Vitamin D

These instructions are for Children's Hospital of Philadelphia (CHOP) patients to learn about Vitamin D given as a dietary supplement.

Important information about vitamin D:

• Learn more about Vitamin D.

• Vitamin D is a fat-soluble vitamin. The fats in foods help these vitamins to be absorbed in our gut. Vitamin D is found in some foods, but our main sources of vitamin D come from supplements (tablets, capsules, or liquids) and the sun.

• Vitamin D helps your body absorb calcium. All children need vitamin D to grow and to have healthy bones and teeth. Vitamin D is also important in maintaining the health of our muscles and our immune system. Studies show that vitamin D plays a role in decreasing the risk of many chronic diseases, such as arthritis, cancer, diabetes and high blood pressure.

• Vitamin D dosing depends on your child's health. Recommended vitamin D doses are:

  • Healthy infants 1 year of age or younger: 10 mcg (400 units) daily

  • Healthy children older than 12 months of age: 15 mcg (600 units) daily

  • Children with medical conditions may need extra vitamin D

• If your child does not get enough vitamin D from what they eat and drink, a Vitamin D supplement can help. Your healthcare provider will tell you how many micrograms (mcg) or units of supplemental vitamin D to give your child each day.

Important information about vitamin D supplements:

• There are two forms of vitamin D found in foods and supplements.

  • Vitamin D2 (ergocalciferol): available by prescription or as an over-the-counter product.

  • Vitamin D3 (cholecalciferol): available as an over-the-counter product.

  • Some over-the-counter vitamin D supplements may contain other vitamins or minerals. Contact your healthcare provider before using these supplements.

• Product labels for vitamin D supplements show the strength and concentration in micrograms (mcg) instead of units (IU). Note that 10 mcg of vitamin D is equivalent to 400 units.

• If your child is following a specific diet, carefully read the label to identify ingredients that you need to avoid. If you still have questions about the product, contact your healthcare provider.

• Vitamin D supplements can be found at your local pharmacy in the vitamins and minerals section.

• If the supplement is not available at your pharmacy, you may need to buy it on the internet. Speak with your healthcare provider before ordering any vitamin D supplements from the internet.

• Products that are "USP verified" are preferred when available to ensure product quality.

  • https://www.quality-supplements.org/verified-products/verified-products-listings

• If a USP verified product is not available, here is a list of other vitamin D supplements by website you may consider:

  • http://www.bioticsresearch.com

  • http://www.carlsonlabs.com

  • https://www.enfamil.com/products/enfamil-d-vi-sol-drops

  • https://www.nordicnaturals.com [Vegan D3 option available]

  • http://www.puritan.com

  • https://www.pureencapsulations.com [Vegan D3 option available]

  • https://vitaminddrops.com/us-en [Vegan D3 option available]

Follow these instructions for giving vitamin D supplements:

• All products: give with food to improve how it is absorbed into the body.

• Liquid products: carefully read the concentration of your home product. This will determine how much medicine volume you will need to give your child's prescribed dose.

• Use the label to find how many micrograms (mcg) of medication are in the "Amount Per Serving" section.

  1. Look at the package label to find the concentration (mcg per ml OR mcg per drop).

  2. Then use the label to find how many milliliters (mL) or drops the "Serving Size" is. "Amount Per Serving" divided by the "Serving Size" will be the concentration.

• If the concentration of your liquid product doesn't match what your healthcare provider recommended, contact them to clarify how to give your child's dose.

• Pay attention to how your vitamin D liquid product is packaged:

  • Bottle with dropper tip: if your child's dose does not round to a full drop, contact your healthcare provider for other options. You may be able to remove the dropper tip and draw up your child's dose in an oral syringe instead.

    • 
      Bottle with dropper tip

      Doses given by mouth:

      • Place the prescribed number of drops in a small volume of water, milk, or soft food. Do not mix with other medicines. Make sure your child takes the entire mixture so they get the full dose.

      • Avoid dropping directly into your child's mouth to avoid giving more than intended.

      • For infants, place the prescribed number of drops on a clean fingertip, pacifier, or mother's nipple for the infant to suckle for 30 seconds.

    • Doses given by feeding tube:

      • Mix the prescribed number of drops in 1-2 mL of water or milk, then draw up the total volume into an oral syringe.

      • Give medicine through feeding tube as you have been taught.

  • 
    Bottle with
    dropper syringe

    Bottle with dropper syringe:

    • Doses given by mouth:

      • Only use a dropper syringe if it comes packaged for use with your vitamin D product.

      • Tilt the dropper syringe toward the inside of your child's cheek to gently give the dose.

    • Doses given by feeding tube:

      • A dropper syringe cannot be used with a feeding tube. You can request an oral syringe from your local pharmacy to measure your child's dose instead (see "Bottle with oral syringe").

  • Bottle with oral syringe: If your child's prescribed dose is smaller than 0.05 mL of volume, this is too small to correctly measure with an oral syringe. Please talk to your healthcare provider about a different product that will allow you to measure your child's dose accurately.

    • 
      Bottle with oral syringe

      Doses given by mouth:

      • Use the smallest size oral syringe that fits your child's full dose.

      • Tilt the oral syringe toward the inside of your child's cheek to gently give the dose.

    • Doses given by feeding tube:

      • Use the smallest size oral syringe that fits your child's full dose.

      • Give medicine through feeding tube as you have been taught.

Additional information about foods that provide vitamin D:

• Pink salmon, canned, 3 ounces: 13.25 mcg (530 units)

• Tuna, canned, 3.5 ounces: 5.75 mcg (230 units)

• Fortified milk, 8 ounces: 2.5 mcg (100 units)

• Fortified orange juice, 8 ounces: 2.5 mcg (100 units)

• Infant formulas, 8 ounces: 2.5 mcg (100 units)

• Fortified yogurts, 8 ounces: 2.5 mcg (100 units)

• Fortified cheeses, 3 ounces: 2.5 mcg (100 units)

• Fortified breakfast cereals, 1 cup: 1 mcg (40 units)

• Egg yolk, 1 large: 0.5 mcg (20 units)

*Listed values are examples. Actual vitamin D content may vary between different products and brands.

Call your CHOP healthcare provider with any questions or concerns.

Reviewed on May 1, 2022, by Susan Ramsey, PharmD, BCPPS