The American Academy of Pediatrics has recently doubled its recommendation of vitamin D intake for children, from 200 IU to 400 IU per day.  Not only is vitamin D important in the prevention of ricketts, but there is increasing evidence that its deficiency can promote type 2 diabetes, cancer, and autoimmune diseases.  Some doctors think 400 IU may not be enough.

This recommendation is all well and good, but I draw the line at this:  Breastfed and partially breastfed infants should be supplemented with 400 IU a day of vitamin D beginning in the first few days of life.  The reason?  [B]ecause of vitamin D deficiencies in the maternal diet, which affect the vitamin D in a mother’s milk, it is important that breastfed infants receive supplements of vitamin D.

There's a point there.  If the nursing mother isn't getting enough vitamin D, one or both of the pair will suffer.  And I suppose the widespread recommendation of supplementation is the best a group like the AAP can do to address a general problem.  But I would be more inclined to address the real problem by making sure the mother is properly nourished, and in ways as natural as possible rather than through artificial supplements.

How can one acquire 400 IU of vitamin D?  A teaspoon of cod liver oil will get you more that, but if you want more palatable sources, 3.5 ounces of cooked salmon have 360 IU, the same amount of cooked mackeral has 345, 1.75 ounces of sardines in oil have 350, and 6 ounces of tuna canned in oil have 200.

Then there's my favorite source:  playing outside in the sun.  It doesn't take much, although the amount is variable, depending on latitude, time of year, and cloud cover.  The factors that affect UV radiation exposure and research to date on the amount of sun exposure needed to maintain adequate vitamin D levels make it difficult to provide general guidelines. It has been suggested, for example, that approximately 5-30 minutes of sun exposure between 10 AM and 3 PM at least twice a week to the face, arms, legs, or back without sunscreen usually lead to sufficient vitamin D synthesis.

There you go:  permission granted to play outside a few minutes several times a week.  Maybe schools should re-institute a sound recess policy.  Northern children would need longer playtimes, however.  The UV energy above 42 degrees north latitude (a line approximately between the northern border of California and Boston) is insufficient for cutaneous vitamin D synthesis from November through February; in far northern latitudes, this reduced intensity lasts for up to 6 months. Latitudes below 34 degrees north (a line between Los Angeles and Columbia, South Carolina) allow for cutaneous production of vitamin D throughout the year.  [Pardon the source's obvious prejudice against the southern hemisphere.]

Did you note the clever design here?  The northern climes, in which sun exposure is insufficient for at least part of the year to produce adequate levels of vitamin D, have the cold-water fish whose oils are high in that vitamin.  How efficient is that?  It's another indication to me that the system was designed to work, and since babies were designed to subsist solely on mother's milk for at least the first several months of life, it makes much more sense to me for the mother to make sure she gets plenty of vitamin D herself, and to take her baby outside with her now and then, than to give artificial supplements.

Legal disclaimer:  I'm a grandmother, not a doctor.  This is my opinion, not medical advice.  Check with your own doctor, do your own research, and use your own common sense.  [No, I'm not paranoid about the recent lawsuits against bloggers...not really....]
Posted by sursumcorda on Thursday, October 16, 2008 at 4:25 pm | Edit
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So where's the clever design for us land-locked folks north of the 45th parallel? All the sources you mention are saltwater fish...

Posted by Stephan on Saturday, October 18, 2008 at 3:05 pm

Hmmm, I know it doesn't help you, but most of Switzerland might benefit from the higher altitude. My source also says you could get 400 IU by eating 20 eggs or a kilo of "Swiss" cheese (the only type of cheese to make the list) -- a little extreme but a smaller feast might make up for some of the lack of sunshine.

Posted by SursumCorda on Saturday, October 18, 2008 at 5:26 pm
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