Vitamin D is essential for the absorption of calcium and phosphorus, which are both needed to form healthy bones. — Freepik
As a parent, you may have heard of vitamin D in passing, often linked to healthy bones or sunlight.
However, vitamin D is more than just a nutrient; it’s a vital component of your child’s overall health.
This “sunshine vitamin” helps regulate calcium in the body, supports bone development and plays a crucial role in immune function.
But what happens if your child doesn’t get enough of this vitamin?
In today’s column, let’s explore the importance of vitamin D, the risks of deficiency and how to ensure your child gets enough of this essential nutrient.
Why it is important
Vitamin D is actually a prohormone, which is a precursor to a hormone.
It is mainly produced in the skin upon exposure to sunlight.
It comes in two main forms:
- Vitamin D3 (cholecalciferol)
Produced in the skin after sunlight exposure, it is also found in fortified foods like milk, dairy, fatty fish, liver and egg yolks, as well as many supplements.
Vitamin D3 is more effective than other forms of vitamin D.
- Vitamin D2 (ergocalciferol)
Found in plant-based foods, fortified foods and some supplements.
Once consumed or produced by the body, both forms of vitamin D are converted into an active form known as calcitriol (1,25-dihydroxyvitamin D).
This active form is essential for:
- Regulating calcium and phosphorus
Vitamin D is essential for the absorption of calcium and phosphorus from the intestinal tract, both of which are necessary for healthy bones.
Without enough vitamin D, the body can’t absorb adequate calcium, leading to weakened bones.
- Promoting bone health
Vitamin D is crucial for building strong bones.
Without it, children can develop rickets, a disease that leads to soft, weak bones, and deformities like bowed legs.
- Helping immune function
Vitamin D helps the immune system function properly, enhancing the body’s ability to fight infections.
A deficiency may increase the risk of childhood respiratory infections like colds and coughs.
Importance of getting enough
A lack of vitamin D can lead to several health issues:
- In severe deficiency
The most well-known consequence is rickets, a condition that causes soft and weak bones.
This leads to deformities like bowed legs, a curved spine and a bulging chest.
Severe deficiency may also result in hypocalcaemia (low calcium levels), leading to muscle spasms, heart failure or seizures in infants and children.
- In mild deficiency
Less severe deficiency can still have lasting effects.
Children with low vitamin D levels may have weakened bones, making them more prone to fractures.
Symptoms like muscle aches, fatigue or general tiredness can also indicate insufficient vitamin D.
Additionally, there are studies linking vitamin D deficiency to other health conditions like respiratory infections, allergies, autoimmune diseases (e.g. type 1 diabetes), and even cancer, though more research is needed in these areas.
While sunlight is the most natural source of vitamin D, other sources include food and supplements.
Here are some ways to ensure your child gets enough of this vitamin:
Vitamin D is produced in the skin when exposed to sunlight.
For fair-skinned children, 10 to 15 minutes of daily sun exposure on the face, arms and legs is typically sufficient.
Children with darker skin may need more exposure as their skin contains more melanin, which reduces the ability to synthesise vitamin D.
However, excessive sun exposure is not recommended due to the risk of skin damage.
Even in tropical regions like Malaysia where sunlight is abundant, many children still suffer from vitamin D deficiency.
Factors such as indoor lifestyles, wearing clothes that block sunlight, air pollution and the use of sunscreen can limit vitamin D synthesis.
Although sunlight is the main source, foods can supplement vitamin D intake.
Foods rich in vitamin D include fatty fish (e.g. salmon, mackerel, tuna), fortified foods (e.g. milk, dairy products, breakfast cereals), egg yolks and beef liver.
In many cases, especially when sunlight exposure and dietary intake are insufficient, vitamin D supplements are necessary.
The general recommendations for daily vitamin D intake (from food and supplements) are: 400 IU for babies aged up to 12 months, and 600 IU for children aged one to 18 years.
A much higher initial dose might be needed if a child has vitamin D deficiency as confirmed with a blood test, or in those who are at risk of such a deficiency.
Supplements come in various forms, including liquid drops, chewable tablets and gummies, making it easier for children to take.
If you suspect your child may not be getting enough vitamin D, consult with their paediatrician.
While calcitriol can be prescribed, it should not be given to replace simple vitamin D deficiency due to the higher risk of side effects as it is already activated.
It should only be prescribed for specific medical indications with advice from a paediatric endocrinologist.
Those at risk
Certain factors increase the likelihood of vitamin D deficiency in children:
- Limited sun exposure
Children who stay indoors most of the time or live in places with long winters may not get enough sunlight.
- Dietary restrictions
Children who follow a vegan or vegetarian diet may lack adequate vitamin D.
- Chronic illnesses
Children with conditions like coeliac disease, cystic fibrosis, obesity or other medical conditions may struggle to absorb vitamin D properly.
- Medications
Certain medications, including steroids and anti-epileptics, can interfere with vitamin D absorption.
- Dark skin
Children with darker skin tones have higher melanin levels, which reduces the body’s ability to produce vitamin D from sunlight.
If you suspect your child has a vitamin D deficiency due to inadequate sun exposure, poor diet or any other risk factors, it’s important to consult a healthcare provider.
Blood tests can measure vitamin D levels in the body, and if a deficiency is found, your paediatric endocrinologist or paediatrician will recommend a treatment plan.
In conclusion
Vitamin D is essential for healthy bones, a strong immune system and overall health.
Ensuring that your child gets enough vitamin D through a combination of sunlight, food and supplements can help them grow strong, healthy and resilient.
If you suspect your child may have a deficiency or if they fall into a high-risk category for vitamin D deficiency, it’s important to consult with their healthcare provider.
Through proper prevention and treatment, vitamin D deficiency can be easily managed to support your child’s long-term health.
Dr Jeanne Wong Sze Lyn is a consultant paediatrician and paediatric endocrinologist. For more information, email starhealth@thestar.com.my. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
