Paediatrics News South Africa

You and your baby may need Vitamin D supplementation says research

This report appeared in the respected journal Paediatrics this week. There has been growing awareness regarding deficiency of Vitamin D in children and adults. This vitamin is important for healthy bones, immunity and other bodily processes. In children, inadequacy of this vitamin in diet may lead to bone damage, rickets, repeated infections and heart disease in later life.

Consider this

•According to the American Academy of Paediatrics, most infants should be getting supplement to meet the 400 IU daily requirement

•According to researchers at the US Centres for Disease Control and Prevention

•Only 5-13% breast fed babies are getting adequate Vitamin D in diet

•Less than 20-37% of formula fed babies consume the needed amount of this vital vitamin

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"We have to educate moms and the health-care community that vitamin D supplementation is something that they should do [and] recommend," says the lead author of the study, Cria Perrine, Ph.D., of the CDC's division of nutrition, physical activity, and obesity.

American Academy of Paediatrics in 2008 upped their daily recommended dose of Vitamin D from 200 to 400 international units.

"Most infants will require a vitamin D supplement to reach the new AAP recommendations, while in the past we only thought that breast-fed infants would need supplementation," says Perrine. "Formula-fed infants would need to consume a litre of formula a day to meet the new recommendations, and most infants don't do that - especially those who are being fed with both formula and breast milk."

Although just 10-15 minutes of sun exposure per day provides adequate amounts of Vitamin D that the body can make for itself, the AAP discourages sun exposure for infants less than 6 months except with sunscreen and protective clothing. Supplementation in diet thus becomes essential.

The results - especially concerning formula-fed babies- are eye opening, says Carrie Drazba, M.D., a paediatrician at Rush University Medical Centre, in Chicago. "I don't think a lot of us realised that formula-fed babies are not meeting their vitamin D requirements," she says.

Mothers need Vitamin D just as much

In another study, also published in Paediatrics this week, 58% infants and 36% of mothers were found to be Vitamin D deficient. There was a severe deficiency in 38% babies and 23% mothers.

Infants whose mothers were supplemented with Vitamin D in their second and third trimesters were found to have less deficiency than those born to mothers without such supplementation.

Among adults with this deficiency the risks of heart disease, certain cancers, osteoporosis, diabetes, Alzheimer's disease, schizophrenia, depression, and some autoimmune disorders is clearly raised.

Experts speak

Samantha Heller, a dietician, nutritionist and exercise physiologist, said, "Low levels of vitamin D may not seem like a big deal but we are finding out it is. Research is suggesting that low vitamin D levels are linked to autoimmune diseases such as multiple sclerosis, psoriasis, as well as cardiovascular disease, hypertension, osteoporosis, mood deregulation, muscle problems, certain cancers and more."

Heller added: "Sun exposure is one of the best ways to get vitamin D since it is not found in many foods. However, for people living in northern latitudes the sun is not strong enough to generate vitamin D production many months of the year. In addition, we encourage people to use sunscreen to protect against skin cancers, which also minimises skin's ability to produce vitamin D."

Supplements are the next best option, Heller said. "Experts now recommend a minimum of 800 to 1,000 IU per day for adults and children year round. In July 2008, the American Academy of Paediatrics recommended that infants who are exclusively or partially breast-fed receive 400 IU of supplemental vitamin D daily, beginning in the first few days of life," she said.

"This study suggests that parents are unaware of the need for vitamin D supplementation in infants and other studies show the same for older children. Health professionals need to get the word out to the public that infants, children, adolescents and adults need to get appropriate amounts of vitamin D all year," she added.

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