Recently another baby died in England – of Vitamin D deficiency. Vitamin D is increasingly low in babies these days. This entirely preventable disease should never occur, and yet it is on the rise. Every parent should be on top of this issue and determine with a health professional what is optimal for their baby.
Vitamin D is made from the sun
When the sun shines on our skin, it combines with cholesterol in our skin. This causes a chemical which converts to an inactive form of Vitamin D in the liver. A gland on top of our thyroid, the parathyroid gland, whose hormones are monitoring calcium levels in the blood, signals the kidneys to convert Vitamin D to its active form for immediate usage.
Vitamin D for strong bones
In the Industrial Revolution in Britain in the late 1700s, children working in factories and rarely seeing sunlight, developed rickets. This weak bone disease left them with bowed legs or misshapen skulls. The bones could not harden because calcium cannot be absorbed without sufficient Vitamin D. We thought rickets was behind us, but new cases are now showing up as children avoid the sun due to their parents’ fear of skin cancer.
Vitamin D for asthma
Vitamin D is also linked to asthma. In one randomised controlled trial, a control group of asthmatic children were compared to a Vitamin D supplemented group. Those supplemented with Vitamin D reduced their asthma attacks 3-fold. You can watch a short video about it <here>.
Calcium and Vitamin D
Most people know that calcium is necessary for strong bones and teeth, but it is also vital for the heart’s normal function. Heart muscles require calcium in order to squeeze blood out of the heart and into the arteries. Calcium flows into the heart muscle cells through tiny channels, working as a switch to allow heart muscle fibres to slide past each other to contract or shorten.
Vitamin D determines the calcium levels in the body. When the parathyroid gland determines that calcium levels are getting low in the body, it activates stored Vitamin D. This activated Vitamin D allows the stomach to absorb two to four times the amount of calcium from foods rich in calcium.
low Vitamin D = low calcium = heart muscles seize up (eg. baby has a fit/cardiac arrest)
Eating calcium-rich foods is of little use if Vitamin D is not present to allow their absorption. Calcium-rich foods include
- seeds
- cheese
- yoghurt
- sardines
- canned salmon
- beans
- lentils
- almonds
- low-oxalate greens such as broccoli, bok choy, kale, watercress and cabbage
What really low Vitamin D looks like
Some signs of infant hypocalcaemia (low Vitamin D) are
- respiratory arrest (struggling to breathe, turning blue)
- cardiac arrest (heart stopping)
- a cough
- seizures
- poor feeding and
- low weight for age
Of course, these symptoms can have other causes, but Vitamin D deficiency leading to low calcium cannot be ruled out without testing.
Other signs can be rickets symptoms:
- pain and tenderness in the bones of arms, legs, pelvis and spine
- stunted growth
- muscle aches
- tooth enamel holes
- skeletal deformities – deformed skull or bowed legs.
Who is at risk?
Darker skinned children are at greater risk of Vitamin D deficiency. In Australia, children of Middle Eastern, Indian, Pacific Islander and Maori descent who are exclusively breastfed are at greatest risk. Children with darker skin need more exposure to the sun than light-skinned children.
Breastfeeding concerns
Breastfeeding mothers need sufficient sun exposure in order to pass on sufficient Vitamin D to their babies in the early months. Breastmilk does not contain sufficient Vitamin D to sustain a baby beyond the first few months of life, even if the mother’s Vitamin D status is good. By this age, the baby will need either regular sun exposure or Vitamin D supplementation. In areas where consistent sun exposure is difficult because of the climate, supplementation is recommended.
How much Vitamin D do babies need?
The Vitamin D Adequate Intake set by the government is 200 IUs (“international units”) per day for babies under 12 months, with 1000 IU being the Upper Limit (above which negative side effects occur).
Studies in the US indicate that 2 hours of sun exposure per week with only the baby’s face exposed, or 30 minutes per week with only a nappy on, is sufficient for the child NOT to need supplementation. For darker-skinned babies, more sun exposure is needed to achieve the same status.
If this is not possible, supplementation is the way to go.
The supplementation recommendation is for
- lactating mothers to supplement (themselves) with at least 400IU/day, and
- after a month or two, the baby should take 200IU Vitamin D a day.
Vitamin D drops are widely available for infants and nursing mothers in these amounts. Check the ingredients of your baby’s formula for Vitamin D if bottle-feeding.
Should we fear the sun?
When I was a child, over 50 years ago, it was normal for mothers to put their babies outside in the sun in their nappy in summer for a ‘sun-kick’ (see the above picture). Few babies in those days suffered from low Vitamin D. Today parents fear the sunshine on soft baby skin.
This fear is not unfounded as the Western diet contains too few sun-protective micronutrients. Carotenoids (antioxidant micronutrient pigments of coloured fruit and vegetables) protect the skin against sun damage. Read more about sun-protective foods <here>. Much skin damage from the sun is likely due to low-antioxidant diets. Breastfeeding mothers should eat a diet full of brightly coloured fruit and vegetables. This will help to protect them and their babies’ skin against the sun.
Babies in cold climates
10% of young children in southern Tasmania (Australia’s most southern state) show Vitamin D deficiency. Families in cold climates have long supplemented their children with Vitamin D. British children used to take a teaspoon of vile tasting cod liver oil each day, as did children in Scandinavian countries. Cod Liver Oil is high in Vitamin D. Supplementation is important for all children (as well as for adults) where regular sun exposure is not possible.
If your baby shows low Vitamin D symptoms
If your baby begins to show signs of severe deficiency (hypocalcaemia) as listed above, the hospital emergency department is the only option. Supplementation will not help. In this case, the medical staff will administer a Vitamin D injection (if low Vitamin D is diagnosed). This can turn things around if not given too late.
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