In Reply.—We thank Dr Blandino for the letter and the opportunity to clarify the two points that he addresses. Vitamin D supplementation may not be necessary for those infants who are breast-fed for 6 months or less,1,2 whose mothers have either adequate stores or synthesis or intake of vitamin D while breast-feeding,3 and who receive adequate exposure to sunshine.4 Although we recommended vitamin D supplementation for all breast-fed black infants, in practice, we supplement the recommended dosage of vitamin D in all breast-fed infants.
An intake of 400IU of vitamin D is the standard recommended daily allowance for infants for prevention of rickets.5,6 The Food and Nutrition Board of the National Academy of Science also recommends 400 IU of vitamin D daily for children up to age 18 years.6 An intake of 400 IU of vitamin D is safe, nontoxic, and appropriate.5,6 In fact, as little as 100 IU of vitamin D may prevent rickets.6
BHOWMICK SK, JOHNSON KR, RETTIG KR. Call for Clarification of Vitamin D Recommendations-Reply. Am J Dis Child. 1992;146(1):14. doi:10.1001/archpedi.1992.02160130016011