Vitamin D Deficiency in Children and Adolescents

Child playing outside

Vitamin D is an essential nutrient that plays an important role in calcium homeostasis and bone health. While many parents feel their child is getting enough vitamin D from milk and sunshine, recent studies suggest otherwise.


In fact, as many as one in 10 U.S. children are estimated to be deficient – and 60% of children may have suboptimal levels. While it is most common in malnourished children and in children with chronic illnesses, every child is at risk.

Who is at Risk?

Populations at risk include exclusively breastfed infants, particularly when the mothers were vitamin D deficient during pregnancy; darkly pigmented children, and those with limited sun exposure. This would include most people living in Western Pa.

One of the biggest concerns is deficiency in infants, especially if they are premature. The vitamin D content of breast milk is low (15-50 IU/L) and exclusively breast-fed infants ingest only about 10-40 IU/day of vitamin D in the absence of sun exposure. This is far less than the recommended daily intake of 400 IU/day for all infants and children.

Older children are at risk if they don’t get enough fortified milk or other dairy products in their diet, with deficiencies most commonly occurring in children who are obese, malnourished children or with chronic diseases. These children are also at risk if they have conditions that impair fat absorption including celiac disease, inflammatory bowel disease, pancreatic insufficiency, and gut surgery.

Health Risks of Vitamin D Deficiency

Vitamin D deficiency has been associated with a higher risk of upper respiratory infections, hypertension, metabolic syndrome, and elevated blood sugars. There is even an association with food allergies, asthma, & dental caries in the pediatric population.

While less common, severe deficiencies (<10ng/ml, occurring in 1-2% of cases) can cause rickets, hypocalcaemia (low calcium levels) and seizures in infants and children.

Accepted Recommendations for Preventing Vitamin D Deficiency:

Even in areas with limited sun exposure per year, there are a few wildly accepted practices to prevent vitamin D deficiency in your child:

  • Pregnant women should have sufficient vitamin D intake (600 IU/day). Some studies even recommend (1000IU/day)
  • Exclusively breastfed infants should receive (400IU/d) of vitamin D. This should continue until the infant is weaned and taking fortified cow’s milk or infant toddler formula. Keep in mind some bottle fed infants may also develop deficiencies.
  • Healthy children aged 1-18 should receive (600IU/day)
  • A diet high in (eggs, fish, salmon, fortified bread, cereals, milk, juice) also is recommended.
  • Vitamin D supplements (1000-2000IU) are usually Vitamin D3 and are available commercially as daily supplements.
  • Play outside! 10-15 minutes of sun exposure near midday is sufficient for Vitamin D synthesis in most individuals.

Contact us with additional questions or if you have concerns about this condition.