milk is fortified with vitamin D, dairy products (yoghurt, cheese, ice cream) contain very little. The only natural sources of vitamin D are egg yolks and fatty fish such as salmon, mackerel, herring or trout.

Food Amount Value (IU)
Salmon 90 g 496
Cod liver oil 15 ml 426
Egg yolks 2 47
Enriched milk (1%, 2% or 3.25%) 250 ml 90
Enriched soy beverages 250 ml 87
Enriched margarine 15 ml 78
Enriched orange juice 250 ml 100
Enriched cheddar cheese 50 g 3
Enriched yoghurt 125 ml 51

 

When exposed to sunlight, the skin has the ability to synthesize vitamin D. However, because of the risk of skin cancer, it is recommended to minimize exposure to direct sunlight, especially in children. They should be protected from the sun with clothing, hats and sunscreen. When skin is well covered, it is difficult to synthesize vitamin D. Other factors can also prevent the synthesis of vitamin D, for example dark skin color, clouds and pollution. In addition, during the 5-6 months of winter in Quebec, the sunrays are not strong enough and there is not enough exposed skin for optimal synthesis. For all these reasons, the synthesis of vitamin D from the sun cannot be considered a sufficient daily source, and the needs must be met primarily through food.

Regarding cow’s milk, it contains 90 IU of vitamin D per 250 ml. A child should consume more than 1.5 liters of milk per day in order to reach the recommendation of 600 IU which is not only unrealistic, but is more than double the recommended amount for the child, which is 750 ml of milk per day.

In summary, a supplement of 400 IU is recommended for all children whose needs of 600 IU are hardly met, that is to say during winter or in those who only consume little amounts of milk, fortified products or fatty fish.

There is no need to worry about an excessive intake of vitamin D with potential toxic effects, because the maximum intake of vitamin D per day is 2 500 IU in children aged 1 to 3 years and 3 000 IU for those aged 4 to 8 years. It is difficult to reach such amounts even when combining supplementation and dietary intake.

If in doubt, a pediatrician or nutritionist will assess the need for a supplement based on an individual intervention. It is mainly by checking vitamin D blood levels that the specialist will determine whether supplementation is necessary or not.

References

  • Godel, J.C. (2007). Les suppléments de vitamine D : Recommandations pour les mères et leur nourrisson au Canada, Société canadienne de pédiatrie, Comité de la santé des Premières nations, des Inuits et des Métis, Paediatr Child Health, 12(7):591-8
  • Ostéoporose Canada. (2015). La vitamine D : un élément clé pour une bonne absorption du calcium. http://www.osteoporosecanada.ca/losteoporose-et-vous/la-nutrition/la-vitamine-d/
  • Ross, A.C., Taylor, C.L., Yaktine, A.L., Valle, H.B.D. (2010). Dietary Reference Intakes for Calcium and Vitamin D. Washington, DC: Institute of Medicine of the national academies, Press NA.
  • Santé Canada. (2010). Fichier canadien sur les éléments nutritifs. http://www.hc-sc.gc.ca/fn-an/nutrition/fiche-nutri-data/index-fra.php
  • Santé Canada. (2014). La nutrition du nourrisson né à terme et en santé : Recommandations pour l'enfant âgé de 6 à 24 mois. http://www.hc-sc.gc.ca/fn-an/nutrition/infant-nourisson/recom/recom-6-24-months-6-24-mois-fra.php#q6
  • Webb, A.R., Kline, L., Holick, M.F. (1988). Influence of season and latitude on the cutaneous synthesis of vitamin D3: exposure to winter sunlight in Boston and Edmonton will not promote vitamin D3 synthesis in human skin. The Journal of clinical endocrinology and metabolism, 67(2):373-8.

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The views expressed herein do not necessarily represent the official views of the Public Health Agency of Canada.