With Winter Here Many Kids Could Use Vitamin D Supplements
Katherine Hobson
In northern climes, the winter sun is too weak for people to generate vitamin D on their own, and it can be hard to get enough in food.hide caption
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In northern climes, the winter sun is too weak for people to generate vitamin D on their own, and it can be hard to get enough in food.
My 3-year-old drinks milk, but not very much of it, and that could be a problem for her.
We live in the Northeast, where the sun’s rays are weaker. And now that the days are shorter, my kid arrives at day care a few hours after sunrise and leaves when it’s dark. That all made me wonder whether she’s getting enough vitamin D, and if not, what we should be doing about it.
Why should I, or anyone else, care about vitamin D? It’s essential to building strong bones during childhood and adolescence. Children who are extremely low in the nutrient can develop rickets, which is characterized by soft, weak bones. Some research has tied low levels of vitamin D in active teen girls with higher rates of stress fractures. There have been a host of studies associating low vitamin D levels with other chronic diseases and ailments, but the Institute of Medicine, or IOM, says there’s no direct evidence that low levels cause those problems.
To maintain sufficient vitamin D levels in the blood, the IOM recommends taking in 400 international units, or IU, of vitamin D per day in the first 12 months of life and 600 IU for older kids.
How Do I Know If My Child Has A Deficiency
A blood test can identify vitamin D deficiency. Infants and children should be screened for deficiency if they have signs of:
- poor growth
- have dark pigmented skin
- use known Vitamin D lowering medications
- have malabsorption syndromes or inflammatory bowel diseases
- incur frequent fractures
- have low bone mineral density
- are overweight or obese
Risks And Side Effects
What happens if you take too much vitamin D? Can you overdose on vitamin D?
Taking high doses of vitamin D causes your liver to produce a chemical called 25D, which makes calcium accumulate in your bloodstream. Youre most likely to experience symptoms of too much vitamin D when taking supplements in high doses for a long period of time. This can potentially cause side effects if levels of 25 in the blood become elevated.
Potential side effects can include high blood calcium levels exhaustion abdominal pain and digestive issues like nausea, constipation, diarrhea or loss of appetite increased thirst and dry mouth and possibly kidney stones. The best way to avoid experiencing vitamin D toxicity is to not take very high doses of vitamin D in supplement form, such as 10,000 IU per day for more than several days in a row. Instead, get the vitamin D you need from sunlight, a healthy diet and supplements in the recommended dosage range.
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Sunlight And Vitamin D
Vitamin D is a unique vitamin. This is because your body can make it when it is exposed to sunlight.
Many factors can reduce how much vitamin D your body makes, including:
- smog
- amount of skin exposed to sunlight
- age:
- you make less vitamin D as you get older
These factors make it hard to estimate the amount of vitamin D you make from sun exposure.
How Can I Make Sure My Child Is Getting Enough Vitamin D
Your childs age matters when it comes to cows milk. For children older than 12 months, plain whole cows milk is a great source of vitamin D.
Most cows milk sold in stores is fortified with vitamin D. For babies younger than 12 months, cows milk is not recommended because it may put your baby at risk for intestinal bleeding. It also has too many proteins and minerals for your babys kidneys to handle easily and does not have the right amount of nutrients your baby needs.
For babies who are fed onlybreast milk or who receive both breast milk and infant formula:
- Breast milk usually does not provide all the vitamin D a baby needs, so breastfed babies will need a supplement of 400 IU of vitamin D per day beginning shortly after birth.
For babies who are receiving onlyinfant formula:
- Vitamin D supplementation is not needed.
- Infant formulas are fortified with vitamin D.
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Risks Of Vitamin D Deficiency
In order to counteract this, doctors recommend supplements for people of all ages, but especially for children. Vitamin D deficiency in children is a serious problem and can lead to a variety of health concerns. Kids under the age of two can develop bone-softening diseases, like rickets. For older children and teens, lack of vitamin D can lead to an increased frequency in bone fractures.
Its important to remember the symptoms of vitamin D deficiency, which could include general body aches and fatigue, says Mitchell Stroh, D.O., an orthopedic surgeon fellowship-trained in sports medicine.
Infants under the age of 1 should be receive a daily dose of 400 international units of vitamin D. If the child is being breastfed, he or she will need supplement drops. If the child is formula-fed, 32 ounces of formula per day is needed to ensure proper vitamin D levels. Adolescents, teens and adults should take a daily supplement of 600 IU.
Who Is At Risk Of Vitamin D Deficiency
Groups at risk of deficiency include exclusively breastfed infants, people with limited sun exposure, and people with conditions that disrupt their ability to absorb dietary fat such as ulcerative colitis, cystic fibrosis, and Crohns disease.
Most people get their vitamin D needs met through exposure to sunlight. However, concerns about staying protected from the sun due to skin cancer concerns may affect whether or not people are getting enough vitamin D from sun exposure. If possible, let your kids run around in the sun for five to 10 minutes before applying sunblock. It doesnt take more than that amount of time for exposed skin to make a significant amount of vitamin D precursors.
In colder climates, when winter comes, people spend more time indoors, or if they are outdoors, theyre very bundled up so they get fewer opportunities to get vitamin D efficiently when the sun is less intense. In those cases, it may be necessary to add vitamin D supplements to your childs diet.
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Why Children And Adults Need Vitamin D
Children need vitamin D for bone growth and development. So do babies developing in the womb. Vitamin D helps us absorb calcium.
Serious vitamin D deficiency in children can cause rickets, delayed motor development, muscle weakness, aches and pains, and fractures.
Vitamin D deficiency in adults has been linked to osteoporosis, some cancers, heart disease and diabetes.
If women dont get enough vitamin D during pregnancy, their children are at greater risk of developing rickets later in childhood. This risk is reduced if children get enough vitamin D after birth.
Babies Need A Vitamin D Boost
Because a typical mothers breast milk does not give her baby enough vitamin D, breastfed babies need vitamin D supplementation. Either the baby can be given drops of 400 IU a day directly or the mother can take 5,000 IU a day , which will fortify her milk with enough vitamin D for the baby. We call this super milk!
Although all standard infant formulas are fortified with vitamin D, vitamin D supplementation is also recommended for formula-fed babies. A baby would need to drink a quart of formula each day to get the recommended amount of vitamin D, Dr. Levine says, and young infants may not take in that much. Consult with your babys pediatrician or healthcare provider to make sure they are getting all the vitamin D they need.
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Memo To Pediatricians: Screen All Kids For Vitamin D Deficiency Test Those At High Risk
As study after study shows the fundamental role vitamin D plays in disease and health, vitamin D deficiency which often develops insidiously in childhood should be on every parents and pediatricians radar, say physicians from the Johns Hopkins Childrens Center.
Vitamin D deficiency can be a problem year round, but because sun exposure is critical for vitamin D synthesis and production, the winter months further exacerbate what is a perennial problem, says Johns Hopkins Childrens Center endocrinologist Dominique Long, M.D.
Levels at or below 20 nanograms per milliliter are considered suboptimal. Levels below 15 constitute deficiency and should be treated with supplements.
Hopkins experts say pediatricians should screen all children for risk factors and order blood tests for those found to be at high risk. Children at risk for vitamin D deficiency include:
- those with vitamin D-poor diets
- breast-fed infants because breast milk contains minimal vitamin D
- obese children
- those with darker skin because darker skin synthesizes less vitamin D from sun exposure than lighter skin
- those with certain medical conditions, including cystic fibrosis, type 1 and type 2 diabetes and certain gastrointestinal disorders, such as inflammatory bowel disease, which can interfere with food absorption
The good news is that once detected, vitamin D deficiency can be usually corrected easily with high-dose supplementation, Long says.
Do Kids Need Vitamin Supplements
In general, kids who eat a healthy, balanced diet dont need vitamin supplements.
However, infants have different nutrient needs than children and may require certain supplements, such as vitamin D for breastfed babies .
The American Academy of Pediatrics and the United States Department of Agriculture Dietary Guidelines for Americans dont recommend supplements over and above the recommended dietary allowances for healthy children older than 1 year who eat a balanced diet.
These organizations suggest that kids eat a variety of fruits, vegetables, grains, dairy products, and protein foods to obtain adequate nutrition (13,
- follow a vegetarian or vegan diet
- have a condition that affects the absorption of or increases the need for nutrients, such as celiac disease, cancer, cystic fibrosis, or inflammatory bowel disease
- have had a surgery that impacts the intestines or stomach
- are extremely picky eaters and struggle to eat a variety of foods
In particular, kids who eat plant-based diets may be at risk of deficiencies in calcium, iron, zinc, and vitamins B12 and D especially if they eat few or no animal products .
Vegan diets can be particularly dangerous for children if certain nutrients such as vitamin B12, which is found naturally in animal foods are not replaced through supplements or fortified foods.
Failing to replace these nutrients in childrens diets can lead to serious consequences, such as abnormal growth and developmental delays .
24 ).
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Overdose Of Vitamin D
Adverse effects of Vitamin D overdose are rare but care should be taken with multivitamin preparations as Vitamin A toxicity is a concern. Multivitamin preparations often contain a surprisingly low dose of Vitamin D.
Vitamin D toxicity is exceedingly rare below serum concentrations of 375nmol/L. Massive overdose causes hypercalcaemia but there is no agreement on the threshold concentration or amount of Vitamin D that results in toxicity. In adults, prolonged daily intake of Vitamin D up to 10,000 IU or serum concentrations of 25D of up to 240 nmol/L appear to be safe. SACN has accepted the European Food Safety Authority recommendations of a safe upper limit of 1,000 units/day for infants up to 1 year of age, 2,000 units/day for children aged 1-10 years and 4,000 units/day for those older than 10.
How Much Vitamin D Should I Get From The Sun
In addition to wondering how much vitamin D should I take, many people wonder how much vitamin D should I get from the sun.
Theres a reason that vitamin D is referred to as the sunshine vitamin. Sunlight exposure on our bare skin is the single best way to get enough vitamin D. Unfortunately most people today dont spend enough time in the sun, due to factors like working long hours inside, living in cold climates, being afraid of sunburns, etc.
In order to get enough vitamin D naturally from the sun its important to get outside and expose your skin to sunlight, without sunscreen. Aim to spend about 1020 minutes in the sun daily with as much of your bare skin exposed as you can, which will help your body produce vitamin D. You will absorb the most sunlight between about 11 a.m. and 3 p.m.
Melanin is a substance that affects how light or dark your skin color is. The amount of melanin you have in your skin also affects the amount of vitamin D you can produce, so the fairer your skin, the more easily you can make vitamin D. If you have dark skin, you will likely need more time in the sun, roughly 40 to 60 minutes daily, to make enough vitamin D.
Eating vitamin D-rich foods like eggs, raw milk and fish can also helps improve your blood levels of vitamin D.
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Experts Suggest Ways Children Can Get Vitamin D
By Carolyn Crist, Reuters Health
5 Min Read
– Parents and caregivers should be aware of the three ways children can get the vitamin D they need, according to a new resource published in the medical journal JAMA Pediatrics.
Although many people know calcium and vitamin D are vital for building healthy bones, not everyone knows calcium can only be absorbed when vitamin D is present.
Vitamin D is sometimes misunderstood and underappreciated, especially when it works as a silent partner with calcium, said Dr. Megan Moreno of the University of Wisconsin School of Medicine and Public Health in Madison, who wrote the one-page primer intended for parents and caregivers.
The patient page, accessible for free , is based on recommendations given by the American Academy of Pediatrics. The resource emphasizes the best ways for children to obtain vitamin D through sunlight exposure, diet and supplements.
Current guidelines recommend that infants under 12 months get 400 international units of vitamin D daily from all sources and that children and adolescents get 600 IU daily. For infants who are fully or partially breastfed, daily vitamin D supplementation is recommended until the child is weaned and drinking fortified milk.
Summer is coming up, and there will be many opportunities for kids to be out in the sun, eat more meals at home and be around their parents more, Moreno said in a telephone interview. This is an opportune time for parents to reflect on the ways to get vitamin D.
Why Vitamin D Is So Important For Your Kids
Vitamin D is essential for healthy bones and strong immune systems, but is your child getting enough? Learn more about the benefits and the best sources of Vitamin D.
Vitamin D is essential for healthy bones and a strong immune system, but it’s hard to know if your child is getting sufficient amounts. In fact, research shows about 42 percent of Americans are vitamin D deficient. “Absorbing enough vitamin D has always been challenging for most people who prioritize skin protection over sun exposure, but now with stay-at-home orders, getting vitamin D from the sun is very challenging,” says Kecia Gaither, M.D., M.P.H., F.A.C.O.G., director of perinatal services at NYC Health+Hospitals/LINCOLN.
Keep reading to learn more about the importance of vitamin D and how to ensure your kid is getting their shareeven while social distancing during the coronavirus pandemic.
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Can Babies Get Vitamin D From Sunlight
Our bodies make vitamin D when were exposed to the sun. So can you just spend time outside with your baby and skip the supplement?
UV rays from the sun are damaging to the skin at any age, says Dr. Liermann. Its better to take the supplement than to risk skin damage from the sun. When your baby is outside, cover them with a hat, clothing, or a shade over their stroller or baby carrier. Once theyre 6 months old, you can use sunscreen, but you should still keep them out of the sun as much as possible.
When More Vitamin D Is Needed
Doctors may recommend that your child receive more vitamin D than these recommended amounts depending on a variety of risk factors, including:
- Certain medical problems, like obesity, celiac disease or cystic fibrosis
- If the child is healing from bone surgery
- Or if the child is taking medications that alter the way the body uses vitamin D
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How Much Vitamin D Do I Need
From about late March/early April to the end of September, the majority of people should be able to make all the vitamin D they need from sunlight on their skin.
Children from the age of 1 year and adults need 10 micrograms of vitamin D a day. This includes pregnant and breastfeeding women, and people at risk of vitamin D deficiency.
Babies up to the age of 1 year need 8.5 to 10 micrograms of vitamin D a day.
A microgram is 1,000 times smaller than a milligram . The word microgram is sometimes written with the Greek symbol followed by the letter g .
Sometimes the amount of vitamin D is expressed as International Units . 1 microgram of vitamin D is equal to 40 IU. So 10 micrograms of vitamin D is equal to 400 IU.
