Choosing a Vitamin D Supplement for Your Child

Choosing a Vitamin D Supplement

Making ‘D’ Right Choice for Your Child

Vitamin D supports a child’s health in a multitude of ways, from making their bones and teeth strong to helping with brain formation. While sunlight and food are acceptable sources of vitamin D, most kids are unable to fulfill their vitamin D needs through these two sources alone.

What’s wrong with food and sunlight?

Vitamin D can be found in seafood, mushrooms, fortified dairy products, breakfast cereals, and egg yolk. Seafood is an abundant source of vitamin D. Fatty fish like salmon can contain upwards of 500 IU of vitamin D per 3 ounces! But the level of vitamin D in the other foods in that list drops off after that. For example, most dairy products provide a maximum of 150 IU per serving (1). What about egg yolk and fortified cereals and juices, you ask? Even less. Couple these limited food options with an even limited appetite of your little one, and a vitamin D deficiency is right around the corner! 

Similarly, while sunlight is a wonderful source of vitamin D for a child’s body, concerns about the harmful effects of sun exposure can drive most parents far, far away from seeking this option. Long winter months, especially in the North, can also make it tough to synthesize vitamin D from the sun. This is where supplements come in! Vitamin D can be packaged into gummies, sprays, and drops and delivered in the form of supplements. This is the most convenient and reassuring option for most parents as they will not need to stress about meeting their child’s vitamin D needs everyday. 

is my child at risk for vitamin d deficiency?

The following factors can increase the risk for a vitamin D deficiency (1):

• Low intake of vitamin D-rich foods

• Increased requirements (for example, during adolescence)

• Low sun exposure

• Exclusively breastfed infants: breastmilk is packed with many nutrients, but it is not a good source of vitamin D. 1 cup of breastmilk provides roughly 10 IU of vitamin D (2). This amount is even lower if the mother is deficient in vitamin D.

• Milk allergies, lactose intolerance

• Veganism or ovo-vegetarianism

• Darker skin colour

• Pregnant/breastfeeding mother’s low intake of vitamin D

how much vitamin d does my child need?

• Infants (0-12 months) need 400 IU daily (1)

  • Exclusively and partially breastfed infants are recommended to take a vitamin D supplement

  • If formula-fed infants are not consuming at least 1 liter of fortified formula every day, they are also recommended to take a vitamin D supplement

• Preterm infants 

  • 400-1000 IU vitamin D from supplements is recommended (2)

• Children and adolescents (1-18 years) need 600 IU daily (1)

  • 400 IU vitamin D from supplements and 200 IU from food (2)

Choosing ‘D’ Right Vitamin D Supplement

1. Vitamin D supplements can interact with other medications, which can decrease the absorption of vitamin D in the body. Make sure to inform a pediatric practitioner about all the medications your child is on before initiating vitamin D supplementation.

2. Always check for the 8-digit Natural Product Number (NPN) whenever you purchase a supplement of any kind. This number indicates that Health Canada has reviewed the product for its safety and quality.

3. Toxicity from an overload of vitamin D is possible! Make sure to follow the dosing instructions on the packaging. If you know that your child consumes a lot of vitamin D-rich foods like seafood and mushrooms, you might want to consider estimating how much vitamin D they are receiving in total from supplements and food. This number should not exceed:

   • 1000 IU per day for 0-6 month olds

   • 1500 IU per day for 7-12 month olds

   • 2500 IU per day for 1-3 year olds

   • 3000 IU per day for 4-8 year olds

   • 4000 IU per day for 9-18 year olds

Vomiting, constipation, poor appetite, and weakness are some signs of a vitamin D overload (3).  

4. Vitamin D supplements are sometimes labelled as D2 or D3 supplements. This can get confusing. Let’s break it down for you. Vitamin D3 is from animal-based foods while D2 is from plant-based foods (2). You may want to keep this in mind if your child is vegan or vegetarian. There is a lot of evidence from scientific studies which supports the idea that vitamin D3 is more effective than D2 (2,4). So whenever possible, choose vitamin D3 for your child.

5. Chewables, gummies, sprays, and drops are the different forms in which vitamin D supplements are made. Chewables and gummies may be a good option for kids aged 3 years or older as they have better chewing abilities. Younger children will benefit from the drops or sprays (2).

6. Look around for a single vitamin D supplement rather than a multivitamin. Multivitamins contain many other vitamins and minerals in different amounts. Your child may already have sufficient levels of these nutrients. Supplementing with these nutrients on top of their body stores may lead to an excessive level of these vitamins and minerals in the body (2). 

7. The supplement’s label may list the amount of vitamin D in micrograms (mcg) or International Units (IU). 1 mcg = 40 IU (2). Keep this conversion rate in mind when choosing a supplement for your child as the dose will vary depending on their age. Also, make sure to read the dosing instructions carefully!

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Blog Contributor

Maria Fatima, Dietetic Intern

Masters Program

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References

1. National Institutes of Health [Internet]. Bethesda, MD: U.S. Department of Health & Human Services; [updated 2020 Mar; cited 2020 Aug 18]. Vitamin D: Fact Sheet for Health Professionals; [about 15 screens]. Available from https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. 

2. Alberta Health Services [Internet]. Edmonton: Government of Alberta - Ministry of Health; c2019 [updated 2019 Oct; cited 2020 Aug 18]. Nutrition Guideline. Healthy Infants and Young Children. Vitamin D; [about 10 screens]. Available from https://www.albertahealthservices.ca/assets/info/nutrition/if-nfs-ng-healthy-infants-key-nutrients-vitamin-d.pdf 

3. John Hopkins Medicine [Internet]. Petersburg, FL: John Hopkins All Children’s Hospital; c2020 [cited 2020 Aug 18]. Vitamin D and Your Child; [about 4 screens]. Available from https://www.hopkinsallchildrens.org/Patients-Families/Health-Library/HealthDocNew/Vitamin-D-and-Your-Child

4. Multiple Sclerosis Society of Canada [Internet]. Toronto: Multiple Sclerosis Society of Canada; c2020 [cited 2020 Aug 18]. Vitamin D Fact Sheet; [about 8 screens]. Available from https://mssociety.ca/library/document/38cuveX9sSrF0QEZ1DfOMUaBilKTyRJk/original.pdf