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Showing posts with label Vit D. Show all posts
Showing posts with label Vit D. Show all posts

Sunday, October 10, 2010

Article: Lack of Vitamin D in Children 'Shocking' | LiveScience zvitd

 Shocking to get attention.

Lack of Vitamin D in Children 'Shocking' | LiveScience
http://www.livescience.com/health/090803-vitamin-d-children.html

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Health

Lack of Vitamin D in Children 'Shocking'

By LiveScience Staff
posted: 03 August 2009 08:58 am ET
About 70 percent of U.S. children have low levels of vitamin D, which puts them at higher risk for bone and heart disease, researchers said today.
"We expected the prevalence of vitamin D deficiency would be high, but the magnitude of the problem nationwide was shocking," said Dr. Juhi Kumar of Children's Hospital at Montefiore Medical Center.
Cases of rickets, a bone disease in infants caused by low vitamin D levels, have also been increasing, other research shows.
The new finding, from a nationwide study, adds to growing evidence that children as well as many adults also lack the vitamin.
"Several small studies had found a high prevalence of vitamin D deficiency in specific populations of children, but no one had examined this issue nationwide," said study leader Dr. Michal L. Melamed of the Albert Einstein College of Medicine of Yeshiva University.
The cause? Poor diet and lack of sunshine, the researchers conclude today in the online version of the journal Pediatrics.
Millions of children
The researchers analyzed data on more than 6,000 children, ages 1 to 21, collected by the National Health and Nutrition Examination Survey 2001-2004.
The researchers found that 9 percent, or 7.6 million children across the country, were vitamin D deficient and another 61 percent, or 50.8 million, were vitamin D insufficient.
Low levels were especially common in girls, African-Americans, Mexican-Americans, the obese, those who drank milk less than once a week, and those who spent more than four hours a day watching TV, playing videogames, or using computers. The deficiency was more common among the older children in the data set, too.
Lighter skin is more efficient at producing vitamin D. So darker-skinned people produce less when exposed to sunlight.
The decline in vitamin D levels in the United States was reported widely a year ago and has been underway for 20 years, Melamed said.
"Kids have more sedentary lifestyles today and are not spending as much time outdoors," Melamed said. "The widespread use of sunscreens, which block UV-B rays, has only compounded the problem."
The body uses UV-B sunlight to convert a form of cholesterol in the skin into vitamin D.
What to do
Melamed recommends that children should consume more foods rich in vitamin D, such as milk and fish. "But it's very hard to get enough vitamin D from dietary sources alone," she said.
Vitamin D supplementation can help. In the study, children who took vitamin D supplements (400 IU/day) were less likely to be deficient in the vitamin. However, only 4 percent of the study population actually used supplements.
The American Academy of Pediatrics, which recently updated its vitamin D guidelines, now recommends that infants, children, and teens should take 400 IU per day in supplement form.
Supplements are especially important for children living in northerly regions where the sun may be too weak to maintain healthy vitamin D levels. Supplements are also critical for infants who are breast-fed, the researchers said in a statement today. Breast milk contains relatively little vitamin D, while formula is fortified with the vitamin.
What else can parents do?"It would good for them to turn off the TV and send their kids outside," Melamed said. "Just 15 to 20 minutes a day should be enough. And unless they burn easily, don't put sunscreen on them until they've been out in the sun for 10 minutes, so they get the good stuff but not sun damage."
Other experts caution that extended exposure to the sun — tanning and burning — increases the risk of deadly skin cancer.
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Friday, May 15, 2009

vitamin D deficiency AAP statement

Vitamin D Deficiency Clinical Report

Patient FAQs

Here are some commonly asked questions and answers on the recommendations in the AAP Clinical Report, "Prevention of Rickets and Vitamin D Deficiency in Infants, Children and Adolescents."

1. Q. Why do babies and older children need vitamin D?

A. Vitamin D is needed to help your body develop strong bones.

2. Q: Why is it necessary to give vitamin D supplements to my breastfeeding baby?  Doesn't human milk have all the essential nutrients for babies?

A. The AAP recommends breastfeeding of infants for at least 12 months and for as long thereafter as the mother and infant desire. However, human milk does not contain enough vitamin D to prevent rickets. Sunlight is the usual source of vitamin D production in the skin.

3. Q: If my baby goes out in the sunlight every day or every other day for an hour or so, isn't that enough?

A: It may be enough sunlight exposure in some parts of the country throughout the year, but sunlight exposure is difficult to measure. Factors such as the amount of pigment in your baby's skin and skin exposure affect how much vitamin D is produced by your body from sunlight. In the more northern parts of the country during the winter, the amount of sunlight is not enough for any baby. Exposing infants and children's skin to sunlight has been shown to increase the risk for skin cancer later in life. We now recommend that infants and young children not be in direct sunlight when they are outside, particularly infants younger than 6 months of age. Sunscreens should be used on all children when in sunlight but it prevents vitamin D formation in the skin.

4. Q: Do I need to give vitamin D supplements to infants who are fed infant formula?

A. No. All formulas sold in the United States have a sufficient amount of vitamin D that infants need as long as they are given 27 to 32 ounces of infant formula per day.

5. Q: When I take my baby outside, I always cover all of his skin with sunscreen, just as the AAP recommends. Isn't that enough to protect him from cancer and yet give him vitamin D?

A: No, the sunscreen prevents the skin from making vitamin D.

6. Q: How do I give vitamin D to my infant?

A: Liquid multivitamin drops with vitamin D are available. If you give your baby the recommended amount from the dropper in the vitamin drops bottle, the baby will get all the vitamin D needed to prevent rickets.

7. Q: When should I start giving the vitamin D drops?

A: You should start during the first few days of life.

8. Q: How often do I give the vitamin D drops?

A: You should give the drops once a day, every day. But, if you forget one day, it is all right. The vitamin D is stored in the baby and there will be enough in the baby's body to prevent rickets.

9. Q: If I give the vitamin drops to the baby, will the baby not want to breastfeed?

A: No, the drops will not interfere with breastfeeding. The amount is very small and giving a few drops from the dropper in to the corner of the baby's mouth toward the cheek will not give the baby any problem with breastfeeding.

10. Q: Don't the vitamin drops taste bad?

A: Some vitamin drops do have a strong taste, especially the ones that contain vitamin B, but the triple vitamin drops that contain only vitamins A, C, and D taste all right.

11. Q: Do babies need vitamins A and C also?

A: Breastfed babies do not need vitamins A and C, but giving them these additional vitamins in this dosage is not harmful. In some parts of Africa, there is deficiency in vitamin A and those babies may also need the vitamin A.

12. Q: How long do I keep giving the vitamin D drops?

A: You should keep giving it until your child has weaned from breastfeeding and is receiving 27 to 32 ounces of infant formula every day. The AAP recommends that "infants weaned before 12 months of age should not receive cow's milk feedings but should receive iron-fortified infant formula". Once your child begins drinking at least a quart of vitamin D-fortified milk after 12 months of age, he/she does not need additional vitamin D drops or a tablet. If, however, your child drinks less than one quart of regular milk, you should give him/her vitamin D drops or a tablet. This recommendation applies to children of all ages and even to adults.

13. Q: How will I know if my baby or child has rickets from vitamin D deficiency?

A: Rickets is a disease of the bones and is difficult to diagnose clinically without an X-ray before your infant begins to walk, at which time there will be excessive bowing of the legs.  There may also be swelling of the wrists and ankles.  Many infants with vitamin D deficiency will have slow growth.  Some may have breathing and heart problems.

14. Q: My older children do not drink any milk. How can they get extra vitamin D?

A: There are the same concerns for protecting the skin of these children from direct sunlight exposure to prevent skin cancer later in life. Vitamin D-fortified milk is the  sole dietary source of vitamin D. Any child who is not consuming at least 32 ounces of vitamin D-fortified milk should receive vitamin D as part of a vitamin drop or pill to ensure adequate vitamin D intake. It is now recommended that even adults consume vitamin D in milk or vitamin pills.

February 2009


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John C Kim MD
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www.wholefamilyjoy.com

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I am a pediatrician specializing in General Pediatrics, International Adoption Medicine, and in the diagnosis and coaching of families pursuing joy.