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Posted on: January 20, 2013
by John Cannell, MD
Dr Clare Wall and colleagues of the University of Auckland recently reported in an interesting paper the vitamin D levels of exclusively breastfed infants in New Zealand.You must be a paid member to read the rest of this post. Please login or register now.
How much do you recommend supplementing infants with Vitamin D3? Any more than the recommended 400 IU, especially during the winter months? Thank you.
@amecrepes, the Vitamin D Council recommends 1000 IU/day per 25lbs of body weight, rounding up.
So if a baby weighs 15lbs, the recommendation is 1000 IU/day.
I am a long time reader of Dr Cannell and the Vitamin D Council newsletter. 1000 IU/day per 25 lbs of body weight, equals 40 IU per pound per day. So if a baby weighs 15 lbs, the recommendation is 600 IU/day.
Your calculation equates to 66.6 IU per pound per day. This is closer to what Dr Cannell would recommend for a child with Autism.
Dr. Cannell writes that it is sensible to limit your infant’s full body sun exposure to ten minutes per day when your shadow is shorter than you are. The question is, would this exposure time result in vit D sufficiency for the exclusively breastfed infant whose mum is insufficient, or would the infant still need to be supplemented? Is this suggested time exposure derived from knowledge about vit D manufacture rates in the skin and first principles or is there also supporting research? Pam.
Thanks for the comment Mark. Dr Cannell has stated it both ways, getting detailed, like the example you laid out, and being general and rounding up. Here is an example of the latter: http://blog.vitamindcouncil.org/2012/06/05/influencing-change-one-at-a-time/
The Vitamin D Council’s health professional’s position statement does not specify whether to round up or to further tailor the recommendation to 40 IU/day per lb. While tailoring the recommendation (ie 600 IU for a 15lb baby) will still well-ensure sufficiency, the greatest goal is to keep it simple for family and parents, as that best ensures they’ll supplement their family if recommendations are simple.
Tailoring can get really complicated and turn a parent off. If they have a 35lb child, for example, they need 1400 IU/day. As ridiculous as it sounds, a 1400 IU/day recommendation begins to stress a parent out. They start to ask, “Where can I find a 1400 IU supplement?” Then they wonder why it’s not on the market. Then they wonder if 1400 IU is really the right amount if Nature Made doesn’t make it. If you say, “Just round up to 2,000 IU,” it’s much simpler and the parent can follow the lead much easier and feel more comfortable about supplementing.
I think as vitamin D enthusiasts, we all have the tendency to really complicate recommendations and get detailed, when the opposite approach is more effective. Patients and the public will always follow through the simplest path/advice/approach.
@Pam, great questions.
“Would this exposure time result in vit D sufficiency for the exclusively breastfed infant whose mum is insufficient, or would the infant still need to be supplemented?”
I don’t believe this has ever been studied, so it’s hard to comment. Anyone know?
“Is this suggested time exposure derived from knowledge about vit D manufacture rates in the skin and first principles or is there also supporting research? ”
I think the advice is primarily founded on both (a) avoiding sun-burning and (b) what we know about adults manufacturing vitamin D. If a person with skin type II is fully naked with the sun high in the sky, they can make lots of vitamin D in 10 minutes, maybe around 5000 IU. Again, not sure if it’s known how much an infant could make. Certainly a lot less with less skin exposed with the smaller body.
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A recent study discovered vitamin D deficiency was associated with slower walking speed in middle aged and elderly individuals.