(21-06-13) Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents

Carol L. Wagner and Frank R. Greer


ABSTRACT

Rickets in infants attributable to inadequate vitamin D intake and decreased
exposure to sunlight continues to be reported in the United States. There are www.pediatrics.org/cgi/doi/10.1542/
also concerns for vitamin D deficiency in older children and adolescents. peds.2008-1862
Because there are limited natural dietary sources of vitamin D and adequate doi:10.1542/peds.2008-1862
sunshine exposure for the cutaneous synthesis of vitamin D is not easily All clinical reports from the American
determined for a given individual and may increase the risk of skin cancer, the Academy of Pediatrics automatically expire

5 years after publication unless reaffirmed,
recommendations to ensure adequate vitamin D status have been revised to revised, or retired at or before that time.
include all infants, including those who are exclusively breastfed and older The guidance in this report does not
children and adolescents. It is now recommended that all infants and children, indicate an exclusive course of treatment
including adolescents, have a minimum daily intake of 400 IU of vitamin D or serve as a standard of medical care.
beginning soon after birth. The current recommendation replaces the previous Variations, taking into account individual

circumstances, may be appropriate.

recommendation of a minimum daily intake of 200 IU/day of vitamin D Key Words
supplementation beginning in the first 2 months after birth and continuing vitamin D, vitamin D deficiency, rickets,
through adolescence. These revised guidelines for vitamin D intake for healthy vitamin D requirements, infants, children,
infants, children, and adolescents are based on evidence from new clinical trials adolescents, 25-hydroxyvitamin D, vitamin
and the historical precedence of safely giving 400 IU of vitamin D per day in the


Abbreviations

pediatric and adolescent population. New evidence supports a potential role for AAP—American Academy of Pediatrics

vitamin D in maintaining innate immunity and preventing diseases such as 25-OH-D—25-hydroxyvitamin D

diabetes and cancer. The new data may eventually refine what constitutes 1,25-OH2-D—1,25-dihydroxyvitamin D

vitamin D sufficiency or deficiency.

Source: Pediatrics 2008;122;1142
DOI: 10.1542/peds.2008-1862
D supplements

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