Kadakkal Radhakrishnan, M.D., U.S. News & World Report
Vitamin D is not only crucial for your child’s development, it’s also necessary for overall good health. But if you think your child is get is getting enough vitamin D, you could be in for a surprise. The number of kids with vitamin D deficiency is alarming – and this number continues to rise. Children and adults living in the northern part of North America and Canada are prone for vitamin D deficiency due to relative lack of sun exposure. Though the exact incidence of vitamin D deficiency in this specific population is not clear, up to 50 percent of people in that region may be vitamin D deficient. In addition, people with a darker skin complexion may be at higher risk.
The Importance of Vitamin D
Vitamin D is essential in maintaining optimal calcium and phosphate balance, which leads to the growth of bones and teeth. Although good bone health can be achieved with physical activity and adequate calcium intake, the role of vitamin D is equally important. Without vitamin D, our bodies cannot effectively absorb calcium, so it’s easy to see why it’s vital to make sure your child is receiving enough of this necessary nutrient. Promoting better bone health in childhood will help ensure optimal bone health in adulthood, which is why vitamin D deficiency should be on every parent’s radar.
Ways to Get Vitamin D – Naturally
The two “natural” ways children can receive vitamin D is through sun exposure and foods. Sun exposure is the most efficient and organic way of ensuring adequate vitamin D levels. Just five to 30 minutes of sun exposure on the face, arms, legs and back at least twice a week from 10 a.m. to 3 p.m. may provide sufficient vitamin D synthesis; however, the risk of skin cancer from UV rays in sunlight has to be carefully weighed and should be discussed with your physician. If you and your children live in a sunny place, chances are your vitamin D levels are pretty good, but many of us are not able to rely solely on the sun and need to maximize our vitamin D intake from food sources. Oily fish such as salmon, fresh tuna and mackerel and fish liver oil are the best sources. Fortified foods, including milk, low-fat spreads and breakfast cereals also provide an adequate amount of vitamin D.
The Downfalls of Vitamin D Deficiency
Severe vitamin D deficiency in children can cause a disease called rickets – a disorder that softens and weakens the bones and can occasionally lead to skeletal deformities. In older children and adults, vitamin D deficiency leads to a condition associated with soft bones called osteomalacia. In small children, very low vitamin D levels can cause low calcium levels – which can give rise to tetany (muscle spasms) and even seizures. These symptoms can improve once the calcium levels are corrected and vitamin D levels are increased.
Prolonged exclusive breast-feeding without adequate vitamin D supplementation, especially in darker-skinned children nursed by mothers with inadequate vitamin D levels, is an important cause of vitamin D deficiency and sometimes rickets. Children who malabsorb fat, especially those with underlying liver disease, celiac disease, Crohn’s disease and cystic fibrosis without optimal vitamin D supplementation, are also at risk of the disease, so it’s important that these children are monitored regularly for vitamin D deficiency. On a more positive note, the fortification of foods – especially milk – in the United States has drastically reduced the risk of severe vitamin D deficiency and rickets.
How Much Vitamin D Do Children Need?
There is no clear consensus regarding the amount of vitamin D that infants and children should normally consume; however, the American Academy of Pediatrics recommends a minimum daily intake of 400 IU starting from the first few days of life. This recommended amount is especially important for breast-fed babies and children who consume less than 1 liter of vitamin D-fortified milk per day. After the first year, the recommended dose is 600 IU. To have your child checked for vitamin D deficiency, it will just take a simple blood test. If a deficiency is present, the dosing and the duration of vitamin D treatment will have to be formulated by your treating physician. In other words: Please steer clear of heading to your local convenience store and loading up on vitamin D supplements without speaking with your doctor first. Although there are many over-the-counter formulations of vitamin D available in the U.S., I strongly recommend that the choice of the formulation be based on the physician’s advice.
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