VITAMIN D for Paediatrics
The Vitamin D status in an infant is determined by the Vitamin D status of the mother.
Infants meet their vitamin D requirements through stored concentrations obtained across the placenta before birth. A recent study shows that 84% of preganant women in India have vitamin-D deficiency, thereby giving birth to infants with vitamin-D deficiency.
After birth, breastfeeding makes a small contribution and the majority of an infant's vitamin D requirement has to be met by exposure to sunlight. Breastfeeding is the recommended method of infant feeding and provides infants with necessary nutrients and immune factors. However, Breast milk does not provide infants with an adequate intake of vitamin D. Breast milk contains a vitamin D concentration of only 20 IU per liter or less. Bovine milk has no added Vitamin D and formula milk contains a Vitamin D concentration of less than 100 IU / liter.
Infants' ability to synthesize vitamin D through routine sunlight exposure is limited due to poor exposure to sunlight, weather conditions, pollution, clothing covering the skin and the use of sunscreen lotions.
As per a recent study among Indian population published in the Indian Journal of Medical Research, Vitamin-D deficiency (25(OH)D < 15 ng/ml) was found in 66.7% of infants and Vitamin-D insufficiency (25(OH)D 15-20 ng/ml) was found in 19.8% of infants. Radiological rickets was present in 30.3 per cent of infants with 25(OH)D < 10 ng/ml.
The development of deficiency of Vitamin D after birth is without fail related to limited exposure to ultraviolet light and generally doesn't manifest itself until after 6 months of age. Vitamin D deficiency in infants leads to hypocalcemic seizures, lethargy, irritability and a predisposition to recurrent respiratory tract infections.
Recent research reveals that majority of the Children have low levels of Vitamin D which puts them at a higher risk of bone and heart problems. Growing children need Vitamin D to maintain proper levels of calcium and phosphorus which helps in strong bones and teeth.
It is reported that 27% of school going children in India have Vitamin D deficiency. Low levels of Vitamin D were especially common in girls, the obese, those who drank less quantity of milk 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.
Apartment living and lack of open space for outdoor sports activities also limits the children's exposure to sunlight resulting in Vitamin D deficiency. Children in urban areas follow a sedentary life and do not spend much time outdoors.
Further, dark skinned Indian children require more exposure to sunlight to synthesize Vitamin D than Caucasian children, as melanin reduces the production of vitamin D by sunlight.
It is important to provide 400 IU of Vitamin D a day routinely for infants and both younger and older children in order to maintain the required levels of Vitamin D to avoid various problems associated with the deficiency of Vitamin D. A daily supplementation of 400 IU Vitamin D for all infants and children is now also recommended by the American Academy of Paediatrics.