Vitamin D sources for children including sunlight, fortified milk, eggs and oily fish

Vitamin D for Children in Malaysia: Benefits, Sources and Daily Needs

Written by: RUDY RABI BIN MAT RABI, Registered Pharmacist

Summary

Vitamin D helps children absorb calcium and phosphorus, supporting healthy bone mineralisation, muscle function and normal immune function [1, 6, 10]. Low vitamin D is common among Malaysian children [2]. Parents can support healthy vitamin D status through age-appropriate nutrition, sensible outdoor activity and supplements when these are needed or advised by a healthcare professional.

Vitamin D is especially important during childhood because bones are growing rapidly. Severe deficiency can lead to rickets, while milder low vitamin D may be difficult to notice without assessment [7, 8]. The goal is to improve awareness of children’s vitamin D needs and the role of supplements in supporting long-term health.

Why is vitamin D important for growing children?

Vitamin D supports several key functions during growth:

01

Bone Development

Vitamin D helps the gut absorb calcium and phosphorus, minerals needed for normal bone mineralisation [1, 3, 10].

02

Muscle Function

Adequate vitamin D supports normal muscle function, which contributes to movement, strength and balance [10].

03

Immune Function

Low Vitamin D levels are associated with an increased risk of infections, as vitamin D plays a role in immune regulation [6].

04

Long-term Skeletal Health

Childhood and adolescence are important years for building peak bone mass. Reaching a healthy peak bone mass supports stronger bones later in life [4, 9].

What happens if a child does not get enough vitamin D?

When vitamin D deficiency is severe, bones may not mineralise properly. This can cause rickets, in which growing bones become soft and weak [7, 8]. Signs and symptoms can include:

  • Bone Pain or Tenderness
  • Muscle Weakness
  • Delayed Motor Development
  • Bowed Legs or other Bone Deformities
  • Poor Growth or Fractures in more severe cases

These symptoms can have many causes. If a child has bone pain, delayed growth, muscle weakness or a visible bone deformity, medical assessment is important rather than relying on supplements alone.

What are the best sources of vitamin D for children?

Children can obtain vitamin D from sunlight, food and supplements [10]. Each source has advantages and limitations.

01

Sunlight

Ultraviolet B (UVB) light from the sun triggers vitamin D production in the skin. However, the amount made varies with time outdoors, clothing, skin tone, weather, time of day and other factors [8, 10]. Due to this variability, sunlight alone may not provide sufficient vitamin D for many children throughout the year [8].

02

Food

Only a limited number of foods naturally contain much vitamin D, so fortified foods can be important [1, 8, 10].

03

Supplements

Vitamin D supplements can help when a child is unlikely to meet their needs through food and other sources, helping to reduce the risk of deficiency. Pharmacists can advise on the appropriate product and amount based on your child’s age, diet, intake of fortified formula or milk, medical history, and whether a vitamin D deficiency has been diagnosed [1, 10].

For infants (< 6 months old): do not use deliberate direct sun exposure as a vitamin D strategy. Follow age-appropriate sun-safety advice and discuss vitamin D intake with a healthcare professional [10].

Useful food sources may include:

  • Oily fish such as salmon, sardines and mackerel
  • Egg yolk
  • Vitamin D-fortified milk or formula
  • Vitamin D-fortified cereals or other fortified foods

However, diet alone may not provide enough vitamin D for children, particularly those with limited food choices [1, 8].

How much vitamin D do children need each day in Malaysia?

Malaysia's Recommended Nutrient Intakes (RNI) 2017 set the following daily vitamin D intake targets for healthy infants, children and adolescents [2, 11]. These values represent total daily intake from food, fortified foods and supplements; they are not treatment doses for vitamin D deficiency.

Age Malaysia RNI for vitamin D What parents should know
Infants 0-11 months 10 mcg (400 IU) per day Total intake target. Breast milk is naturally low in vitamin D, while formula and fortified foods contribute varying amounts [1, 10].
Children and adolescents 1-18 years 15 mcg (600 IU) per day Total intake target from diet, fortified foods and any supplement. A separate supplement may or may not be needed, depending on the child [2, 11].

Important: If a child has confirmed vitamin D deficiency or rickets, the dose used for treatment can be different from the RNI. Do not use high-dose adult vitamin D products for a child unless a doctor has prescribed or supervised them.

Does every child need a vitamin D supplement?

The dosage of Vitamin D supplement depends on the child's age, diet, fortified-food intake, outdoor exposure, medical conditions and medicines.

The 2024 Endocrine Society guideline suggests vitamin D supplementation for children and adolescents aged 1-18 years to reduce the risk of nutritional rickets and potentially respiratory tract infections [12].

For Malaysian families, a practical approach is to use the RNI as the daily intake target and ask a pharmacist, paediatrician or doctor whether a separate supplement is needed, especially when a child already takes multivitamins or consumes vitamin D-fortified formula or milk [2, 11].

Which children are more likely to have low vitamin D?

Low vitamin D can occur even in sunny countries. Factors that may increase risk include [2, 8, 10]:

  • Spending little time outdoors
  • Wearing clothing that covers most of the skin or having darker skin, which can reduce vitamin D production from the same UVB exposure
  • Eating few vitamin D-containing or fortified foods
  • Higher body weight or obesity
  • Conditions that affect fat absorption, the liver or the kidneys
  • Some medicines, including certain anti-seizure medicines

How common is low vitamin D in Malaysian children?

Low vitamin D levels are common among children in Malaysia, although reported rates vary across studies due to differences in age groups and definitions used.

A nationwide study of 3,542 Malaysian children aged 4–12 years reported low vitamin D levels in 47.5% of participants, while a Kuala Lumpur study of 402 children aged 7–12 years reported 35.3% with deficiency and 37.1% with insufficiency [2]. More recently, a 2026 Malaysian study of 120 preschool children found that 35% had vitamin D deficiency and 20% had insufficiency [13].

Should children have a vitamin D blood test?

Doctors usually assess vitamin D status using a blood test called serum 25-hydroxyvitamin D, or 25(OH)D. Routine vitamin D testing is not recommended for every otherwise healthy child without a specific medical indication [12].

Testing may be considered when a child has symptoms or signs of rickets, a medical condition that can affect vitamin D, a medicine that changes vitamin D metabolism, or when a clinician needs to monitor treatment [2, 12].

Can too much vitamin D be harmful?

Vitamin D is generally safe and beneficial when taken in the recommended amounts. While vitamin D toxicity is uncommon, taking more than needed from supplements over time may cause high calcium levels, which can sometimes lead to symptoms such as nausea, weakness, excessive thirst or urination, or kidney problems [10]. Choose child-appropriate products, follow the label and professional advice, check the total vitamin D from all supplements, and have regular follow-ups if your child has a vitamin D deficiency.

A practical vitamin D checklist for parents

  • Include vitamin D-containing or fortified foods as part of a balanced diet.
  • Encourage regular outdoor activity while following sensible sun-safety practices.
  • Check labels on formula, fortified milk and multivitamins so you know how much vitamin D your child is already getting.
  • Ask a pharmacist or paediatrician about supplementation if your child has limited dietary variety, low outdoor exposure or other risk factors.
  • Seek medical advice for bone pain, muscle weakness, delayed growth, bowed legs, recurrent fractures or other concerns.
Key takeaway

Vitamin D is essential for healthy bones, normal growth, and immune support in children. Low vitamin D levels can weaken bones, slow development, and increase the risk of future bone problems. If you are unsure whether your child needs a supplement or test, ask a pharmacist or doctor.

Speak with a BIG pharmacist

Need help choosing an age-appropriate vitamin D product? Visit your nearest BIG Pharmacy to speak with a pharmacist about product suitability, label directions and safe use for your child.

Find your nearest BIG Pharmacy → Shop Children’s Supplements →

For children, always check age suitability and dosing instructions. A pharmacist or paediatrician can help if you are unsure.

Medical disclaimer: This article is for general health education and is not a substitute for medical advice, diagnosis or treatment. Seek advice from a qualified healthcare professional for concerns about your child's health, growth, medicines or supplements.

Frequently Asked Questions about Vitamin D for Children

How much vitamin D does my child need each day?

Malaysia RNI 2017 recommends 10 mcg (400 IU) per day for infants aged 0-11 months and 15 mcg (600 IU) per day for children and adolescents aged 1-18 years [2, 11]. These are total intake targets, not treatment doses.

Can my child get enough vitamin D from sunlight alone?

Not always. Vitamin D production from sunlight varies with outdoor time, clothing, skin tone, weather and other factors [8, 10]. It is better to think of sunlight as one contributor alongside food, fortified foods and, when appropriate, supplements.

What are signs of vitamin D deficiency in children?

Mild low vitamin D may have no obvious symptoms. Severe deficiency can cause rickets, with bone pain, muscle weakness, delayed motor development and bone deformities such as bowed legs [7, 8]. A doctor should assess suspected deficiency.

Does every child need a vitamin D supplement?

Not every child needs the same supplement or dose. A child's age, diet, fortified-food intake, outdoor exposure and medical history all matter. Ask a pharmacist or paediatrician to help decide whether a separate supplement is appropriate [2, 11, 12].

Should my child have a vitamin D blood test?

Routine testing is not recommended for every healthy child without a medical indication [12]. Testing may be appropriate if there are symptoms, risk factors, chronic health conditions or a need to monitor treatment.

Is more vitamin D better for immunity?

No. Ensure your child gets enough vitamin D to support normal immune function, but avoid giving more than recommended. Higher doses have not been proven to prevent all infections [6, 10].

Can vitamin D supplements be taken together with calcium?

They are often discussed together because vitamin D helps the body absorb calcium [1, 3]. However, whether a child needs a separate calcium supplement depends on dietary intake and individual health needs. Ask a healthcare professional before adding multiple supplements.

View references 13 sources
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  2. Md Isa Z, Mohd Nordin NR, Mahmud MH, Hashim S. An update on vitamin D deficiency status in Malaysia. Nutrients. 2022;14(3):567.
  3. American Academy of Orthopaedic Surgeons. Calcium, nutrition, and bone health [Internet]. Rosemont (IL): AAOS; [cited 2026 Jan 2]. Available from: https://orthoinfo.aaos.org/en/staying-healthy/calcium-nutrition-and-bone-health/ Source
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  10. National Institutes of Health, Office of Dietary Supplements. Vitamin D: health professional fact sheet [Internet]. Bethesda (MD): NIH; 2025 [cited 2026 Jan 2]. Available from: https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/ Source
  11. Nutrition Division, Ministry of Health Malaysia. Recommended Nutrient Intakes for Malaysia: A report of the Technical Working Group on Nutritional Guidelines. Putrajaya: Ministry of Health Malaysia; 2017. ISBN 978-967-12050-4-4. Archived at: https://myagric.upm.edu.my/id/eprint/20366/ Source
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