Question: My child doesn’t drink as much milk as he used to. Do you think he’s still getting enough vitamin D?
Answer: This is a really common question for children about a year or two of age and older. Some will go from breastfeeding frequently or drinking up to 32 ounces a day of vitamin-enriched formula to drinking virtually no milk at all—sometimes within days or weeks. While the loss of protein and calcium supply is of concern in these kids, it’s really the loss of nutritional vitamin D supply that worries me most. There are other ways to get protein and calories—and even calcium—but vitamin D deficiency is epidemic among children and hard to find in other food sources.
What’s so important about vitamin D? In addition to its impact on bone development and growth, this crucial nutrient has important immune- regulating and neurological roles. Children deficient in vitamin D are more likely to suffer from respiratory ailments like asthma and may be at increased risk for certain types of autoimmune diseases and cancer.
The recommended intake of vitamin D for kids—either through diet or supplementation—has been doubled in the last few years by the American Academy of Pediatrics, to 400 IU per day. An 8- ounce glass of milk contains about 100 to 125 IU of vitamin D, so your child would need to drink 3 to 4 cups of milk each day if she’s not allergic or sensitive. Also, I believe that many children, including those with chronic health issues, may need 1,000 IU or more daily for optimal health. Other foods that are relatively rich in vitamin D include other enriched milks (soy or rice, for example) and certain fish, like salmon, herring, and sardines. Talk to your pediatrician about your child’s needs (labs can test for vitamin D deficiency with a doctor’s prescription), and consider cod liver oil or natural vitamin D supplements. Sunlight is still nature’s best source of vitamin D. Being outdoors increases your chances of getting the nutrient, so slather on some sunscreen and go enjoy the good weather!
Lawrence D. Rosen, M.D., is the founder of the Whole Child Center in Oradell, New Jersey, one of the first green, integrative primary care practices in the U.S.
Have a question for Dr. Rosen? E-mail him at firstname.lastname@example.org.