How To Manage Vitamin D Deficiency in Children
By Dr. Vishesh Bharucha +2 more
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By Dr. Vishesh Bharucha +2 more
Table of Contents
Vitamin D is a fat-soluble vitamin, meaning it dissolves in fat and is stored in the body for later use. It is crucial for bone health and helps maintain a strong immune system. Despite its importance, vitamin D deficiency is a global problem, affecting up to 80-90% of people, with children being especially vulnerable1,2.
This deficiency is a serious concern because it can lead to a range of health problems, from bone issues to links with autoimmune disorders, heart disease, and other chronic conditions1. Because of these risks, it’s important to identify and address vitamin D deficiency as early as possible, particularly in children. This article provides practical tips and strategies to help prevent and manage vitamin D deficiency in children, which often goes unnoticed.
Children need vitamin D to build strong bones and support proper growth. It enables the body to absorb and retain calcium and phosphorus, the two minerals crucial for healthy bone development and preventing conditions like rickets. Rickets is a disorder which leads to soft and weak bones, primarily in young children, especially those under two years of age. Not just young children, without sufficient vitamin D, older ones and adolescents may also have brittle bones and are more likely to experience fractures2.
Beyond supporting bone health, vitamin D also contributes to a well-functioning immune system by helping the body fight off infections and stay healthy1. Vitamin D may also influence mental well-being of your child. Emerging research2,3,4 indicates that children with low vitamin D levels may have a higher risk of mood disorders such as depression. This highlights the importance of ensuring adequate vitamin D intake during the growing years, not just for physical development, but for overall health and emotional resilience as well.
The good news is that vitamin D deficiency is easy to prevent with the right diet or supplements, so make sure your child’s intake is regularly monitored.
Parents often wonder how much vitamin D is safe for a child to ensure healthy growth without the risk of overdose. The American Academy of Pediatrics (AAP) outlines the following recommended guidelines in IU. It stands for International Units, a standard way of measuring vitamins:
For kids under the age of 1, the recommended daily intake of vitamin D is 400 IU2,3.
Note: The amount of vitamin D your baby is getting depends on the kind of milk he is drinking (formula or breastfed)3. Therefore, it’s important to consult your paediatrician to ensure your baby is getting the right amount.
For kids over the age of 1, the recommended daily intake of vitamin D is 600 IU2,3.
Note: In some cases, doctors may recommend between 600 and 1,000 IU daily, depending on the child’s health, diet, and risk factors4.
Getting an expert ensures your child receives just the right amount of vitamin D for healthy growth, especially if they have health concerns or dietary restrictions.
Below are the key short- and long-term consequences of insufficient vitamin D levels:
This list may feel overwhelming, but not all risks apply to every child. For peace of mind, speak with your paediatrician to assess your child’s needs and create a plan that supports long-term health. You can support their well-being by encouraging safe sun exposure, including vitamin D-rich foods in their diet, and regularly checking their levels to ensure they’re getting the right balance as they grow.
Common causes of vitamin D deficiency in children include9,10:
Vitamin D deficiency in children symptoms include the following1,5:
It’s important to note that some children may show no obvious symptoms, making regular check-ups and nutritional monitoring essential for early detection of vitamin D deficiency in kids.
Early detection of vitamin D deficiency is crucial, as symptoms like fatigue, muscle weakness, or bone pain are often mistaken for normal childhood fatigue or growth changes. Since vitamin D is vital for bone health, ensuring adequate levels during early years is essential to prevent long-term bone issues like rickets.
If you’re concerned about your child’s vitamin D levels, consulting a paediatrician is recommended. A simple blood test can provide clarity and guide necessary adjustments, whether through diet or supplementation. Some common blood tests include:
Deficiency of vitamin D in children causes long-term complications like stunted growth and weakened immunity if not addressed early. Therefore, managing this condition is highly crucial. Here’s how it can be addressed:
Doctors may prescribe vitamin D supplements for the treatment of vitamin D deficiency in children (based on the child’s specific needs)1,2. A common approach involves 2,000 IU of vitamin D3 daily or 50,000 IU once a week for 6 weeks, under medical supervision. Once blood levels of vitamin D rise above 30 ng/mL, a maintenance dose of 1,000 IU daily is usually advised to keep levels stable5.
It’s important to supplement breastfed infants with 400 IU of vitamin D daily, as breast milk typically contains low levels of vitamin D. However, parents should note that formula-fed infants who consume at least 1 litre of fortified formula generally do not require additional vitamin D supplementation5. Always consult with your paediatrician before starting or changing your child’s vitamin D supplement regimen to ensure they are receiving the appropriate dose for their health needs.
Note: Keep in mind that vitamin D supplementation should only be given based on a doctor’s recommendation. Over-supplementation may lead to harmful effects, such as vitamin D toxicity. Therefore, you should never increase/adjust the dosage on your own. Additionally, regular follow-ups with your healthcare provider are essential to monitor your child’s vitamin D levels and make any necessary adjustments to the dosage to ensure optimal health.
Include vitamin D foods for kids in daily meals. These include foods that are naturally high in or fortified with vitamin D2. To help you choose foods rich in vitamin D, here is a list of common options along with their vitamin D content per serving6:
Food | Vitamin D (IU) per serving |
Cod liver oil, 1 tablespoon | 1,360 |
Trout (rainbow), farmed, cooked, 85 grams | 645 |
Salmon (sockeye), cooked, 85 grams | 570 |
Mushrooms, white, raw, sliced, exposed to UV light, ½ cup | 366 |
Milk, 2% milkfat, vitamin D fortified, 240 mL | 120 |
Soy, almond, and oat milks, vitamin D fortified, various brands, 240 mL | 100 to 144 |
Ready-to-eat cereal, fortified with 10% of the DV for vitamin D, 1 serving | 80 |
Sardines (Atlantic), canned in oil, drained, 2 sardines | 46 |
Egg, 1 large, scrambled | 44 |
Liver, beef, braised, 85 grams | 42 |
Tuna fish (light), canned in water, drained, 85 grams | 40 |
Cheese, cheddar, 42.5 grams | 17 |
Mushrooms, portabella, raw, diced, ½ cup | 4 |
Chicken breast, roasted, 85 grams | 4 |
You may also include foods rich in calcium, such as milk, yogurt, and cheese, as they help enhance the absorption of vitamin D and support bone health14.
Sunlight helps the body produce vitamin D naturally2. Encouraging your kids to spend time outdoors (such as playing or walking in the sunlight) will allow their skin to absorb UVB rays, which trigger vitamin D production15.
Note: While sunlight is essential for vitamin D production, it’s important to be mindful of the risks of overexposure to UV rays, such as sunburn and long-term skin damage. Parents should aim to balance sun exposure with adequate protection.
Additionally, since factors like weather and lifestyle can affect vitamin D production, supplementation could be a helpful backup, especially during months with limited sun exposure. Consult your paediatrician to determine the best approach for your child’s vitamin D needs based on their individual health, lifestyle, and environment.
Minimising the risk of vitamin D deficiency in children is critical in reducing the risk of skeletal disorders and other long-term health complications in children. Here’s what you can do:
If you’re concerned that your child may not be getting enough vitamin D, or if they show signs of deficiency, such as1,5:
It’s important to consult with your doctor if your child has any risk factors for vitamin D deficiency, including:
In these cases, your doctor may recommend regular monitoring of your child’s vitamin D levels to ensure they stay within a healthy range. Early detection and treatment of vitamin D deficiency in children can help prevent complications, like rickets, and ensure your child’s proper growth and development. Regular check-ups provide reassurance and offer a proactive approach to keeping vitamin D levels balanced.
Vitamin D is essential for children’s bone health, growth, and immune function. Deficiency of vitamin D in children causes a range of health issues, including poor bone development, muscle weakness, and an increased risk of rickets. While this deficiency is common, it is also avoidable and manageable through a combination of sunlight, a nutritious diet, and supplements when needed. Therefore, timely diagnosis and appropriate management can help support healthy growth and overall well-being in children.
During autumn and winter, when sunlight may not be strong enough to allow your body to produce adequate vitamin D, supplementation may be necessary, especially for those who live in areas with limited sun exposure or who spend little time outdoors.17 It’s important to consult your doctor to assess your individual needs and determine the best way to meet your vitamin D requirements during these months.
Consuming too many vitamin D supplements over an extended period can lead to a dangerous buildup of calcium in the body, a condition known as hypercalcemia. This can weaken bones, damage kidneys, and negatively affect the heart. It’s crucial to follow your doctor’s recommendations regarding the appropriate dosage and never exceed the advised intake without professional supervision17.
It is not possible to overdose on vitamin D through sun exposure because the body naturally regulates its production of the vitamin. However, excessive sun exposure can lead to skin damage and increase the risk of skin cancer. Always protect your skin with sunscreen, wear protective clothing, and avoid prolonged exposure to the sun, especially between 10 a.m. and 4 p.m17.
Vitamin D supplements for children are available in several forms, including liquid drops (ideal for infants), chewable tablets, gummies, and soft gels. Your doctor can guide you on the most appropriate form and dosage based on your child’s age, health needs, and dietary habits2,10.
Low vitamin D levels may indicate insufficient sun exposure, inadequate dietary intake, or absorption issues due to underlying health conditions. High levels, on the other hand, may suggest excessive vitamin D intake, particularly from supplements, and should be monitored closely. Symptoms of vitamin D toxicity are rare but can include nausea, weakness, and kidney problems. It’s important to regularly monitor vitamin D levels and work with your healthcare provider to ensure they stay within a safe range1,10.
Disclaimer: The information provided here is for educational/awareness purposes only and is not intended to be a substitute for medical treatment by a healthcare professional and should not be relied upon to diagnose or treat any medical condition. The reader should consult a registered medical practitioner to determine the appropriateness of the information and before consuming any medication. PharmEasy does not provide any guarantee or warranty (express or implied) regarding the accuracy, adequacy, completeness, legality, reliability or usefulness of the information; and disclaims any liability arising thereof.
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