CLINICAL REPORT Prevention of Rickets and Vitamin D Guidance for the Clinician in Rendering Pediatric Care Deficiency in Infants, Children, and Adolescents

Rickets in infants attributable to inadequate vitamin D intake and decreased www.pediatrics.org/cgi/doi/10.1542/ exposure to sunlight continues to be reported in the United States. There are peds.2008-1862 also concerns for vitamin D deficiency in older children and adolescents. doi:10.1542/peds.2008-1862 Because there are limited natural dietary sources of vitamin D and adequate All clinical reports from the American sunshine exposure for the cutaneous synthesis of vitamin D is not easily Academy of Pediatrics automatically expire determined for a given individual and may increase the risk of skin cancer, the 5 years after publication unless reaffirmed, recommendations to ensure adequate vitamin D status have been revised to revised, or retired at or before that time. include all infants, including those who are exclusively breastfed and older The guidance in this report does not children and adolescents. It is now recommended that all infants and children, indicate an exclusive course of treatment or serve as a standard of medical care. including adolescents, have a minimum daily intake of 400 IU of vitamin D Variations, taking into account individual beginning soon after birth. The current recommendation replaces the previous circumstances, may be appropriate. recommendation of a minimum daily intake of 200 IU/day of vitamin D