With adequate exposure to sunlight, the skin manufactures enough vitamin D. However, not all children have sufficient sun exposure or drink enough beverages containing the daily recommended amount of vitamin D.

The American Academy of Pediatrics has issued new guidelines for vitamin D. Previously, it was recommended that infants, children and adolescents have 200 international units (IU) of vitamin D daily.

Now, the AAP advises this be doubled to 400 IU daily. Infants who drink one quart of formula a day, and older children who drink four glasses of milk daily (or another beverage or food with an equivalent amount of vitamin D) do not need additional vitamin D, because it is already added to these products.

Those who should be given supplemental vitamin D are breast-fed babies and those who drink less than the amount of formula and milk stated above.

Vitamin D is found in all multivitamins including infant drops.

Those with darker skin and with little sunlight exposure are at increased risk for vitamin D deficiency, which typically causes rickets, a bone disease.

However, recent evidence also links low levels of vitamin D with other diseases such as certain cancers and autoimmune diseases.

Beware nontraditional pets

Most of us are familiar with diseases that usual pets -- cats and dogs -- can transmit to us. However, a large number of households have nontraditional pets, and these may be equally dangerous. The more common examples of these pets include reptiles (e.g., turtles, lizards and snakes), rodents (e.g., hamsters, mice, gerbils, guinea pigs and chipmunks), and amphibians (e.g., frogs and salamanders), all of which commonly transmit salmonella infections.

Any animal with teeth can cause bite injuries, and young children are especially susceptible. All the above animals also may cause allergies by their dander, scales, fur, feathers, excrement and saliva.

The illegal worldwide exotic animal trade is huge, estimated at $6 to $10 billion annually. These animals may be diseased before entering the United States or cause a new disease in a human, such as the outbreak of monkeypox in 2003.

Update on cold products for 4-and-younger set

Cold and cough products are enormously popular. According to the New York Times, there are more than 800 of these products sold in the United States, and each has at least one of the 39 drugs claiming to help coughs and colds.

The only problem is there is no good evidence showing any of these works; in fact, they may be harmful, especially to children. Last year, the FDA pressured manufacturers to warn the public not to use cough and cold products in children younger than 2.

This month, manufacturers extended this warning stating these products should not be used in children younger than 4. Many officials are trying to get this age limit raise.

The opinions expressed are solely those of the writer. Robert A. Dershewitz, M.D., Sc.M., FAAP, is a pediatrician at Healthy Kids Care Center in St. John and is affiliated with The Community Hospital in Munster.