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In Reply.—Dr Adelman's letter reminds us that nutritional rickets is encountered frequently in developing countries when breast-fed infants are deprived of sunlight and vitamin D supplements. As we noted in our article, most reports of nutritional rickets in the United States have been from the northeast, where seasonal sunlight variations remain a risk factor, especially for black breast-fed infants who are not given vitamin D supplements. To prevent this occasional nutritional deficiency, it seems reasonable to recommend vitamin D supplementation for all nursing infants.
STEIN M. Nutritional Rickets-Reply. Am J Dis Child. 1988;142(4):414. doi:10.1001/archpedi.1988.02150040064010