Ensuring your child gets enough vitamin D

If your child doesn’t get enough time outside to be adequately exposed to sunlight, do ensure that their diet has enough vitamin D-rich foods. — Positive Parenting

Even though Malaysia is a tropical country and receives sunlight all year long, almost half (47.5%) of the children here suffer from vitamin D insufficiency, according to the Nutrition Survey of Malaysian Children (Seanuts Malaysia).

Vitamin D is essential for the development of strong bones and a healthy immune system in children.

Being deficient in this nutrient can predispose them to serious health risks like rickets, and also delay their growth and development.

Vitamin D acts as a hormone that regulates calcium and phosphorus levels in the body.

The balance of these minerals is crucial for healthy mineralisation of bones and teeth.

This is important in children as they have rapid growth spurts, especially in the first few years of their lives.

Adequate levels of vitamin D are necessary for the proper development of their skeletal system.

Besides that, vitamin D plays a part in the modulation of the immune and neuromuscular systems.

Children with sufficient levels of this nutrient will experience better muscle strength and coordination, enhanced immune function, and an overall reduction in the risk of getting infections.

According to the Health Ministry, the recommended nutrient intake (RNI) of vitamin D for Malaysian children is:

• 10µg per day for infants (birth to 12 months)
• 15µg per day for children (one to 12 years)

Where to get it

The sun – or more specifically, its ultraviolet B (UVB) radiation – is the most abundant source of this vital nutrient.

UVB penetration into the skin aids in the synthesis of vitamin D.

However, lifestyle choices, such as spending more time indoors and wearing protective clothing or sunscreen, can reduce the body’s ability to produce sufficient vitamin D in children.

To address this limitation, parents must include foods rich in vitamin D in their child’s diet.

Some of the essential dietary sources of this nutrient include:

• Natural foods like fatty fish (e.g. mackerel and tuna), cod liver oil and egg yolk
• Fortified foods like milk, cereals and margarine that are fortified with vitamin D
• Supplements – available in liquid or chewable form, and should be given to your child only after consultation with a paediatrician.

When it’s deficient

In infants and young children, vitamin D deficiency can lead to rickets.

Rickets is a condition in which the bones become soft and weak due to impaired mineralisation.

Common symptoms children will present with are bone pain, muscle weakness and cramps.

If left untreated, rickets can lead to serious complications like bone fractures, slow dental development and permanent bone deformities, including bowed legs and a hunched back (kyphosis).

ALSO READ: When rickets makes the bones go ‘soft’ in young children

In addition to skeletal issues, children with deficient vitamin D are also at risk of delayed growth and development, a weakened immune system that makes them susceptible to infections, and a higher chance of developing metabolic and autoimmune conditions like diabetes mellitus, multiple sclerosis, allergies and eczema.

Preventing the problem

Due to the serious manifestations of vitamin D deficiency in children, it is crucial for parents to ensure that their child receives a sufficient amount of this nutrient from an early age.

Strategies for this include:

• Encouraging your child to play outside around mid-morning or mid-afternoon for adequate UVB exposure.

   

  Exposing the skin for a short burst of time on multiple days per week allows for greater vitamin D production.

  Conversely, dark skin tone, cloud cover, sunscreen or protective clothing may limit the penetration of UVB into the skin.

• Providing a balanced and varied diet, which includes vitamin D-rich foods.
• Choosing foods and beverages that are fortified with vitamin D.
• Considering vitamin D supplements, especially for infants who are exclusively breastfed.

   

  Consult with your child’s physician for the age-appropriate dose of vitamin D to prevent overdose and toxicity.

Vitamin D deficiency is a serious health concern in children, as it not only affects their normal growth and development, but also predisposes them to a range of health conditions.

Children should be encouraged to play outside to promote natural vitamin D production in their bodies, while parents must ensure their child gets adequate amounts of this nutrient through their diet.

Talk to a nutritionist or dietitian to learn more about how you can increase your child’s vitamin D levels with the right foods and supplements.

Professor Dr Poh Bee Koon is a nutritionist and member of the Nutrition Society of Malaysia. This article is courtesy of the Malaysian Paediatric Association’s Positive Parenting programme in collaboration with expert partners. For further information, please email [e-mail]. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Information published in this article is not intended to replace, supplant or augment a consultation with a health professional regarding the reader’s own medical care. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.