The following guidance is for children with vitamin D deficiency (serum vitamin D < 30 nmol/L). Those insufficient in vitamin D (serum vitamin D 30-50 nmol/L) should be advised to take an over-the-counter vitamin D supplement appropriate for their age or as per the maintenance doses in the table below.

Treatment for children with vitamin D deficiency (<30nmol/L)

Treatment dose vitamin D is given initially (with calcium if required). Following treatment course, maintenance vitamin D dose should be recommended.

Vitamin D (cholecalciferol or ergocalciferol)

  • Age less than 3 months - Give 2000 units once daily.
    • Calcium is not required due to an exclusive milk diet which has adequate calcium.
  • Age 3 to 6 months - Give 2000 units once daily together with calcium if required.
  • Age 6 months to 12 years - Give 3000-6400 units once daily together with calcium if required.
Once the initial Vitamin D course is complete, continue with maintenance vitamin D until the child has stopped growing.
• Adolescents 12-18 years – Give 6000 units once daily.
Once vitamin D course is complete - continue with maintenance treatment of vitamin D.

If there are compliance concerns

If compliance is an issue a single oral or intramuscular dose of 50 -300 000 units may be given every 3 months, with calcium (30mg/kg/day) for 12 weeks.

Large single doses of oral Vitamin D are generally not available in community pharmacies or district general hospitals.

Calcium therapy (may need to be adjusted according to response)

If the child is hypocalcaemic, has a low phosphate or an elevated alkaline phosphatase or they have a poor calcium containing diet (assessed by dietician), treatment should be for at least 4 weeks or longer if required.