Vitamin D deficiency

Vitamin D deficiency is a common problem that can affect children of all ages.This page will highlight the current advice for parents who have babies and older children who are unsure about whether Vitamin D supplementationis necessary for their child. Vitamin D is an essential vitamin required for healthy bone growth. Most of our vitamin D comes from exposure to sunlight and only a small proportion comes from our diet. Oily fish is the only significant dietary source but small amounts are provided by egg yolk, red meat and fortified foods, such as formula milk, some breakfast cereals and margarine.

Lack of vitamin D can result in rickets, poor bone growth, bone pain and low calcium levels.

Because most of our vitamin D is manufactured by exposure to sunlight there is a clear seasonal variability in levels of vitamin D. In the UK, there is little appropriate sunlight to manufacture vitamin D from October to April. During this time, we rely on body stores body stores from sun exposure in the summer and dietary sources to maintain vitamin D levels.

How much vitamin D should I give my child?

The following table gives you an idea of how much vitamin D a child should take per day (Note that 1microgram = 40 units)

AgeRecommended Daily intake
0- 1 year8.5 micrograms per day
Older than 1 year10 micrograms per day
  • Breastfed babies from birth to one year of age should be given a daily supplement containing 8.5 to 10mcg of vitamin D, to make sure they get enough.
  • Babies fed infant formula should not be given a vitamin D supplement until they are receiving less than 500ml (about a pint) of infant formula a day, because infant formula is fortified with vitamin D
  • Children aged 1 to 4 years old should be given a daily supplement containing 10mcg of vitamin D

How much vitamin D is there in recommended foods?

FoodVitamin D per 100g of food
Oily fish5-10 micrograms
Cereal3-8 micrograms
Egg yolk5 micrograms
Red meat1 micrograms
Margarine7 micrograms

Most infant formulas are fortified with vitamin D and if your child is receiving at least 500ml of formula milk per day this should provide them with their daily vitamin D requirement.

What are the risk factors for developing vitamin D deficiency?

One of the main risk factors is poor sunlight exposure, age, ethnicity (particularly those from asian backgrounds) and those who cover their bodies and face.

The following video clip from the children’s e-hospital gives a good summary of vitamin D deficiency and answers some commonly asked questions.

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Extra vitamin D?

Who should receive supplements?

The following is the recommendation from the chief medical officers of England, Scotland, Northern Ireland & Wales:

“All infants and young children aged 6 months to 5 years should take a daily supplement containing vitamin D in the form of vitamin drops, to help them meet the requirement set for this age group of 7-8.5 micrograms of vitamin D per day. However, those infants who are fed infant formula will not need vitamin drops until they are receiving less than 500ml of infant formula a day, as these products are fortified with vitamin D. Breastfed infants may need to receive drops containing vitamin D from one month of age if their mother has not taken vitamin D supplements throughout pregnancy.”

Free supplements?

Can I get free vitamin D supplements?

Women & children who are eligible for the governments healthy start scheme can get free vitamin supplements which includes vitamin D.

Women qualify for Healthy Start from the 10th week of pregnancy or if they have a child under four years old, and if she or her family receive:

Income Support, or

Income-based Jobseeker’s Allowance, or

Income-related Employment and Support Allowance, or

Child Tax Credit (but not Working Tax Credit unless the family is receiving Working Tax

Credit run-on only) and has an annual family income of £16,190 or less.

Women who are under 18 and pregnant also qualify, even if they do not get any of the above benefits or tax credits. Further information can be found on the Healthy Start website at www.healthystart.nhs.uk

NHS organisations can choose to sell the vitamins or supply them free of charge to those who are not eligible for Healthy Start but this is dependent on the policy adopted by the local commissioning group.

Alternatively, vitamin D supplements are available for purchase from most or can be prescribed for those who are not eligible for the scheme.

Symptomatic?

What about if my child is unwell with vitamin D deficiency?

If your child has symptoms of vitamin D deficiency your GP may arrange to do a blood test to check the levels of vitamin D in the body. Once this level is known they will decide on whether or not your child needs standard vitamin supplements or whether a higher treatment dose of vitamin D is needed.

Authored by: Dr Tim Ubhi

Published: 8th March 2019

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