Vitamin D and Your Child

By Dr. Virendra Mittal in Paediatrics & Neonatology

Nov 20, 2020

Vitamin D is important for bone and muscle health vitamin D helps the body absorb calcium and phosphate from food which are important for healthy and strong bones.

Vitamin D despite its name it is not a vitamin but a pro hormone or precursor of hormone.

Vitamin D is a fat soluble hormone, it is absorbed in small intestine, generally vitamin are not produced in body but   they have to consumed from the diet  but vitamin D can be produced in body by the help of sunlight,

Vitamin D has multiple roles in the body,

Promoting healthy bone and teeth

Supporting immune, brain and nervous system

Regulating insulin levels

Supporting lung functions and cardiovascular system

Sources of vitamin D

• Getting sufficient sunlight is the best way to help the body to produce enough vitamin D.
• India is the country in which most of the days are sunny days. Because the body makes vitamin D when your skin is exposed to sunlight. you may be at risk of deficiency if you are home bound ,live in northern latitude wear long robes or head coverings for religious reasons or have an occupation that prevent sun exposure ,
• Most food contain only small amount of preformed vitamin D although fatty fish as salmon, mackerel and tuna are rich sources other sources are
• Egg yolk, cheese, beef liver, red meat mushrooms and fortified milk , and oils,
• Human milk contain only 30 to 40 IU/ltr
• Mother milk  is a poor source of vitamin D but exposure to sunlight and vitamin D supplementation for nursing mother can increase the vitamin D content in breast milk.

Vitamin D requirements,

 Since vitamin D is produced in the body endogenously in the skin by help of sunlight there is no nutritional requirement of vitamin D when sufficient sunlight is available, however if there is lack of sun exposure due to any reason there is need to supplement vitamin d in diet,

Babies who are exclusive on breast milk need vitamin D supplementation, 400 IU/day up to 1year of life. Most formula feed contains 400 IU of vitamin D in 1ltr of milk so if baby is consuming less than 1 ltr of milk in a day also need vitamin D supplementation in diet,

The recommended daily allowance in infants is 400IU/day and for children 600 IU/day,

Teen age children 600IU/day.

Signs and symptoms of vitamin D deficiency ,

the prevalence of vitamin D deficiency is 50-90% in the Indian subcontinent and is attributed to low dietary calcium along with skin color and changing life style .

few common symptoms are ;

• Fatigue
• Bone and back pain
• Low mood
• Impaired wound healing
• Low mood
• Hair loss
• Muscle pain

If vitamin D deficiency is more sever in children it may leads to hypocalcaemic seiuzre, tetany in infants and also it may also leads to rickets,

Red flag signs

if there is any symptoms like skeletal deformity ,bowed legs in toddlers, knock knees in older children, soft skull  in infants , growth disturbance ect , urgent medical consultation required,

We should checked our vitamin D levels on the regular intervals

Deficient                      less than 10 IU

Insufficient                  10-20 IU

Optimal                        20-60

High                              60-90

Toxic                             >90

Treatment for deficiency of vitamin D

Several therapeutic regimens have been attempted for deficiency of vitamin D . short term administration of vitamin D(Cholecalciferol) 2000 IU/day or 60000IU/weekly for 8wks with calcium supplementation,

Total dose of vitamin D has been reported to be more predictive of vitamin D sufficiency rather than the frequency of dosing.

After the completion of treatment vitamin D has to be continued at 400 -800 IU /day

Over dose of vitamin D,

too much vitamin D in the body can be toxic and raise blood calcium levels which can lead to kidney stones and heart rhythm problems.

Signs of too much vitamin D include;

• Vomiting
• Poor appetite
• Constipation
• Weakness
• Weight loss
• Polyurea, polydipsia, azotemia
• nephrolithiasis