400 IU of vitamin D does not help infants much (no surprise)

Vitamin D supplementation in the healthy pediatric population - June 2025

Anales de Pediatría (English Edition) Spanish Association of Paediatrics https://doi.org/10.1016/j.anpede.2025.503874

To review the current scientific evidence on the efficacy of universal vitamin D supplementation in healthy children with no risk factors and to propose updated modifications to the recommendations provided in the main clinical practice guidelines.

Methods

Scoping review through a literature search conducted in PubMed for articles published in English or Spanish in the past 15 years using the following MeSH search terms: (vitamin D) AND (supplementation). The search yielded 2133 articles, of which 22 were selected.

Results

In infants aged less than 1 year without risk factors, administration of 400 IU/day improves serum levels of calcifediol, but most studies have not found an association with improved bone health assessed by dual-energy X-ray absorptiometry.

In children aged more than 1 year with calcifediol levels of less than 35 ng/mL, supplementation with 400 to 800 IU/day of vitamin D decreases the risk of respiratory infection. There is still no evidence in the pediatric population that vitamin D supplementation either decreases the risk or severity of other infections or offers any other clinically significant extraskeletal benefits.

Conclusion

Based on the main clinical practice guidelines, supplementation with vitamin D at a dose of 400 IU/day is recommended for breastfed infants aged less than 1 year or infants who do not achieve the recommended daily intake through infant formula. In children aged more than 1 year, supplementation should be individualized.

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See related in VitaminDWiki

• 400 IU of Vitamin D provided no benefit to children (not a surprise) – RCT March 2018

• Far fewer respiratory track infections in infants and children getting 400 IU of Vitamin D – many studies

• Virtually all infants in Poland got 400 IU of Vitamin D daily (not enough, non-daily is better) – April 2021

• Vitamin D for infants – 100,000 IU monthly is better than 400 IU daily – RCT Oct 2020

• 400 IU of Vitamin D in food provided virtually no benefit to children - March 2018

• Half of infants had less than 20 ng of Vitamin D with 800 IU (need more) – RCT Sept 2022

• Infant Vitamin D – JAMA said 1600 IU, Europe says 1,000 IU upper limit – June 2018