Vitamin D in winter: does my child need a supplement?
In Sweden the skin makes no new vitamin D from the sun during the winter half of the year, so food matters more now (Rikshandboken). The recommended intake for children is 10 micrograms a day (Livsmedelsverket). The Swedish Food Agency does not recommend a supplement for every child: it recommends 10 micrograms (400 IU) a day for children who do not eat fish, do not eat foods with added vitamin D, wear clothes that cover the face, arms and legs, or are not out in the sun in summer (Livsmedelsverket). Do not give more than 50 micrograms a day in total at ages 1–10, or 100 micrograms from age 11 (Livsmedelsverket).
| Situation | Vitamin D supplement per day | Source |
|---|---|---|
| Eats fish and foods with added vitamin D, and is out in the summer sun | No supplement recommended | Livsmedelsverket |
| Does not eat fish | 10 micrograms (400 IU) | Livsmedelsverket |
| Does not eat foods with added vitamin D, such as milk, yoghurt, plant drinks or spreads | 10 micrograms (400 IU) | Livsmedelsverket |
| Wears clothes that cover the face, arms and legs, or is not in the sun in summer | 10 micrograms (400 IU) | Livsmedelsverket |
| Covering clothes or no summer sun, and also no fish and no foods with added vitamin D | 20 micrograms (800 IU) | Livsmedelsverket |
| Upper limit, all sources together | Ages 1–10: 50 micrograms. From age 11: 100 micrograms | Livsmedelsverket, NHS |
Why children need vitamin D
The body needs vitamin D, among other things, to absorb calcium and build bones and teeth (Livsmedelsverket). A long-term lack can cause rickets in children, which shows as soft and misshapen bones. Severe deficiency can cause cramps, but this is very unusual in Sweden (Livsmedelsverket).
Sun in summer, food in winter
In summer, sun on the skin is the main source. In June and July, about a quarter of an hour outdoors in a T-shirt and shorts two to three times a week is enough, also for children with dark skin, although darker skin needs a little longer (Livsmedelsverket). Avoid getting sunburnt (Livsmedelsverket).
Vitamin D is stored in the body, so a sunny summer covers part of the winter need (Livsmedelsverket). But at Swedish latitudes no new vitamin D is made from sunlight in the winter half of the year, which is why food and, if needed, a supplement matter (Rikshandboken).
Advice varies between countries. In the UK, the NHS advises everyone to consider 10 micrograms a day in autumn and winter (NHS).
Foods with vitamin D
In Sweden, milk, fil, yoghurt and plant-based alternatives with up to 3 percent fat, as well as spreads, must have vitamin D added. Butter and cooking oil do not have to, and milk powder is usually not fortified. Check the ingredients list (Livsmedelsverket).
- A child portion of salmon: about 7 micrograms
- 1 egg: about 2 micrograms
- Fortified milk or plant drink: about 1 microgram per decilitre
- Fortified fil or yoghurt: about 1 microgram per decilitre
- Fortified spread: about 2 micrograms per 10 grams
Figures from Livsmedelsverket. Fish two to three times a week is a good goal, and children who do not eat fish need a supplement instead (Livsmedelsverket).
Giving a supplement safely
- Check the dose: 10 micrograms is the same as 400 IU. Check how much your supplement contains (Livsmedelsverket).
- Most important in winter: a supplement matters most in the winter months. A child who is out in the sun can pause from May to August (Livsmedelsverket).
- Count everything: the upper limit is 50 micrograms a day for ages 1–10 and 100 micrograms from age 11 (Livsmedelsverket, NHS). Large amounts of vitamin D are toxic and can lead to too much calcium in the blood and damage to the kidneys (Livsmedelsverket).
- Food and sun are safe: it is not possible to get dangerous amounts from food (Livsmedelsverket) or from sunlight (NHS).
- No routine blood tests: Swedish paediatric guidance does not recommend routinely testing vitamin D levels in healthy children who are growing normally (Svenska barnläkarföreningen).
Try this week
- Look at a normal week: does your child eat fish two to three times and fortified milk, yoghurt, plant drink or spread on most days?
- If not, choose a vitamin D product with 10 micrograms (400 IU) per daily dose and make it part of breakfast during the winter.
- Read the labels of every supplement your child takes and add up the vitamin D, so the total stays well below the upper limit.
When to get help
Talk to your health centre, or the school nurse, if your child eats a very limited diet or if you are unsure whether they need a supplement. If a doctor recommends a different dose, follow their advice (NHS). For medical advice in Sweden, call 1177. Read more about everyday food in our guide what should my school-age child eat?