Food for Thought: Rickets on the Rise?
"If you have a toddler and are going to use an alternative to milk, make sure it is fortified with vitamin D and adequate protein," he says. "Select products formulated fortoddlers. Check the label carefully and run it past your pediatrician."
Beyond that, Carvalho suggests that mothers of the most at-risk babies -- black babies, infants who are breastfed longer than average, and those who get little sun exposure -- add vitamin D supplement to the babies' diets.
Tomashek agrees that vitamin D supplementation can be a good idea.
"If an infant is breastfed, parents and their [doctor] should discuss the need for supplementation," she says. "In addition, toddlers should be transitioned to vitamin D-fortified cow's milk or a beverage that is nutritionally equivalent to ensure adequate nutrition. Cheese, yogurt, and other dairy products typically do not contain vitamin D."
On the issue of vitamin D supplementation, the American Academy of Pediatrics essentially leaves the decision up to the pediatrician, but the organization currently is re-examining that policy.
Two months after his ordeal, Bianca reports that Japhet, now 9 months old, has recovered.
"He is happy, strong, and very smart," she says. "He's crawling and even starting to walk. He is very, very healthy."