Learn about how much vitamin D your child needs, the top vitamin D foods for kids, and how to include them in your child’s diet. 

Worldwide, there’s a high prevalence of vitamin D deficiency, according to The Vitamin D Council and numerous research papers. I’m not surprised. A pediatrician told me that nearly every time he checked a child’s vitamin D status (with a blood draw), it was low. He was located in Vermont.

In my own pediatric nutrition practice, I’ve seen kids with low levels of vitamin D, a history of multiple bone fractures, or diets that have few vitamin D foods. Oftentimes, these kids aren’t taking vitamin D supplements.

In this article, you will learn about the role of vitamin D in children’s health, vitamin D foods for kids, and how to plan meals and snacks to ensure children get enough.

The Sunshine Vitamin

Vitamin D is a fat-soluble vitamin, and known as the sunshine vitamin. When the sun hits your skin it activates the inactive form of the vitamin in the skin. As many kids wear sunscreen (and that’s a good thing), the ultraviolet rays that trigger vitamin D production in the skin may be blocked.

To add to the picture, in the Northern states, the UVB rays are too low in the winter to activate vitamin D in the skin. Generally, populations in the Northern hemisphere get low sun exposure and are at higher risk for a deficiency. 

And don’t forget cloudy skies, the time of day, season, and air pollution, all of which potentially interfere with UV rays reaching the skin.

All this to say, eating a diet rich in vitamin D foods is a main strategy to getting enough of this nutrient.

“…consumption of vitamin D through diet is the most dependable way to ensure adequate intake.” Lisal Folsom, MD, FAAP from the AAP Recommendations on the prevention and management of rickets.  

In this article, you will learn about what this nutrient does, and which foods can help your child get a healthy dose of vitamin D. If you want to dive deeper into this nutrient, read All About Vitamin D for Kids.

How Does vitamin D Help?

Vitamin D is both an essential nutrient and a hormone. For kids, it is crucial for developing strong bones and growth. 

Essentially, vitamin D helps enough calcium get absorbed into the bones, making them harder and stronger. 

It also plays a role in keeping the immune system strong, improves mood, and has some evidence for protecting against certain cancers, respiratory illness, heart disease, neurodegenerative diseases, and both type 1 and type 2 diabetes.

How Does Deficiency Impact Health?

When children don’t get enough vitamin D from a combination of food, supplementation and sunshine, they can become deficient. 

A deficiency is evaluated by using a blood test. Your pediatrician will draw blood and send it to a lab. The lab will report the level as 25-hydroxy Vitamin D (25OHD). 

• Vitamin D deficiency is a value of less than 12 nanograms/mL (or <30 nmol/L).
• Insufficiency is a value of 12-20 nanograms/mL (or 30-50 nmol/L)

There are several conditions children may experience when they are deficient, but the most common are:

• Rickets, a bone disease that causes softening of bone, malformation, and bowed legs. The U.S. incidence of rickets is 24 cases per 100,000, according to the AAP. This level is higher than other developed countries, including the UK and Canada. Children with darker skin, and those who are breastfed are at the highest risk for rickets and impaired bone development. 
• Bone fractures, which may be due to weakened bones. Studies have shown that children who are deficient or who have low intake of vitamin D are at higher risk for bone fractures.  Furthermore, bone fractures are more severe in deficient children.

 Certain factors place children at higher risk for low vitamin D levels, including: 

• Dark skin pigmentation 
• Lack of vitamin D supplementation in babies who exclusively drink breast milk and in formula-fed babies under a year of age who aren’t supplemented 
• Babies whose mothers had vitamin D deficiency  
• A diet low in calcium and D
• Living in the northern part of the United States
• Regular sunscreen use or sun protection with clothing when outside 

How to Prevent a Deficiency

In addition to safe sunshine exposure, two other ways to ensure your child gets enough of this nutrient are optimizing the diet and the addition of vitamin D supplementation.

Let’s dive into vitamin D foods because this is something you can take action on right away.

The Recommended Dietary Allowance for Kids 

The following are recommendations for vitamin D in infants and children:

• Babies under the age of 1 year need 400 IU of vitamin D each day. 

• Breastfeeding moms need to provide their babies with a vitamin D supplement. Generally, vitamin D drops are prescribed shortly after birth for breastfeeding babies. Talk with your doctor if your baby isn’t on a supplement.

• Formula-fed babies get this nutrient in the formulation, however, until a baby turns 12 months, they may not get enough. Your baby should be drinking 1 liter of infant formula per day to get the full amount of vitamin D from baby formula. I cover the details of this in my book, The Smart Mom’s Guide to Starting Solids. It’s a good idea to talk with your pediatrician about a daily supplement.

• Children from age 1 to 18 years need 600 IU per day. Adults need the same amount.

Top Food Sources with Vitamin D

Only a few foods contain a natural source of vitamin D:  

• mushrooms
• egg yolks
• fatty fish 

Several foods are fortified with vitamin D:

•  milk and some dairy products like yogurt
• ready-to-eat breakfast cereals
• fortified juices, like orange juice

You’ll generally find two forms of vitamin D in foods: D2, found in plant foods, and D3 primarily found in animal foods.

Vitamin D Milk

Vitamin-D fortified milk is the main food source of vitamin D for Americans. Generally, there’s about 100-125 IU per cup of milk.

In the US, fluid milks can be fortified with vitamin D, however, the fortification is not mandated at the federal level. Most fortification mandates are done at the state level. 

In the 1930’s, rickets was rampant among poor children, particularly in the Northern states. The U.S. government started fortifying milk in an effort to eradicate this bone disease in children. Sadly, recent studies suggest a rise in the occurrence of rickets in children.

Mushrooms 

Mushrooms can make nutritionally relevant amounts of vitamin D when exposed to sunlight or a UV lamp. They are a good source of vitamin D for everyone, but especially for vegetarian and vegan children.

Fatty Fish

Oily fish are naturally good sources of vitamin D. Look for salmon, tuna, mackerel, sardines, and products made from fish, like cod liver oil.

[Read: 5 Ways to Get Your Child to Eat More Fish]

D-fortified Eggs & Orange Juice

Some packaged foods have been fortified with the sunshine vitamin. For example, many ready-to-eat breakfast cereals are enhanced with vitamin D. Eggs and vitamin D-fortified orange juice are another food source.

In the alternative milk category, nearly all beverages, such as rice, almond, and oat are fortified with vitamin D as well as other nutrients like calcium.

[Read: 5 Surprising Things to Know about Alternative Milks] 

Does Yogurt have vitamin D?

Yogurt is not typically fortified with vitamin D, much to the average consumer’s surprise. Increasingly, yogurts are fortified with vitamin D, however. Read the label and aim for a Daily Value (DV) of 20% or higher. 

[Read: How to Choose the Best Kids Yogurt]

Vitamin D Meals for Kids 

I’ve put together a sample meal plan to help you visualize what adequate vitamin D foods in your child’s daily diet might look like. 

What do you notice?

I hope you can see it’s possible to achieve an adequate amount of vitamin D from food. There are some key foods that anchor this meal plan. Milk is one food that contributes quite a bit of vitamin D. A serving of milk at each meal provides 300 IU, or half of a child’s daily needs. 

Eggs, fortified cereal and orange juice, and salmon provide the rest of a child’s vitamin D needs with this meal plan.

Simple Ways to Increase Vitamin D Foods for Kids

1. Serve milk or a fortified alternative with every meal.
2. Choose ready-to-eat breakfast cereals that pack a punch of vitamin D.
3. Offer fish like salmon and tuna twice a week.
4. Choose vitamin D-enhanced eggs and vitamin D-fortified orange juice when shopping. 

What if my child is lactose intolerant?

You can still get a good source of vitamin D from lactose-free milk. The amount of vitamin D included is the same as regular milk.

[Read: The Ultimate Guide for Lactose Intolerance in Children]

What if my child is allergic to milk?

If your child has a milk allergy, you’ll need to consider a milk alternative like soy milk or oat milk that’s fortified with vitamin D. Read the label to see amounts of vitamin D (20% DV or higher is ideal).

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