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June 15th, 2010
03:52 PM ET

Infants can get too much vitamin D, FDA warns

By Val Willingham
CNN Medical Producer

Parents could be overdosing their children with liquid vitamin D,  the U.S. Food and Drug Administration warns.

Many of the vitamin D supplements in stores use droppers that could allow anyone to accidentally give harmful amounts of the vitamin to a baby.  Although the FDA says it wants to be sure not to alarm adults on this issue, the agency believes parents and caregivers should just be aware that there are risks to giving too much vitamin D and that they should use the appropriate dropper.

"It is important that infants not get more than the recommended daily amount of vitamin D," says Linda M. Katz, M.D., M.P.H., interim chief medical officer in FDA's Center for Food Safety and Applied Nutrition. "Parents and caregivers should only use the dropper that comes with the vitamin D supplement purchased."

Vitamin D causes calcium absorption in the stomach and plays a key role in the development of strong skeletal system. A lack of vitamin D in children can lead to thinning, soft and misshaped bones, causing a condition known as rickets. Pediatricians says it's important some infants, especially those who were breast fed, get their recommended 400 international units of vitamin D a day.

However, too much vitamin D can cause nausea and vomiting, loss of appetite, excessive thirst, frequent urination, constipation, abdominal pain, muscle weakness, muscle and joint aches, confusion, fatigue, as well as more serious consequences like kidney damage. So the FDA recommends the following.

– No more than 400 international units of vitamin D a day for a child.
Keep the vitamin D supplement product in its original package with its original dropper and read the package instructions carefully.
Make sure the vitamin D dropper is is clearly marked with units of measurement.
If you don't know how much is a correct dosage, ask your physician.
If your child takes infant formula, best to check with your pediatrician before giving your child vitamin D supplements at all.

The FDA believes following these tips and keeping in touch with your pediatrician should help avoid any problems with vitamin D overdosing.

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soundoff (34 Responses)
  1. jason

    400IU a day? That's it? I disagree with this number. The Vitamin D Council Recommends 1000IU/day, and their research is much more up to date than the FDA panels.

    June 15, 2010 at 16:16 | Report abuse | Reply
    • David

      If you look closer at the Vitamin D Council their statements are not backed by research and state at the bottom of the page "These statements have not been evaluated by the FDA. These products are not intended to diagnose, treat, cure, or prevent any disease." They reference very few research articles that we currently use in healthcare. There is a significant amount of current research that indicates 400 IU is adequate. I suggest you use American Academy of Pediatrics for your information.

      September 15, 2010 at 16:22 | Report abuse |
  2. RockyBob

    How bizarre! In Finland until 1968 children were given 2000 IU daily. The only scholarly documented effect was that 30 years later those children had at least a 80% reduction of the incidence of type 1 diabetes. With adequate sun exposure adults get the equivalent of at least 10,000 IU daily (in the first 30 minutes. No on gets too much vitamin D from sun exposure.

    June 15, 2010 at 17:56 | Report abuse | Reply
  3. Chuck

    Is the normal 25 hydroxy-vitamin D level in infants different than adults? It would seem to make since to monitor the blood levels. The following abstract on Pubmed seems to contradict the above articlet.

    http://www.ncbi.nlm.nih.gov/pubmed/15671235?ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

    The FDA recommendation on Vitamin D has been too low for years. Monitor the blood levels

    June 15, 2010 at 18:04 | Report abuse | Reply
  4. Swede

    Why don't they ever mention getting the infants in the sun? Only a little daily exposure is needed to make adequate vitamin D (which by the way, your body produces several photocompounds as opposed to just vitamin D3 that is in the supplement).

    June 15, 2010 at 19:01 | Report abuse | Reply
    • Rachel

      Children under six months are not to be exposed to sunlight, it can be damaging to there gentle skin, children over 6 months are reccomened to have at least spf 50 on them when in sunlight.

      December 1, 2010 at 20:55 | Report abuse |
  5. MsAledella

    "Pediatricians says it's important some infants, especially those who were breast fed, get their recommended 400 international units of vitamin D a day."
    Vitamin D deficiency and breastfeeding do not go hand-in-hand. A breastfed child whose mother eats a well-balanced diet and is provided with a few minutes of daylight each day will certainly not become vitamin D deficient. Isn't this the same mentality that convinced women in the '50s that breast milk wasn't "good enough" and they should give babies formula instead? And still, we have to prove that breast milk is perfect.

    June 15, 2010 at 19:13 | Report abuse | Reply
  6. Lee

    Vitamin D is not a nutrient, it is a prehormone best to left up to the body to produce as needed.

    June 15, 2010 at 19:56 | Report abuse | Reply
    • RL

      Sorry Lee, bad advice. Correct– D3 is a hormone or pre, but human beings unfortunately don't get outside anymore, and with winter coming, all the worse. It is a natural process, but we're (many of us) are stuck unnaturally in front of these computer screens all day, talking about Vitamin D, instead of soaking some in.

      November 10, 2011 at 15:26 | Report abuse |
  7. Zory

    I breastfed my child for 13 months exclusively. Never gave her even one dose of vitamin D. She is full of energy, completely healthy 5 year old girl that eats tons of fruits and veggies.

    June 15, 2010 at 20:16 | Report abuse | Reply
  8. DP

    Yeah, but these recommendations could still be under-dosing. Pediatricians, get off your duffs and figure out what the correct dosing really is. Yes, I see the FDA recommendations right there in the article. No, I don't believe they represent anything but an outdated guess at correct dosing.

    June 16, 2010 at 00:08 | Report abuse | Reply
  9. DP

    Oh, yeah, and there's nothing "missing" in the design of breastmilk. It's the mothers who are Vit D deficient. We've been underdosed forever, too. this 400IU stuff is bunk. A mother's dose is at least 5000IU, maybe more, but we won't know for a long time because there's too much foot-dragging over 400IU being the recommendation for a long time. Being a long-standing recommendation doesn't make it sacred. You're not burning your fellow scientists in effigy to do a real study and find a real upper limit.

    June 16, 2010 at 00:15 | Report abuse | Reply
  10. Pete

    I believe they said no more that 400IU a day for babies up to 1 year old, not children. Above 1 year old they said no more than 2000IU a day.

    Why a 2 year old and a 12 year old have the same upper limit I do not know it seems very strange.

    June 16, 2010 at 04:21 | Report abuse | Reply
  11. A. Cesan

    OK, so is this the final word on vitamin D for infants? They only need 400 IU per day supplementation? The medical news is saturated with reports that kids and adults are severely deficient in vitamin D, and I often read that recommendations are guesstimates based on old research. Is there new research to support 400 IU/d for infants? Please share it. Thanks.

    June 16, 2010 at 07:01 | Report abuse | Reply
  12. Nat Bourre

    There is an alternative to the dropper-style liquid Vitamin D for infants that few parents know about yet. It is called Baby Ddrops. Just 1 drop provides the full daily recommended dose of 400 IU (as per the American Pediatrics Academy and the Canadian Pediatric Society). It is specially designed with a EuroDropper which provides a consistent size drop, so baby always gets 400 IU Vitamin D3. Here is their website http://www.ddrops.ca

    June 16, 2010 at 08:59 | Report abuse | Reply
  13. Holly

    Just get out into the sun! Especially if you are black- you need more time in the sun to synthesize vitamin d if your skin is darker. 20 to 30 minutes in the summer will do it for someone as white as me ; ). I have an abdominal swelling problem that doesn't respond to vitamin d3 in pill form, but getting 30 minutes of sunshine (and not getting constipated) eliminates the problem. Cloudy week? Well, my problem resurfaces then. The pill doesn't help me much, at 2000 IU a day. The natural form of the vitamin is always better. Consider a high quality cod liver oil, which contains vitamins a and d in their proper ratio (see westonaprice.org), and eat wild caught alaskan salmon every so often. It's still not enough without sunshine, though!

    June 16, 2010 at 09:26 | Report abuse | Reply
  14. E. C

    Unfortunately, breast milk does not contain vitamin D, no matter how adequate the mother's store. Yet, overall, the benefits of breast milk far out weigh the benefits of formula feeding just because formula contains vitamin D. Breast milk is biologically meant for baby.

    June 16, 2010 at 11:06 | Report abuse | Reply
  15. Tanya

    For a long time the FDA recommended 400 IU a day for everyone. Now this has been proven insufficient. For infants, time in the sun would be more beneficial than a supplement. I'm a breastfeeding mom & I take an extra 1000 IU on any day where I don't get sufficient sun, and this is in addition to the 1000 IU in my prenatal & calcium supplements.

    Interesting sun exposure calculator:
    http://blog.nutritiondata.com/ndblog/2009/08/how-much-sunshine-does-it-take-to-make-enough-vitamin-d.html

    June 16, 2010 at 11:23 | Report abuse | Reply
  16. The_Mick

    jason wrote: "400IU a day? That's it? I disagree with this number. The Vitamin D Council Recommends 1000IU/day, and their research is much more up to date than the FDA panels."

    Jason, those are numbers for ADULTS. An infant, weighing 5-10x less than an adult, needs significantly less.

    Please note that in adults, taking more than 2000IU per day is related to the development of kidney stones. An infant taking 1000IU per day is probably being placed in the same danger.

    I get Vitamin D results from blood tests every three months and, during the Winter, I need 2000IU per day just to stay above the min. desired 32 ng/mL, but still fall a little under the desired 40-50 levels. But I'm not going to go above the 2000IU's, even though you can buy 500 1000IU tablets for about $7, because of the health problems that increase may cause.

    June 16, 2010 at 12:00 | Report abuse | Reply
    • Bonecrusher

      2,000 is nothing. 4,000 IU is the resting metabolism of an average male. You will continue to fail.

      September 23, 2014 at 12:42 | Report abuse |
  17. Mrs. H

    E.C.–I would disagree that it is "unfortunate" that breastmilk contains a smaller amount of Vit D. (It does contain *some*.) If breastmilk were insufficient to produce healthy children, humans would have disappeared a long time ago. As long as Mom is consuming a healthy diet and getting Baby out in the sun every day, there is no need to supplement a breast fed baby.

    June 16, 2010 at 12:15 | Report abuse | Reply
  18. GW

    400 IU a day for an infant would seem to translate by weight to about 6000 IU for a 150 pound adult (assuming a 10 pound infant, which is large but they exist). This discrepancy in rda for infants and adults is probably due to the growth requirements of the baby. As far as the rda for adults, show me the clinical trials linking vitamin D to illness frequency in a dose dependent manor. Until then, I'll stick to my 2000 IU per day.

    June 16, 2010 at 14:04 | Report abuse | Reply
  19. Dr. Mama

    This is very confusing information for parents. Especially since it comes right on the heels of multiple warnings from pediatric groups about the need for vitamin D supplementation.

    I'm in the position of telling parents ... "Your child a) probably doesn't need a multi-vitamin, BUT b) probably DOES need added vitamin D, BUT c) not too much, or it may cause serious illness.

    No wonder the public is suspicious of what they're told by medical professionals.

    http://mamasoncall.com

    June 16, 2010 at 14:20 | Report abuse | Reply
  20. Jane

    I work in a lab that does huge volumes of vitamin D testing, both for D2 and D3, and infants 1 year or younger are very difficult to get an accurate read on the levels of vitamin D because they make another compound that shows up in the test the same way vitamin D does, which can lead to false elevations. The lab I work for uses the guidelines that between 25 and 80 ng/mL are "normal" while between 10 and 24 are "mild deficiency" and <10 is "severe deficiency" Over 80 is rare, but can be just as bad, meaning too high a level can cause health problems too.

    June 16, 2010 at 16:18 | Report abuse | Reply
  21. Victoria

    400 IU a day is WAY too little. If a parent is worried they are overdosing, get the Vitamin D levels tested. Once again the FDA is caught making harmful recommendations.

    June 17, 2010 at 00:22 | Report abuse | Reply
  22. Ted Hutchinson

    For many years in Finland it was common practice for babies to receive 2000iu vitamin D3 daily.
    During that time there were no reports of toxicity.

    Intake of vitamin D and risk of type 1 diabetes

    There were no reports of adverse events. What did result was that Type 1 Diabetes incidence was reduced over the next 30yrs by 80%.

    Ideally of course babies should get Vitamin D3 replete breast milk directly from their mother. The free full text online paper More ...
    Circulating 25-Hydroxyvitamin D Levels in Fully Breastfed Infants on Oral Vitamin D Supplementation
    shows this can be achieved if the mother takes 6400iu/daily vitamin D3 and achieves a NATURAL 25(OH)D status around 60ng/ml. 150nmol/l. This is a natural bio marker for human 25(OH)D homeostasis that allows the body to hold a stored reservoir of Vitamin D3 and should be adopted by everyone wanting to prevent chronic illness.

    June 18, 2010 at 04:56 | Report abuse | Reply
  23. Ted Hutchinson

    @ E.C
    There is an article here summarizing the work of Hollis and Wagner showing human breast milk can flow replete with D3 if mothers reserves of vitamin D are adequate.
    Dr. Bruce Hollis' NIH Vitamin D in Pregnancy Study is Now Complete. High Dose Vitamin D (4000 IUs) Significantly Improved Health & Outcomes for Moms and Babies.

    June 18, 2010 at 05:06 | Report abuse | Reply
  24. Ted Hu

    Ted Hutchinson, thanks for monitoring the interwebs and being such a strong advocate of Vitamin D. I try to do the same, and hopefully such efforts will make a difference in people's lives.

    Wrt question at hand, a good rule of thumb is to ingest 1,000 IUs of D for every 25lbs of body weight. Of course get your blood tested to see if you hit the 60ng/ml level in your bloodstream.

    I would have to say that given the Swedish experience of giving infants 2,000 IUs a day, I am going to lean towards the side of giving my child to be at least 1,000 IUs a day, calibrated to his/her body weight.

    That seems only prudent. 400IU sounds dogmatic and not well reasoned. Other than "just because".

    June 28, 2010 at 21:08 | Report abuse | Reply
  25. joseph moss

    Vitamin D3 Supplements:

    NOW Vitamin D softgels supply this key vitamin in a highly-absorbable liquid softgel form. Vitamin D is normally obtained from the diet or produced by the skin from the ultraviolet energy of the sun. However, it is not abundant in food. As more people avoid sun exposure, Vitamin D supplementation becomes even more necessary to ensure that your body receives an adequate supply. Vitamin D3 Supplements on discount at NutroVita.com.

    For more details please visit:
    http://www.nutrovita.com/32760/now-foods/vitamin-d-3-2-000-iu.htm

    July 24, 2010 at 00:35 | Report abuse | Reply
  26. John Haaland

    I wouldn't trust the FDA. Only 400 IUs of vitamin D can be had by seconds of sunlight exposure. Your body can produce over 20,000 IUs in one day if you have strong enough sun exposure. It's remarkably unexplainable why the FDA would only recommend 400.

    August 7, 2010 at 21:28 | Report abuse | Reply
  27. justindylan111

    • The people are loosing their moral while becoming modern. The society needs to be attentive that moral value.
    **********
    justindylan111

    Vitamins for Skin & Hair – Health & Beauty Tips

    November 29, 2010 at 13:24 | Report abuse | Reply
  28. Rachel

    Some parents do need to realize that it is not always healthy to have a infant in the sun most places it is too cold to have your child out and exposed in the sunlight, also sunlight can be damaging to some skin types. I have a fair skin, fair hair, blue eyed baby. I am not exposing her to harsh sunlight. I have to wear spf 50 outside so i don't freckle and burn being fair skinned fair hair and blue eyed myself. Also every mom and there breast milk is different. I live in Alaska, we do not see the sun very much in the winter only 5 hours or less of daylight for months at a time, our cold period lasts from September to May, I am not taking my child out in the sun when it is 15 below outside. Best advice is to trust the pediatrition that you selected to give the best care to your baby.

    December 1, 2010 at 20:52 | Report abuse | Reply
  29. mike

    folks, when it comes to the mother......it does not have to be a guessing game, you can hae it measured via blood test, and then supplement accordingly........go to grassroots health, they have posted a graph, that show almost 4000 members who have supplemented and the corresponding d serum numbers, this blog is depresssing.......TAKE THE TEST, YOU NEED NOT GUESS,
    I can tell you this, most adults who do not spend much time in the sun(Canadians) need atleast 5000iu per day.

    August 19, 2011 at 18:44 | Report abuse | Reply
  30. novak85

    I disagree:
    http://renegadehealth.com/blog/2013/01/18/which-type-of-vitamin-d-supplement-is-best
    Sincerely, Jesse

    October 26, 2016 at 17:41 | Report abuse | Reply

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