Overview

It’s finally that time of year again, Spring – when the sun will again grace us with its presence. And as it makes its glorious comeback, many of us will wisely keep a bottle of sunscreen close at hand. After all, overexposure to sun could lead to some pretty serious health consequences. But what about underexposure?

Sunlight is the primary source of Vitamin D, a fat-soluble vitamin involved in many biological processes in the human body. It’s most known for its role in bone health, which is particularly important during childhood and adolescence since bones are developing during this time. But recently, research has taken more notice of its additional roles in immune health, prevention of chronic illness, and decreasing risk of adverse outcomes during pregnancy.

Vitamin D is pretty important stuff! But unfortunately, it can be a bit tricky to get enough of it, especially for African Americans. So, this nutrient may need a little more attention. And since we parents are responsible for the “what” of feeding, knowing a bit about it can help us provide opportunities for our children to get enough. 

A Sunny Debate Among Scientists

It may surprise you to learn that there’s currently some pretty heated debate around sun exposure recommendations. After all, the link between sun exposure and skin cancer is well-documented. As I mentioned earlier, however, information regarding the role of Vitamin D is ever-expanding (evidence increasingly suggests that deficiency may even affect severity of COVID-19 symptoms). So, like all things science, recommendations are ever-changing.

Here’s what is certain: too much exposure to sun (burning, etc.) is not good for us. What’s less certain is how much is enough? Some experts maintain a cautious approach, insisting that, based on current evidence, unprotected sun exposure isn’t worth the risk. Others believe it may be time to rethink our message about sunlight.

Because several factors affect Vitamin D synthesis with sun exposure (such as skin tone and UV index) nailing down a recommendation for sun exposure is very difficult. Most advocates of “sensible sun exposure” recommend getting short stints of sun and protecting skin before it has a chance to burn during the Spring and Summer months. Keep in mind, however, that skin tone is an important factor in determining how long the window of exposure before causing damage to the skin – so children with darker pigmentation may need more than children with a lighter complexion. 

Vitamin d before 6 months

Sunscreen isn’t safe for babies under 6 months old. And of course, their new skin is particularly sensitive. That’s why it’s recommended that infants 0-6 months be kept out of direct sunlight completely. So, how do they get Vitamin D? The simple answer is supplementation. There are, however, some key differences in Vitamin D between formula-fed and breastfed babies.

Infant formulas are fortified with Vitamin D, but depending on intake, it may not be enough. If you are formula-feeding, your child’s pediatrician can help determine Vitamin D needs based on your child’s intake.

Conventional advice for breastfed infants is to provide a Vitamin D supplement for baby until cow’s milk (or alternative) can be started at 12 months old. Some recent evidence, however, has shown that high doses of maternal Vitamin D supplementation may be enough to provide adequate levels of Vitamin D for both mom and baby – because mom’s health is important too!

Regarding supplements: I will say this one time… and then many more times throughout this post. Always, always discuss supplements with your pediatrician before giving them to your child. 

Vitamin D and Milk

Some foods are fortified with Vitamin D. While a few other foods, such as cereals and yogurts, may also have some added amounts of Vitamin D, the most notable source here is milk (as well as many milk alternatives).

Fortified foods are great for helping to meet daily Vitamin D needs! That is to say, milk alone won’t get you to the recommended 600 IUs (for ages 1-71). Why? Because the recommendation for total intake of dairy is between 1 & 2/3 to 3 servings per day (depending on age). Notice I said dairy. Cheese (which is typically low in Vitamin D) counts here. A glass of milk contains about 100 IU per day, so (for you folks who don’t eat cheese – not us!), milk contributes about 165 to 300 IUs of Vitamin D per day at best. 

So, just drink even more milk, you might say. Listen folks, dairy is a wonderful thing. But all things in moderation. In fact, too much dairy can be quite problematic, especially for children. Most notably, children who consume too much dairy are at risk for iron deficiency, which is particularly important since iron is crucial for cognitive development. Why? For two key reasons:

1. Dairy is a poor source of iron.
2. Milk and milk products are fairly high in protein, so too much of these foods leave little room for foods that are a significant source of iron.

In other words, milk (and other fortified foods) will likely only get you part of the way there.

Natural Food Sources 

Remember, sunlight is the primary source of Vitamin D. Therefore, few foods contain significant amounts of this nutrient. There are, however, a few exceptions worth mentioning. Those are:

• Trout: 645 IUs
• Salmon: 570 IUs
• Sardines: 46 IUs
• Eggs: 44 IUs
• Tuna: 40 IUs
• Some mushrooms (amount varies)

As you can see, the list is small. And a lot of these foods contribute just a minimal amount of Vitamin D to overall intake. They can certainly be helpful for aiding in meeting Vitamin D needs, but eating these foods alone will not be sufficient for achieving optimal Vitamin D status for health. 

A Note About Supplements

Sometimes you need a little help meeting your (or your child’s) nutrient needs – and that’s ok! At the end of the day, “healthy” looks a little different for everyone. Remember that your primary mission here is fostering a positive relationship with food. If supplements are needed to get you there (even if temporarily), then feel free to take a second to pause in celebration of medical science.

But if you are considering supplements for your child, keep in mind that supplements are a medication with the potential to become toxic if given at high doses. So, always, always consult your child’s pediatrician before starting any new medicines, including supplements. 

A Ray of Sunshine at the End

Here’s what I’m not saying: it’s time to ditch the sunscreen. Since sun damage can be particularly harmful in early life, skin protection for your child is irrefutably important.

Personally, our family likes to practice what we (and some vitamin D researchers) call “sensible sun exposure”. Our daughter, for example, is very fair – so it should be pretty easy for her to make Vitamin D. We don’t let her play outside on a sunny day without sunscreen for more than a few minutes. My “first born” (my sister who is significantly younger than I am), however, is blessed with a beautiful tan complexion and doesn’t burn easily. We tend to let her play outside for 20 minutes or so before we apply sunscreen. And when fall starts, we are more mindful of fortified and natural Vitamin D sources.

But perhaps you prefer a more cautious approach when it comes to sun exposure. Maybe your family wears more clothing due to cultural or religious customs. Perhaps your family does not consume dairy. Nutrition is flexible and must fit into your family’s lifestyle. Your child’s Vitamin D status may, however, just need a little more attention – even when the weather is sunnier. Choose foods naturally higher in Vitamin D as well fortified foods to include in your child’s diet (always check the label – not all orange juices, for example, are fortified). And of course, if supplements are needed to meet your child’s requirements, always discuss medications with your pediatrician first.

Regardless of how your child gets Vitamin D, outdoor play is beneficial for both children and adults. And it’s, well, FUN. So, on the next sunny day, gather up your family and get outside. Plan a picnic. Take a walk. Whatever you do, share a little sunshine… and a lot of smiles.