April 2019

Spike in rickets: Are children getting too little vitamin D?

For the most part, no. But a recent increase in rickets suggests some children, particularly low income, might not be getting enough in their diet. And new research indicates that even patients taking a multivitamin might still not be getting adequate amounts of vitamin D

The American Academy of Pediatrics recommends that infants and children receive at least 400 IU of vitamin D daily, either through the diet, supplementation, or a combination. Most parents assume that if they give their child a multivitamin, they are receiving adequate amounts of vitamin D and additional supplementation isn’t necessary. A new study out of the UK suggests this isn’t always the case.

In a new study, researchers analyzed 67 children’s multivitamin products available in the UK. Only 25-36% of them provided at least 400 IU of vitamin D. Additionally, products provided to low-income families for free only included 300 IU. This isn’t a problem for children who drink vitamin D–fortified milk (100 IU per 8-oz serving) and eat vitamin D–fortified foods like cereals and eggs. But if they aren't getting vitamin D from any fortified food sources, this can lead to deficiency. This is especially true in places such as the UK, where sunlight is limited during late fall and winter.

Make sure parents are educated about this concern. Vitamin D deficiency and its associated conditions are preventable with a well-rounded diet and/or appropriate supplementation. Healthy children who consume a well-rounded diet shouldn’t need a multivitamin. If parents of otherwise healthy children are specifically concerned about vitamin D levels, they should find a vitamin D supplement. Advise parents to always check product labels to make sure the product they’ve chosen provides adequate amounts. Look for vitamin D supplements containing cholecalciferol (vitamin D3). This seems to be more potent than another form of vitamin D called ergocalciferol (vitamin D2). Lastly, tell parents not to skimp on the sunscreen just because they want to increase their child’s vitamin D production. The increased risk of sunburns and skin cancer isn’t worth it, and most people don’t apply enough sunscreen to block out all vitamin D-producing UV rays.

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