What Vitamins does my baby or child need? Spotlight on Vitamin D
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One of the questions I get asked about all the time, in clinic and on social media, is “What vitamins does my child need?”. As parents, we always want to ensure our children get all the nutrition they need, and in some cases, this means we have to top up their diet with specific vitamin and/or mineral supplements. This blog focuses specifically on Vitamin D supplements for babies and children because this is one of the vitamins almost all children in the UK are recommended to have.
This blog covers:
Why babies and children need a Vitamin D supplement
Food sources of Vitamin D
UK Vitamin D recommendations for children
How much Vitamin D you should give your child depending on their age
How to choose a good Vitamin D supplement
When to give a Vitamin D supplement
Why do babies and children need Vitamin D?
Vitamin D is an essential nutrient needed to support the health of your child’s bones, teeth and muscles. It also has a very important role in the healthy functioning of your child’s immune system. Unlike most Vitamins which we get from our diet, Vitamin D is largely obtained through the act of sunlight on our skin. This means during the winter months in the UK, it’s much harder for us to get enough Vitamin D.
In children, Vitamin D deficiency is one of the most common deficiencies we see, with almost 1 in 5 children in the UK found to have vitamin D levels lower than recommendations (1). Very low levels of Vitamin D in children are related to bone conditions such as rickets.
What foods contain Vitamin D?
Vitamin D isn’t found in many foods, which is one of the reasons why supplementation is recommended. That said, you can find Vitamin D in foods like these:
Oily fish e.g. salmon, mackerel, sardines
Eggs
Red meat and offal like liver
Fortified milk e.g. Arla Big Milk or plant-based milk alternatives
Mushrooms (top tip - leave them in the sunlight to boost their Vitamin D content)
Even if your child includes these foods within their diet, it is still recommended that they follow the advice below about supplementation.
How much Vitamin D supplementation does your child need?
How much Vitamin D to give your child, and when to give it e.g. time of year depends on their age. Find the age of your child below, to see the most current recommendations:\
Recommendations
Baby 0-6 months old *exclusively breastfed*- 8.5-10ug* daily from birth. If you’re a breastfeeding mum, it is also recommended you supplement daily with 10ug Vitamin D too
Baby 0-6 months formula or combination fed (breast milk & formula milk) - 10ug/day but only once having <500mls of formula**
Baby or child from 6+ months - 4 years - 10ug daily, ideally alongside a Vitamin A supplement
*Formula-fed babies, only need to start supplementation when having <500mls formula/day
Child - 4+ years - 10ug of Vitamin D per day during the winter months e.g. September to March in the UK
*ug - micrograms
**This is because formula milk already contains Vitamin D
As you can see from the above, daily supplementation is recommended for babies and young children (unless having >500mls formula milk per day) until 4 years of age, moving to winter supplementation from around school age. That said, some children benefit from daily Vitamin D supplementation all year round. These children would be considered at higher risk of having lower Vitamin D levels, and include:
Children who are not often outdoors
Children who usually wear clothes that cover up most of their skin when outdoors
Children with dark skin e.g. African, African-Caribbean, South Asian background
Children who take medications that can interfere with Vitamin D absorption e.g. anti-epileptic drugs (please check with a health professional)
Children with moderate to severe eczema - whilst this isn’t formally included in guidelines to date, my clinical experience has found, alongside some scientific evidence that many children with eczema have low levels of Vitamin D, and may also benefit from Vitamin D supplementation (2)
How to choose a good Vitamin D supplement?
Choosing the right Vitamin supplement can be intimidating - the supplement aisle in the supermarket seems to grow every year. Here are some key tips for choosing the right Vitamin D supplement:
Make sure it contains enough Vitamin D - you’d be surprised how many children’s vitamins in the UK don’t contain enough Vitamin D. Check the label to ensure the dose is 10ug of Vitamin D (sometimes written as 400 IU- International Units)
Ideally choose a supplement that uses Vitamin D3, not D2 - you will see D2 and D3 available. D2 is derived from plant based sources e.g. mushrooms, fungi whereas D3 is derived from animal sources. High-quality scientific research shows that Vitamin D3 is much better at raising Vitamin D levels in the body than Vitamin D2 (3)
Choose a form your child can take easily - there are lots of options available from drops and sprays to chewable supplements. Choose a preparation that is safe for your child e.g. spray or drop is preferred for babies and young children, and accepted easily
For children 6 months to 4 years - vitamin A supplementation is currently recommended daily alongside Vitamin D (as research shows vitamin A deficiency can also be more common in this age group). Choosing one supplement that gives both can be helpful. Check out my recommendations below!
Check the ingredients - lots of supplements contain extras parents don’t expect! Be mindful of added sugars, or allergens like peanut oil or soya which can creep into some vitamin supplements. There are also options suitable for vegetarians and vegans, as often D3 is derived from animal sources,
Vitamin D supplement options I use and recommend for babies and children include:
Baby Vitamin D:
Baby (6+ months) and child Vitamin A and D combined:
Older kids (4+ onwards) Vitamin D supplement:
Can you give too much Vitamin D?
Like any vitamin or mineral, it is possible to give too much, and it is always recommended to give the recommended doses to babies and children. This is particularly important for fat-soluble Vitamins like Vitamin D and A, as they are stored rather than excreted (removed) by the body. It can be reassuring to know, however, that there are not many cases of vitamin D toxicity in children reported in the literature, and many children may marginally exceed their intake at times without any negative consequences
When should I give my child’s Vitamin D supplement?
Fat-soluble vitamins, like Vitamin D, can often benefit from being offered alongside foods or meals which contain fat. Calcium and Vitamin D are also a match made in nutritional heaven, so giving Vitamin D alongside foods like breakfast cereals with milk, yoghurt or even a cheese sandwich is great! The most important factor however is consistency, so giving at a time you remember each day to build a routine, no matter what time of day that is!
https://www.gov.uk/government/news/new-review-launched-into-vitamin-d-intake-to-help-tackle-health-disparitieshttps://f1000research.com/articles/11-274Tripkovic, L., Lambert, H., Hart, K., Smith, C. P., Bucca, G., Penson, S., Chope, G., Hyppönen, E., Berry, J., Vieth, R., & Lanham-New, S. (2012). Comparison of vitamin D2 and vitamin D3 supplementation in raising serum 25-hydroxyvitamin D status: A systematic review and meta-analysis. The American Journal of Clinical Nutrition, 95(6), 1357-1364. https://doi.org/10.3945/ajcn.111.031070
