WISSAM NADRA, MD
Why Vitamin D?
Vitamin D is one of the most important vitamins because insufficiency of this vitamin especially in infants and children results in failure of bone mineralization i.e. adequate bone growth. The growth plates of bones continue to enlarge, but in the absence of adequate mineralization, weight bearing limbs (arms and legs) become bowed, which results in rickets in children. Vitamin D deficiency also increases a child’s future risk of osteoporosis.
In a report released on October 13th, 2008, the AAP (American Academy of Pediatrics) urged parents to ensure all children receive 400 International Units (IU) of vitamin D each day from their first days of life.
Who is at risk and why should we be concerned?
The first group at risk is breastfed infants. While breastfeeding is still the best food for a baby to eat, vitamin D in breastmilk is inadequate and needs activation by sunlight. Since babies are not supposed to be exposed to direct sunlight, exclusively breastfed infants require vitamin D supplementation.
The next group is toddlers who, due to lactose intolerance or other perceived health reasons, are weaned to soy or rice milk, rather than cow’s milk fortified with vitamin D.
The third group is children who are confined indoors or in daycare most of the time. As a result these children have inadequate opportunities to play outdoors in direct sunlight, and may spend increased amounts of time watching TV or playing video games.
The next group is young kids who drink fruit juice and / or “pseudo” juice drinks made with addition of high fructose corn syrup and water. As a result, these children get inadequate vitamin D fortified milk.
The final high risk group is dark skinned children. The darker a person’s skin tone, the less sunlight it absorbs.
What Can We Do ?
Exposing yourself and your children to sunlight is the most important source of vitamin D since sunlight triggers vitamin D production in your skin. In addition to this, adequate exercise of one hour per day and a well-balanced diet with vitamin D fortified milk / milk products is essential.
Ten to 15 minutes of sun exposure at least twice a week to the face, arms, hands, or back without sunscreen is usually sufficient to provide adequate vitamin D synthesis. Remember to follow this initial exposure to sunlight with an application of a sunscreen with an SPF of at least 15 to protect the skin.
Hope that this information is helpful to you and your family. Remember to always consult with your physician on any questions you may have about any of the information above.
Wissam Nadra is Clinical Director of Lakeshore Pediatric Center in Denver.