How do you treat vitamin D deficiency in children?

To achieve a blood level of 25(OH)D above 30 ng/mL

• 1000 IU/day of vitamin D for about 6 weeks for infants less than 1 month old

• For children aged 1–18 years 2000 IU/day of vitamin D2 (ergocalciferol) or Vitamin D3 (cholecalciferol) for 6 weeks, or

With therapy, radiologic evidence of healing rickets is usually evident in 2–4 weeks in nutritional rickets.

• Stoss therapy: 100,000–600,000 IU of vitamin D orally (over 1–5 days) or 50,000 IU of vitamin once weekly for 6 weeks followed by maintenance therapy of 400–1000 IU/day (0–1 years) maintenance therapy of 600–1000 IU/day Some patients with low calcium levels may also require supplementation with

• Calcium: 30–75 mg/kg/day of elemental calcium in 3 divided doses at the start of vitamin D therapy (doses to be weaned over 2–4 weeks)

• Calcitriol in doses of 20–100 ng/kg/day in 2–3 divided doses until calcium levels normalize.

Goals of treatment in rickets are to

• Relieve symptoms of pain

• Correct bony deformities

• Decrease the necessity for surgeries

• Improvement in growth

• Correct any underlying metabolic abnormality.