THE Committee on Nutrition of the American Academy of Pediatrics has strongly endorsed the use of milk and infant formula products as primary vehicles for vitamin D supplementation to ensure a total vitamin D intake of 400 I.U. per day by all infants and children. Although in the United States there are significant regional differences with respect to dairy practices in fortifying fluid milk, almost three-fourths of all whole milk sold at retail is fortified with vitamin D, and almost all evaporated milk and infant formula products contain 400 I. U. of vitamin D per reconstituted quart. In addition, vitamin D is readily available in vitamin supplements, and, undoubtedly as a result of the wide distribution and ready availability of vitamin D, the incidence of infantile rickets in the United States has remained at a very low level.
This report draws attention to the lack of vitamin D in nonfat dry milk, a product used in significantly increasing amounts for preparing milk for home use for children, and possibly for infants. The use of nonfat dry milk has been accelerated recently by the increase in prices of fluid milk. For example, in 1965, the last year for which figures are available, consumer sales of nonfat dry milk amounted to 2.5 billion pounds of fluid equivalent, or about 5% of the total national consumption of milk. This total reflects an increase in consumption of almost 70% over the past 10 years.
The lack of vitamin D in certain major sources of milk for the population invites the reappearance of rickets.