Vitamin D Needs

in WIC Populations
Sean
Servalish
Vitamin D: Why is it important?
Adequate Vitamin D intake:
Supports fetal growth.
Supports the formation of tooth and enamel in infants.
Helps absorb calcium to build stronger bones.
Helps regulate the immune system and the neuromuscular
system.
Plays a role in the life cycle of cells which prevents cancers
and other diseases.

Diseases Linked to Low Vitamin D or Vitamin D

Deficiency:
Osteoporosis and Osteopenia
Varieties of Cancer (including breast, prostate and colon)
Heart Disease
Obesity
Rickets
Multiple Sclerosis
 Vitamin D in Pregnant Mothers
Importance of Adequate Vitamin D:
Lack of Vitamin D in the mother during pregnancy compromises fetal as well as childhood
bone development.
Poor Vitamin D mothers are more likely to have a smaller than average child in both
weight and length.
Mothers with a deficiency are likely to have a child with the same deficiency, causing the
child to have risks associated

Prevalence of Deficiency:
Vitamin D deficiency is common in pregnant mothers. A 2008 study by the International
Association for Dental Research found that of 208 pregnant mothers in Toronto, 35% of
them had a deficiency in Vitamin D. a
A similar study conducted in 2007 in Pittsburgh, found that 83% of African American and
47% of Caucasian pregnant mothers had the deficiency. a
Of these deficient pregnant mothers, 93% of African American infants and 66% of Caucasian infants
were also born Vitamin D deficient
 Vitamin D in Pregnant Mothers

At Risk Mothers:
Obese mothers are at a higher risk than non-obese mothers:
61% of Obese Mothers have a Vitamin D deficiency during pregnancy compared to 36% of
non-obese mothers.
Due to its deposition and dispersion in fat cell compartments it doesnt enter circulation as
well.
Mothers who live in a northern or low-sunlight environment and climate:
Vitamin D is produced naturally in the skin when receiving natural sunlight.
Two, 15 minute sunbathing sessions in a day can produce all of the Vitamin D our body
needs.
In northern, cold and cloudy environments, the sunlight is too weak to activate Vitamin D
production in the skin.
Mothers following a vegetarian or vegan diet:
Vitamin D is highest in fish, cows milk, cheeses, egg yolks and many other animal products
that may be avoided by a vegetarian or vegan.
 Recommendations for Pregnant
Mothers
An intake of about 10 micrograms or 400 IU daily is recommended
for pregnant mothers.
This can be accomplished by 3 fortified glasses of milk daily if no other
sources are consumed
Prenatal multivitamins containing vitamin D
Safe sunbathing is recommended to increase Vitamin D as well
It is said that the two 15 minute sessions of sunbathing can produce as much
as 1,250 mcg of Vitamin D.
Note that there is no evidence of a Vitamin D overdose from sunlight exposure.
 Food Sources
Fish, especially fatty fish like
salmon (340 IU), Tuna (200IU), 1 Whole egg 40 IU
Mackerel Margarine 1 tbsp. (60 IU)
Fortified Cereals 10% DV (40 IU) Cheese, Swiss 1 oz. (12 IU)
Fortified Milks (130 IU)
Fortified Yogurt with 20% DV
including soymilk
(80 IU)
Egg yolk (27 IU)
8 oz. orange juice (100 IU) Beef Liver 3.5 oz. (15 IU)
Sardines 1.5 oz. (250 IU) Mushrooms 1 cup (2 IU)
 Vitamin D in Infants
Breast Fed vs. Formula Fed Infants
Vitamin D is not very prevalent in breast milk; about 50 IU per quart. So all infants
being breast-fed should be on a supplement of Vitamin D to ensure adequacy.
Formula made with cows milk contains much more Vitamin D; about 400 IU per
quart. So if a child is consuming a quart or more, they will not need to be
supplemented. If they consume under a quart then they should be supplemented.
Milk tends to contain higher vitamin D levels in mothers who sunbathe frequently,
however a 2013 study in Journal of Pediatrics noted that high vitamin D intake did
not substantially effect the vitamin D content of the mothers breast milk
 Vitamin D in Infants
Vitamin D is important for proper bone
development and growth as well as
tooth and enamel formation.
Soft bones can result, leading to
bowing legs or other related diseases
in children
Recommendations:
400 IU or 10 micrograms a day after birth is
recommended for infants and toddlers
Chewable multivitamin with vitamin D when
tolerated.
Sunblock should be worn by infants when
exposed to significant amounts of sunlight
 Common Supplemental Forms of
Vitamin D
Not everyone consumes foods that have adequate
vitamin D levels in it. These supplements can help
get the daily recommendation in one serving per
day.
Cod Liver Oil for adults - 1 tbsp. (1,300 IU)

Baby D Drops for infants 1 drop in bottle (400 IU)

 Vitamin D in T0ddlers
Children at risk until age 5:
Those with inadequate sun exposure or too much sunscreen when
exposed to the UV rays of the sun.
Toddlers have sensitive skin but as they age they can benefit more from the
suns rays and should not be sheltered from the sunlight
Those who live in northern areas or have darker pigments of skin are at risk for
this reason
Those who were breastfed or partially breastfed without Vitamin D
supplementation.
Children whos mothers were Vitamin D deficient.
Children with a deficiency may develop low calcium (hypocalcaemia)
levels resulting in Fits or other related health issues. They may also
develop rickets or other bone abnormalities.
Delayed or improper growth of bones, teeth and enamel also may
result.
Introduce high vitamin D foods to children when tolerable or
supplement with Vitamin D or a Multivitamin containing vitamin D until
 Summary
Vitamin D is a common deficiency in pregnant mothers and breast-
fed infants; children up to 5 are also at risk.
Pregnant mothers should be taking a prenatal vitamin containing
Vitamin D for their own levels if they do not meet their needs
through diet. There are also nutritional supplements like cod liver oil
that can supply adequate amounts.
Adequate consumption does not increase breast milk levels
substantially.
Infants who are being breast-fed or fed under a quart of formula a
day should be supplemented Vitamin D in the form of drops or
chewable vitamins when tolerated to meet their levels and support
proper development.
 References
Kim, Yong Joo. Comparison of the Serum Vitamin D Level
between Breastfed and Formula-Fed Infants: Several Factors
Which Can Affect Serum Vitamin D Concentration. Korean
Journal of Pediatrics 56.5 (2013): 202204. PMC. Web. 21 Oct.
2016.
Brown, Judith E. Isaacs, Janet S. Krinke, Beate U. et al.
Nutrition Through the Life Cycle 4th edition. 87-266. 2011
Cengage Learning. Book.