Are Certain Children More At Risk For Developing Vitamin D Deficiency
Certain children are more at risk for developing low vitamin D levels due to factors like (
Vitamin D insufficiency and deficiency can go unnoticed because noticeable symptoms typically dont manifest until a severe deficiency develops. Also, symptoms can be nonspecific, making it hard for parents or caregivers to detect a deficiency.
This is why having your childs doctor regularly test their vitamin D levels is important, especially if your child is considered at risk for developing a deficiency.
Does My Child Need A Vitamin D Supplement
Because breast milk is not a good source of vitamin D, breastfed infants should be given 400 IU of vitamin D daily, beginning soon after birth and continuing at least until they start eating solid foods. This supplement can be given through liquid vitamin D drops. Formula-fed babies should also receive a liquid vitamin D supplement until they drink at least 32 ounces of vitamin D-fortified formula per day.
If you are concerned that your child or teenager is not receiving enough vitamin D from diet or sun exposure, ask your pediatrician if a supplement is needed. A daily multivitamin for kids would include the recommended daily allowance for vitamin D.
If you opt to give your child vitamin D supplements, be mindful of the recommended daily allowances for your child’s age. “It’s possible to have too much vitamin D, and when that happens, kids can develop kidney stones,” Dr. Barlow says.
Fortification And A Comeback
The discovery of vitamin D led to its widespread fortification in Europe and the United States in the 1930s and 40s. Not only in milk but in soda, custard, bread, cereals, and even beer. One advertising for beer said: if you want to keep sunny energy all winter long drink vitamin D fortified Schlitz beer.
In 1931, the United States government established an agency, the Department of Labor, whose main goal was to promote sensible sun exposure to prevent rickets. Within a few years of fortification and guidance on sun exposure, rickets was eradicated.
In the 1950s there was an outbreak of hypercalcemia in England which included infants with heart problems and elfin faces which led to the removal of fortification in Great Britain. Investigators believed it was due to vitamin D toxicity. This ban spread across Europe.
It is now believed that these infants had a rare disease called Williams syndrome, which produces hypersensitivity to vitamin D. Despite this setback, rickets was thought of as a disease of the past.
Yet in the 1970s, rickets began to be reported again. Health experts believe this had to do with a resurgence of breastfeeding. Thats because formula is fortified with vitamin D, but breastmilk is low . Out of several hundred children with rickets, many had been long-term breastfeeders.
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Do Kids Have Different Nutrient Needs Than Adults
Kids need the same nutrients as adults but usually require smaller amounts.
As children grow, its vital for them to get adequate amounts of nutrients that help build strong bones, such as calcium and vitamin D .
Moreover, iron, zinc, iodine, choline, and vitamins A, B6 , B12, and D are crucial for brain development in early life .
Thus, although kids may need smaller amounts of vitamins and minerals than adults do, they still need to get enough of these nutrients for proper growth and development.
Kids usually need smaller amounts of vitamins and minerals than adults. Nutrients that help build bones and promote brain development are especially significant in childhood.
Supplements: To D Or Not To D
Whether a child should get extra vitamin D boils down to how much they are getting in their diet. Here’s what the AAP advises:
- Infants who are being breastfed should get 400 IU a day of vitamin D starting within a few days after birth.
- All infants who aren’t nursing and aren’t consuming 32 ounces of vitamin D-fortified formula need to be supplemented with 400 IU of vitamin D a day.
- Older babies who aren’t consuming 32 ounces per day of vitamin D-fortified milk should get supplements of D.
- Children age 1 and up who don’t get 600 IU of vitamin D per day in their diets should receive a supplement containing that amount. For kids who can’t tolerate cow’s milk, many brands of almond and soy milk are now fortified with vitamin D. Some brands of yogurt have added vitamin D as well, so consider that when estimating how much your child may be taking in.
- Children with an increased risk of vitamin D deficiency, such as those taking certain medications and with chronic diseases such as cystic fibrosis, may need higher doses of vitamin D.
If you and your pediatrician decide your child should be getting a vitamin D supplement, there are plenty of kid-friendly options. For babies and toddlers, there are vitamin drops. Chewable vitamins are fine for kids 3 and over. And of course, once a child is old enough to swallow pills, they can get their vitamin D in that form.
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Sun Exposure And Vitamin D
Vitamin D is a relevant factor influencing the achievement of peak bone mass, which in turn reduces the risk of osteoporosis and fractures in childhood and adulthood. Because the insufficient oral intake, sensible sunlight exposure can provide an adequate amount of vitamin D, which is stored in body fat and released during the winter months when vitamin D cannot be produced. Exposure to a minimal erythemal dose while wearing only a bathing suit is equivalent to ingestion of approximately 20000 IU of vitamin D. Therefore, in order to maintain an adequate 25-hydroxyvitamin D status, exposure of the arms and legs for 530 minutes between 10.00 am and 3.00 pm twice a week is often sufficient .
S Is For Skimpy Sun Exposure
The other source of vitamin D isn’t food at allit’s the sun. Ultraviolet rays stimulate the skin to produce vitamin D. This creates a conundrum, of course, since it’s known that direct exposure to sunlight without sun protection can drive up a child’s risk of developing skin cancer. That’s why the AAP says infants under 6 months should never have direct sun exposure. Older children should be slathered with a generous amount of a broad-spectrum sunscreen with a sun protection factor of 15 to 30 before going outside.
Increased use of sunscreen may be another reason vitamin D deficiency has become more common in kids, so is there really any harm in allowing a child to soak up a few rays in the name of bone health? That’s a tough call, because no one really knows how much sun exposure is enough to get the benefits.
Some vitamin D researchers estimate that just five to 30 minutes of sun exposure to the face, arms, legs, or back between 10 a.m. and 3 p.m., twice a week, is plenty, but you should check with your pediatrician about whether it would be a good idea to let your child go out in the sun unprotected for even short periods of time.
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Do Breastfed Babies Really Need Vitamin D
We often hear that breast milk is a complete food, containing everything your baby needs. But tests have shown that breast milk is lacking in vitamin D.
Infants should get vitamin D drops starting in the first few days of life, Dr. Liermann says. Its especially important in breastfed babies because they get minimal, if any, vitamin D from breast milk.
Infant formula contains vitamin D, but its not enough for younger babies. Formula-fed babies need a vitamin D supplement until they are taking 32 ounces of formula every day, says Dr. Liermann. This usually happens after the first few months of life, but is different in every baby. Newborns, in the first few months of life, dont consume enough formula to get the recommended daily amount of vitamin D.
Advice For Adults And Children Over 4 Years Old
During the autumn and winter, you need to get vitamin D from your diet because the sun is not strong enough for the body to make vitamin D.
But since it’s difficult for people to get enough vitamin D from food alone, everyone should consider taking a daily supplement containing 10 micrograms of vitamin D during the autumn and winter.
Between late March/early April to the end of September, most people can make all the vitamin D they need through sunlight on their skin and from a balanced diet.
You may choose not to take a vitamin D supplement during these months.
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How To Give Your Child More Vitamin D
Fortified foods such as some breakfast cereals and orange juice contain extra Vitamin D. To read about the natural sources of vitamin D, have a read of this article, The best sources of vitamin D: Are you getting enough?
It would not hurt to give these to your child in place of non-fortified versions.
But the best way to boost your childs Vitamin D levels is to encourage them outside in the sunshine during bright sunlight.
If you are worried about the risks, remember that we only need 10 minutes of sunshine on exposed skin to produce Vitamin D.
But what if your child spends a lot of time inside?
Perhaps school and after-school clubs prevent them from getting outside. Maybe they are not keen on outdoor play, or they do an indoor sport?
Government health guidelines recommend giving children a daily Vitamin D supplement every day.
Recommended Dose Vitamin D
Moreover, the infants who are obese, dark skin, the one rarely of outside, or the one wear clothing that covers heir skin. They need a supplement diet to ensure they have level vitamin D in the body. Well, some of the medications interfere with vitamin to make sure that your kids pediatrician knows all the medicines they intake usually.
Hence, in this way, you will come to serve your kid a good amount of Vitamin D. Because it will also be very beneficial in supporting good nervous system health, strengthens defenses against infections, and can improve lung and heart health in every aged person. As per the study shows that good vitamin D supplements can prevent the risk of diabetes, strengthening bones and preventing rickets as well.
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How Much Vitamin D Does My Child Need
Vitamin D is measured in international units .
- Babies younger than 1 year old need 400 IU of vitamin D a day. Baby formula has 400 IU per liter, so babies who drink at least 32 ounces of formula each day get enough. If your baby drinks only breast milk or gets less than 32 ounces of formula each day, ask your health care provider about giving your baby a vitamin D supplement.
- Kids older than 1 year need 600 IU or more of vitamin D a day. Health care providers often want healthy kids to take 600 to 1,000 IU daily.
Some kids might need more vitamin D, such as those who:
- have certain medical problems
Signs Of Vitamin D Deficiency In Babies
Vitamin D deficiency isnt easy to spot in babies, partly because they cant tell you how theyre feeling. And fatigue and muscle pain, symptoms of vitamin D deficiency, are common symptoms of several other conditions. In addition, signs of vitamin D deficiency may not show up until months or years later.
But doctors may check your babys vitamin D levels if your baby has:
- Frequent illnesses or infections.
- Poor growth.
- Frequent bone fractures.
Dont wait to see if your baby has symptoms of vitamin D deficiency, Dr. Liermann says. Supplement Vitamin D regularly to prevent deficiency. And if you have any concerns about your babys health, talk to your pediatrician.
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Elevated Blood Calcium Levels
Vitamin D helps your body absorb calcium from the food you eat. In fact, this is one of its most important roles.
However, if your vitamin D intake is excessive, your blood calcium may reach levels that can cause unpleasant and potentially dangerous symptoms.
The symptoms of vitamin D toxicity are primarily related to hypercalcemia, which means excessively high blood calcium levels (
Hypercalcemia typically develops after people take megadoses of vitamin D for a prolonged period of time.
For example, a 2015 case study reported that an older man with dementia who received 50,000 IU of vitamin D daily for 6 months was repeatedly hospitalized with symptoms related to high calcium levels .
In the 2020 case report mentioned earlier, the woman who took an average of 130,000 IU of vitamin D per day for 20 months was also hospitalized for symptoms related to hypercalcemia .
These included nausea, vomiting, muscle weakness, and kidney injury. Her blood calcium levels were 3.23 mmol/L (
- poor appetite
However, not all people with hypercalcemia experience the exact same symptoms.
One woman experienced nausea and weight loss after taking a supplement that was later found to contain 78 times more vitamin D than stated on the label .
Importantly, these symptoms occurred in response to extremely high doses of vitamin D3, which led to calcium levels greater than 12 mg/dL.
Vitamin D Guidelines For Infants And Children
On November 30, 2010, the U.S. and Canada released new guidelines for calcium and vitamin D intake. The vitamin D guidelines have long been awaited as there is tremendous interest in health effects of vitamin D. I have been privileged to participate in the development of these new as well as the previous guidelines. Here are some key points related to vitamin D and children:
First, and most importantly, breastfed infants should be given vitamin D drops. It is not safe to assume that they get enough vitamin D from the sun or from breast milk. These should generally be given from a dropper that provides 400 IU each day from a single dropper. Begin the drops in the first week or two of life. Then, at 4 months of age , make sure the drops have both vitamin D and iron.
There is a risk of children becoming toxic from too much vitamin D. The new guidelines say that the maximum safe amount of vitamin D intake for infants is 1,000 IU per day going up to 4,000 IU per day in children 9 years of age or more. Do not give higher doses of vitamin D to children without the advice of a physician who is monitoring the safety of these doses.
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Vitamin D And Rickets
In the 1600s, the industrial revolution made its way to Northern Europe. This brought tall buildings, air pollution, and a disease never seen before: rickets.
Rickets is a bone disease resulting in defective bone mineralization, usually brought on by vitamin D deficiency. Children with rickets show skeletal abnormities such as bowed legs, softening of the skull, and frontal bossing . They also have impaired growth and developmental delays.
Left untreated, rickets can result in death. And for more than 200 years the cause of this terrible disease remained unknown.
In the early 1800s, clues about what might help came to light. For instance, experts began to notice that children who lived in the inner city had a higher incidence of rickets than those living in rural areas. Later, children exposed to a mercury arc lamp showed improvements in rickets.
By the turn of the 20th century, 80-90% of children living in Northern Europe and Northeastern United states had rickets. During the time period between 1910 and 1961, 13,807 rickets-related deaths occurred with 8387 of them being in children less than one year old.
Soon vitamin D deficiency was found to be the cause and correcting it the cure of rickets.
How Is Vitamin D Deficiency In Children And Teens Treated
Treatment for vitamin D deficiency depends on age. Its treated differently in infants than in older children and teens.
Your childs healthcare professional will determine the most appropriate protocol for treating vitamin D deficiency. Their treatment plan may differ from the recommendations listed below due to factors like:
- underlying medical conditions
- deficiency severity
For example, the following are global recommendations for treating vitamin D deficiency rickets in infants and children :
- Under 3 months old: 2,000 IU oral supplements daily for 3 months
- Infants between 2 and 12 months old: 2,000 IU oral supplements daily for 3 months or a single dose of 50,000 IU
- Children 12 months to 12 years old: 3,0006,000 IU oral supplements daily for 3 months or a single dose of 150,000 IU
- Children over 12 years old: 6,000 IU oral supplements daily for 3 months or a single dose of 300,000 IU
After vitamin D levels have normalized, its recommended that babies under 12 months old receive a daily maintenance dose of 400 IU , while children 1 year or older receive a daily dose of 600 IU .
Its also recommended that children and teens with vitamin D deficiency rickets maintain a daily calcium intake of at least 500 mg per day.
In teens, vitamin D deficiency may be treated with 300,000 IU given either as weekly doses or multiple daily doses, such as (
|5 capsules per day for 10 weeks||280,000 IU|
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