As parents, we take great pains to ensure that our children stay strong and healthy by eating the right foods that will meet their calcium, iron and vitamin A, B, C and E needs.
Vitamin D is dubbed the “sunshine vitamin”, since the body makes it when the skin is exposed to the sun’s ultraviolet (UV) rays. And thanks to our sunny weather, many of us don’t think twice about our vitamin D intake. This important vitamin helps our body absorb calcium from our diet, building strong bones and teeth. Certain foods also contain this essential vitamin.
Many Asians tend to feel confident that their vitamin D intake is well covered and that only people living in temperate climates will have a deficiency of this mineral, especially during winter season, which has little sunlight.
However, bone-health experts at the 1st Asia-Pacific Osteoporosis Meeting in Singapore in 2010 noted that vitamin D deficiency is fast becoming a concern in Asia. Dr Nikhil Tandon, professor of Endocrinology and Metabolism at the All India Institute of Medical Sciences of New Delhi, pointed out that, “A lack of exposure to sunshine, genetic traits and dietary habits are all factors which influence vitamin D levels.”
Other factors that can give rise to a deficiency include air pollution (it blocks the sun), living at higher altitudes and skin pigmentation. Outdoor activity these days is also less as society becomes increasingly urbanised and people are fearful of damaging their skin, and worse, getting skin cancer.
“In toddlers, lack of vitamin D can result in rickets ― bone fractures and deformities — delayed motor development, poor growth and dental deformities.”
The importance of vitamin D
Vitamin D’s primary objective is to help our body absorb calcium better from the foods that we eat, so as to keep our bones strong and physical growth optimal. Vitamin D also functions as a hormone with many other jobs in the body, including regulating the immune system, producing insulin and growing cells. So, if you lack this mineral, it can cause a range of health problems, from cardiovascular diseases and diabetes, to osteoporosis in adults.
“In toddlers, lack of vitamin D can result in rickets ― bone fractures and deformities ― delayed motor development, poor growth and dental deformities,” explains Bibi Chia, principal dietitian at Raffles Diabetes & Endocrine Centre at Raffles Hospital. If junior is constantly ill with the common flu, cold or fever, it may be an issue with his vitamin D intake, since a shortage has been linked strongly to a weaker immune system and a higher risk of autoimmune diseases.
A pregnant woman with vitamin D deficiency is at an increased risk of giving birth to a baby with reduced bone mass and skeletal deformities, Chia adds. This baby also has a high chance of developing osteoporosis later in life. A lack of vitamin D is also associated directly with pre-eclampsia ― a pregnancy complication that causes high blood pressure, fluid retention and kidney damage. By the way, vitamin D is also critical for muscle function, which is important if you want to deliver your baby vaginally. Otherwise, you are at a higher risk of needing an emergency C-section.
Who’s at risk of vitamin D deficiency?
Mainly people living in places where the sun doesn’t shine regularly. However, in Asia, Chia points out that it’s also those who “have darker skin, wear well-covered clothes, and don’t get enough vitamin D from their diet”.
How much melanin your skin has also affects how much vitamin D your body can absorb. According to HealthXChange, the melanin pigment in dark skin protects it naturally from absorbing ultraviolet rays. “The darker skin tone acts as a natural sunscreen,” Chia explains. This is why those with darker skin, including toddlers and babies, need greater sun exposure to make the same amount of vitamin D as pale-skinned kids.
Another risk group: Couch-potato kids. More and more children are choosing to stay indoors to play with their tech gadgets or watch TV/iPad instead of going out for a swim or to kick the ball, notes Chia. Also, parents these days prefer to keep their little ones indoors to protect them from diseases like Zika, dengue or the haze, since it can cause respiratory problems.
The intake of vitamin D intake also differs between breast- and formula-fed infants. Human breastmilk is a poor source of vitamin D, containing less than 50 IU per quart (947ml). This is low compared to the American Academy of Pediatrics’ recommendation of 400 IU (10mcg) for children from birth to adolescence. Exclusively breastfed babies should receive 400 IU of vitamin D via supplement drops daily. Alternatively, the nursing mum should take up to 6400 IU of vitamin D supplements per day, so that she can pass this nutrient on to her baby through her milk. Since formula milk already contains the recommended amount of vitamin D, bottle-fed babes aren’t at risk of this deficiency.
Allow your tot’s skin to be exposed to the sun for 10 to 15 minutes before slathering sunblock on his skin.
Ways to increase your tyke’s vitamin D intake
As bone growth is at an all-time high during childhood, it’s vital to identify and treat vitamin D deficiency during this time. To enable sufficient vitamin D to synthesise, let the sun shine on your little one’s arms and legs twice a week.
Chia says, “The best time to do is before 10 am and after 4pm for about five to 30 minutes.” This is when the UV rays are at their strongest. If you have paler skin, opt for the minimum amount of time, but stay out just a little longer if you’re darker. Allow your tot’s skin to be exposed to the sun for 10 to 15 minutes before slathering sunblock on his skin. Remember, too much sun can also damage delicate skin!
“Also include more vitamin D-rich foods in your child’s diet,” Chia adds. Meet junior’s nutrient needs by including items such as fortified milk, cereals and juice, oily fish like salmon, cod and mackerel, egg yolk, cheeses and unsweetened soy or almond milk.
While it’s best for your kewpie to get all of his vitamin D from the sun and food sources, if you still feel he’s not getting enough, Chia suggests introducing a supplement. “Any supplements within the recommended amount of 400 to 600 IU (10 to 15mcg) are acceptable,” she notes. This can in the form of chewable multivitamins (which junior is going to love!) or via liquids or drops. Or give him cod liver oil, a tasty child supplement that parents have been making their kids take for generations.
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