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One is to administer the drops to the infant using a dropper. In fully or partially breastfed infants, there are several methods for providing vitamin D. Caution should be taken to ensure that the appropriate dose is givenĪnd that accidental ingestion of high doses of vitamin D does not occur.Ĭurrently, there is no clinical evidence to support the need for routine vitamin D supplementation for infants who are exclusively formula fed. These highlight the importance of identifying the populations of mothers and infants who are at risk in order to ensure adequate vitamin D intake. Cholestasis is another common problem in high-risk neonates and is associated with long-term use of parenteral nutrition. In preterm infants, absorption of vitamin D may be affected by various disease states, including malabsorptive disorders, such as cystic fibrosis. In the first weeks of life, calcium absorption occurs mainly via paracellular mechanisms that are not dependent on vitamin D. This knowledge has prompted current guidelines to recommend that vitamin D supplementation for infants is initiated as soon as possible. Not surprisingly, neonatal vitamin D status reflects maternal status. Therefore, recommendations for vitamin D intake are made assuming minimal or nonexistent cutaneous production of vitamin D. Although cutaneous production of vitamin D occurs in infants, the use of sunblock and other factors limiting sun exposure make this an unreliable source. Most guidelines recommend 400 IU daily of vitamin D to support bone health in preterm and full-term infants. Inadequate vitamin D in infants leads to poor bone mineralization and increased risk of rickets. Vitamin D is essential for transcellular absorption of calcium and for skeletal health. Focus Vitamin D is a critical nutrient for bone health and needs to be provided to all infants whether via infant formula or as a supplement to breastfed infants or high-dose supplement to their mothers Vitamin D in Preterm and Full-Term Infants Key Insight