The importance of a Vitamin D Supplement for babies and toddlers by Dr Piyusha Kapila
Dr Piyusha Kapila is a paediatrician at St John and St Elizabeth Hospital. Her expertise lie in general paediatrics, endocrinology and diabetes. She trained in medicine at Manchester University. Her basic training in paediatrics was carried out at the regional paediatric units in Manchester, Birmingham and Leeds after which she moved to London to work for her MD at the Institue of Child Health and Great Ormond Street Hospital.
She then completed her paediatric training at St Bartholomew’s Hospital and the Whittington. She has held a substantive post as a consultant in the NHS for more than 10 years now and deals with an extensive variety of paediatric problems and also provides care for premature and newborn infants.
Vitamin Supplements
Vitamins are compounds that are essential for the body to be healthy and capable of performing daily functions.
There are 6 vitamins (although Vitamin B can be subdivided into 8 subgroups), each with different function(s) in the body.
Vitamins can be fat or water soluble. The fat soluble vitamins can be stored in the body. Water soluble cannot and therefore sufficient intake on a regular basis is required. Overdosing maybe toxic.
From 6 months to 5 years, the Department of Health recommends supplements of Vitamins A, C, and D as children in this age group can be fussy and may not consume a balanced diet. Dalavit is a combination of Vitamins A,B,C and D and is used to supplement the diets of premature babies or children born in deprived social circumstances as a part of the healthy start initiative. The importance of Vitamin D is discussed further below
| Vitamin | Solubility | Source | Role | |
| A | fat | Dairy products, carrots, swede, mangoes sweet potatoes, green vegetables | Healthy skin, good vision, immune function. | |
| C | water | oranges, broccoli, kiwi fruit strawberries, tomatoes | Scurvy, iron deficiency. | |
| D | fat | Sunlight predominantly, small quantities in oily fish and eggs | Bone disease immune function, seizures muscle weakness |
Vitamin D deficiency, or insufficiency, is being recognised as an international problem. More so, due to increased skin protection from sunlight, combined with a lack of food fortification here in Britain. Cholesterol in the body is converted to Vitamin D by the action of sunlight on skin. It can then be stored in fat cells until used. Vitamin D is converted into active forms, first in the liver (25 Vitamin D), then in the kidneys (1,25 Vit D). It is increasingly being recognised that the actual Vitamin D molecule also has a role in health maintenance.
1.25 Vitamin D is necessary for absorption of calcium from the intestines (diet). When levels are low, calcium is mobilised from the bones, thus weakening them, to maintain blood levels. If this cannot happen, or is prolonged, low calcium levels result in reduced muscle and nerve function e.g. difficulties in walking, cardiac arrhythmias, seizures and bone fractures.
Vitamin D will be transferred across the placenta, and is also present in breast milk, but the quantity depends on the mother’s levels. If levels are low in mothers, the babies will also have a Vitamin D deficiency. Formula milk is fortified with adequate quantities of Vitamin D to maintain levels in the blood. However this will not be sufficient to normalise levels. Breast feeding when maternal levels are low will result in a further drop in the baby which can be dangerous. Women who cover themselves fully, and / or have increased skin pigmentation are at a higher risk of Vitamin D deficiency.
If in doubt, get your and your baby’s levels checked, and use Dalavit in the meanwhile, especially if breast feeding.
Piyusha Kapila MBChB, MD, FRCPCH
Consultant Paediatrician
N Middlesex University Hospital
Hospital St John and St Elizabeth
To clarify things further, only a specific wavelength of light from sunshine is involved in Vitamin D formation. This will generally be present during the late morning, midday, early afternoon period in the summer. Individuals without increased skin pigmentation will be able to maintain levels with exposure for short periods ( less time than taken to cause sun burn) daily, if a sufficient area of skin is exposed, but this will not be enough to normalise levels when deficient. Individual with increased pigmentation comparatively will require at least 3x as much exposure to accrue the same amount of Vitamin D.
Vitamin D is stored in the body, and toxicity cannot occur with endogenous formation, but can with supplements. Frequent holidays on sunny beaches reduces the probability of deficiency, but in the presence of any symptoms, the only reliable method of confirming the position is by getting levels checked. My research on Vitamin D levels in a N London Antenatal population (from a deprived area) showed that even Caucasian women had low levels ( as did their babies subsequently)
Thank you Dr Kapila
You also need vitamin D for other important body functions. These studies show that people with higher levels of vitamin D have a lower risk of disease, although they do not definitively prove that lack of vitamin D causes disease — or that vitamin D supplements would lower risk.
You also need vitamin D for other important body functions. These studies show that people with higher levels of vitamin D have a lower risk of disease, although they do not definitively prove that lack of vitamin D causes disease — or that vitamin D supplements would lower risk.