Peninsula Pediatrics

Category: Preventive Care

Vitamin D for Children

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Vitamin D is an essential nutrient that plays a significant role in helping children grow and stay healthy. It helps the body absorb calcium, which is needed to build strong bones and teeth. Without enough vitamin D, children can develop weak or soft bones, including a condition called rickets. Vitamin D also supports muscle function and overall health from infancy through the teen years.

Quick answer: Babies under 12 months need 400 IU of vitamin D daily and older children and teens need 600 IU. Since breast milk and diet alone often fall short, supplements are sometimes needed. More is not always better, so follow your pediatrician’s guidance.

Why do children need vitamin D?

Vitamin D helps the body absorb calcium to build strong bones and teeth, and it supports muscle function and overall health. Without enough, children can develop weak or soft bones, including rickets. It remains important throughout childhood and adolescence.

How much vitamin D do children need?

According to the American Academy of Pediatrics, babies younger than 12 months need 400 IU of vitamin D daily, while toddlers, older children, and teens need 600 IU each day. Breast milk alone usually does not provide enough vitamin D, so it is recommended to give breastfed babies a supplement shortly after birth. Babies who drink at least 32 ounces of vitamin D-fortified formula each day do not need extra, but those drinking less may still need supplementation.

How can children get enough vitamin D?

Children get vitamin D from a combination of food, supplements, and sunlight. Food sources include fatty fish, egg yolks, shiitake mushrooms, milk, and some cereals and juices. Sunlight also helps the body make vitamin D, but the amount depends on skin tone, sunscreen use, clothing, weather, season, and time outdoors. Because excessive sun exposure can damage skin, babies younger than six months should be kept out of direct sunlight, and older children should continue practicing sun safety.

Why does vitamin D matter for teens?

Teens experience rapid growth and bone development during puberty, but many do not get enough vitamin D. Spending more time indoors, using sunscreen regularly, or drinking less fortified milk can lower levels. Teens who are deficient may feel fatigue, muscle weakness, or bone discomfort. Encourage a well-balanced diet and a daily supplement if recommended by the pediatrician.

Can a child get too much vitamin D?

While vitamin D is needed, more is not always better. Taking excessive amounts of supplements can lead to problems such as kidney stones or other complications. Always follow dosing instructions and talk with your pediatrician before starting supplements beyond the recommended amounts. Remember that many foods and multivitamins already contain vitamin D, so consider the total amount your child receives each day.

Frequently asked questions

How much vitamin D do children need?

According to the American Academy of Pediatrics, babies younger than 12 months need 400 IU of vitamin D daily, while toddlers, older children, and teens need 600 IU each day.

Do breastfed babies need a vitamin D supplement?

Breast milk alone usually does not provide enough vitamin D, so it is recommended to give breastfed babies a vitamin D supplement shortly after birth. Partially breastfed babies may also need supplementation.

How can children get enough vitamin D?

Children get vitamin D from a combination of food, supplements, and sunlight. Food sources include fatty fish, egg yolks, shiitake mushrooms, milk, and some fortified cereals and juices. Because few foods naturally contain it, supplements are sometimes needed.

Can a child get too much vitamin D?

Yes. More is not always better. Taking excessive amounts can lead to problems such as kidney stones, so always follow dosing instructions and talk with your pediatrician before starting supplements beyond the recommended amounts.

If you have questions about whether your child is getting enough vitamin D or whether supplementation may be appropriate, please call our office. Peninsula Pediatrics proudly cares for families across the Rockaways.

Why We Don’t Routinely Test for MTHFR Gene Variants or Heavy Metals

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Quick answer: Pediatricians at Peninsula Pediatrics do not routinely recommend MTHFR gene variant or heavy metal testing in children. MTHFR variants are common, usually cause no symptoms, have no specific treatment, and knowing your status does not change medical care. Following AAP guidance, these tests are not recommended for most kids.

As parents, it’s natural to want the best for your child’s health. You may have heard about MTHFR gene variants or heavy metal testing and wondered whether your child should be tested. There is a lot of information online and in adult medicine, sometimes parents are tested, and it can be confusing.  As pediatricians, we do not routinely recommend these tests, and here’s why.   Understanding MTHFR Gene Variants   MTHFR (methylenetetrahydrofolate reductase) is a gene that helps the body process folate (Vitamin B9), which is essential for cell growth and metabolism. Everyone has two copies of this gene, and variations in the gene are common—about 40% of people have one. A variant may slightly decrease the body’s ability to process folate, but in most cases, the body still processes enough for normal function.   Most people with an MTHFR variant do not experience any symptoms or health issues, which is why routine testing is not useful. There is no specific treatment for having an MTHFR variant, and knowing your status does not change medical care. The more meaningful test, if someone has concerning symptoms, is a homocysteine level, as MTHFR-related issues only become relevant if homocysteine is elevated. However, this is still very rare in children.   Should my child be tested for MTHFR Gene Variants? Based on guidance from the American Academy of Pediatrics (AAP), MTHFR testing is not recommended in children because it does not provide useful or actionable medical information for children. Variations in the MTHFR gene are very common in the general population and, by themselves, do not cause disease. Knowing whether a child has an MTHFR variant does not change medical management, does not predict health problems, and does not guide treatment. Research in pediatrics has shown that MTHFR variants are not a cause of developmental delays, behavioral concerns, anxiety, ADHD, autism, or most other medical symptoms. They also do not reliably predict blood clot risk in children. Because of this, testing can create unnecessary worry without providing any information to help a child. We specifically recommend not testing for MTHFR in children, even when parents have been tested or when there is a family history and instead we focus on symptoms that a child does have and things we can test or do that are helpful and guide us to decisions that can benefit children. Additionally, even when an MTHFR variant is present, children with a normal diet do not need special supplements or treatment beyond standard age-appropriate nutrition. Should I Give My Child More Folate?   If your child has no symptoms or folate deficiency, there is no need to supplement with extra folate as a precaution. A well-balanced diet that includes vegetables, fruits, whole grains, lentils, beans, and fortified cereals provides enough folate for healthy development. If your child is ever found to be deficient, your pediatrician will guide you on the right approach.   Heavy Metals and Children’s Health   Heavy metal exposure can be concerning, but routine testing for metals like mercury, arsenic, and cadmium is not recommended unless there is a clear risk factor or symptoms. These exposures are rare, and our daily environment contains only trace amounts that the body naturally eliminates.   To reduce unnecessary exposure, parents can take simple precautions:  
  • Wash fruits and vegetables thoroughly.  
  • Avoid excessive fruit juice consumption, as some juices have been found to contain small amounts of heavy metals.  
  • Provide a variety of foods to prevent overexposure to any single source.  
  • Ensure your drinking water is safe by checking with your local health department.  
  Heavy Metals in Vaccines   Some parents worry about heavy metals in vaccines, but routine childhood vaccines do not contain harmful levels of heavy metals. Thimerosal, a mercury-based preservative, was removed from most vaccines in the early 2000s, and the trace amounts used in some multi-dose flu vaccines (our office uses single dose prefilled syringes) have not been shown to cause harm. The benefits of vaccines in preventing serious diseases far outweigh any theoretical risks from minimal exposure.   Lead Exposure and Testing   Unlike other heavy metals, lead exposure remains a real concern in certain situations. Children are routinely tested for lead exposure at 1 and 2 years old, or later if they are at risk. Risk factors include:  
  • Living in a home built before 1978 with chipping or peeling paint.  
  • Using imported pots, pans, or toys that may contain lead-based coatings.  
  • Having a caregiver who works in jobs with lead exposure, such as construction or battery manufacturing. 
If you are concerned about lead in your home, talk to your pediatrician about testing and prevention strategies.   Final Thoughts   We understand that navigating health information can be overwhelming, and we are here to support you. While MTHFR variants and heavy metals are widely discussed online, routine testing is not needed in most cases. If you ever have concerns about your child’s health, we encourage you to reach out. We are always happy to discuss evidence-based guidance to help your child grow up healthy and strong.

Frequently asked questions

What is the MTHFR gene?

MTHFR (methylenetetrahydrofolate reductase) is a gene that helps the body process folate, or vitamin B9, which is essential for cell growth and metabolism. Everyone has two copies, and variations are common, with about 40 percent of people having one.

Should my child be tested for MTHFR gene variants?

Based on guidance from the American Academy of Pediatrics, routine MTHFR testing is not recommended. Most people with a variant have no symptoms, there is no specific treatment, and knowing your status does not change medical care.

Is there a more meaningful test?

If someone has concerning symptoms, a homocysteine level is the more meaningful test, since MTHFR-related issues only become relevant if homocysteine is elevated, which is still very rare in children.

Related reading: What to Know About Tylenol, contact our office. Peninsula Pediatrics proudly cares for families across the Rockaways.

Why Vaccines Matter

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As parents and caregivers, we want to keep our children healthy and safe from illnesses, especially life-threatening ones. Although there’s been a lot of recent noise about vaccine safety, medical science and pediatric experts remain clear that vaccination is safe and the most effective way to protect kids from serious illnesses. Extensive studies on vaccines and their potential risks find that recommended vaccines are safe for children and adolescents and are not associated with diabetes, infertility, autism, or any other developmental delay. Large-scale studies conducted in multiple countries over many years have found no credible link between life-saving childhood vaccines and autism. The original study that claimed a connection was retracted due to faulty data. 

Scientific evidence also shows that vaccines do not cause Sudden Infant Death Syndrome (SIDS). While many vaccines are given at ages when SIDS risk is naturally higher, research confirms there is no causal relationship. In fact, some data suggest vaccines may even help reduce the risk of SIDS. Every vaccine undergoes strict testing before it’s offered to children. After approval, it continues to be monitored closely for safety through systems like the Vaccine Adverse Event Reporting System (VAERS). This ongoing surveillance helps catch rare side effects and ensures ongoing confidence in vaccine safety. It’s also important to remember that mild side effects, such as a sore arm or low-grade fever, are normal signs that the body is building protection. More serious adverse events are extremely rare, and pediatricians are trained to respond quickly if they occur.

The American Academy of Pediatrics (AAP) encourages following the recommended immunization schedule for children, which is based on the most recent scientific data. Starting with newborns, it’s recommended to give your infant their first dose of the hepatitis B vaccine before leaving the hospital, to protect against a virus that can lead to serious liver disease. Over their first six months, your baby will begin receiving additional vaccines, often around the 2-month checkup, including vaccines for rotavirus, DTaP (diphtheria, tetanus, pertussis), Hib (Haemophilus influenzae type b), polio (IPV), and pneumococcal disease. These early doses are critical because they protect infants during a time when their immune systems are still catching up. During this same window, babies can also receive medication to prevent respiratory syncytial virus (RSV), a leading cause of hospitalization in infants. Parents who are pregnant during RSV season may receive a vaccine to help protect their baby after birth. 

Starting at 6 months, it is recommended that children get the annual flu vaccine, which is recommended for everyone over 6 months old. Even healthy kids can develop complications from influenza, and yearly vaccination helps reduce severe illness. The COVID-19 vaccine is also recommended for children beginning at 6 months, as young children are at higher risk of hospitalization from COVID. Both vaccines are safe and effective, and they can often be given at the same visit as other scheduled vaccinations. 

As your child reaches 12 to 15 months, it is recommended that they receive vaccines to protect them from MMR (measles, mumps, rubella), varicella (chickenpox), and hepatitis A and get booster doses of earlier vaccines. These prevent illnesses that can cause serious complications, from pneumonia and brain swelling to liver disease. Before starting school, children should receive boosters for DTaP, polio, MMR, and varicella to keep their immunity strong. By this age, your child’s immune system has learned to fight off up to 16 preventable diseases, thanks to the vaccines they’ve received since birth. Staying on schedule not only protects your child but also helps prevent outbreaks in schools and communities.

Parents often wonder why vaccines are timed so specifically. The answer is that years of research show vaccines work best at certain ages and intervals. Following the schedule helps your child’s body build lasting protection during the periods when they are most at risk. Pediatricians keep careful track of each vaccine and can help you catch up if your child ever falls behind.

Hearing conflicting opinions about vaccines can be confusing. But your pediatrician is here to provide guidance and can talk you through the risks and benefits and help you make informed decisions that fit your family’s needs. If your child is behind on immunizations or if you have any questions about vaccines, please call our office.