Use of Vitamin D in Children

Yeditepe University Bağdat Street Clinic Pediatrics Specialist answered the questions about the use of vitamin D in children.

Why did vitamin D gain so much importance with Covid-19?

The relationship of vitamin D with the immune system has been shown in many studies in recent years. The importance of strong immunity in catching Covid-19 Infection and in the course of the disease is very significant. Therefore, the importance of vitamin D has increased even more in this period. Vitamin D levels were measured in patients with a positive Covid -19 test, and the rate of catching the disease was found to be higher in people with vitamin D deficiency compared to people without vitamin D deficiency. Again, in some studies, it has been shown that the disease progresses more severely in individuals with low vitamin D levels and the need for intensive care is less in people with normal vitamin D levels. The important thing here is to take vitamin D supplements at the appropriate dose under the control of a doctor if there is a deficiency or insufficiency of vitamin D.

When should children and babies start taking vitamin D supplements and how should the dose be determined?

Vitamin D is not found enough in breast milk, so vitamin D supplementation should be started from the first days of the newborn. The daily need for vitamin D is 400IU until the first year of age, and then 600IU. If the child has symptoms of deficiency, the blood vitamin D level should be checked and a treatment dose of vitamin D should be given under the control of a doctor.

What causes vitamin D deficiency in children and babies?

Vitamin D is found in some foods such as fish, milk and dairy products, eggs, and cereal foods, but it is synthesized in the skin largely by the effect of sunlight (90%). Vitamin D taken through nutrition and skin is activated in the liver and kidneys and shows its effect in its active form. If enough vitamin D is not taken, first insufficiency and then deficiency develops. Serum vitamin D levels of 30 ng/mL and above are considered sufficient. Levels between 20-30 ng/mL are considered insufficiency and levels below 20 ng/mL are considered deficiency. In general, when vitamin D deficiency is severe, the metabolism is impaired, and diseases known as rickets in children and osteomalacia in adults occur. Patients experience chronic fatigue, weakness, muscle pain, and joint weakness. Apart from this, in recent years, many studies have shown that Vitamin D affects diabetes, heart diseases, cancer, and the immune system, apart from bone metabolism. For this reason, if we do not receive enough vitamin D, our immune system may be insufficient to fight diseases.

What conditions does an excess of vitamin D cause in children?

Although studies are showing that vitamin D deficiency is effective in many diseases such as the immune system, heart diseases, diabetes, and cancer, other than bone diseases, these do not require the use of high-dose vitamin D.

Vitamin D taken without need and in high doses causes high levels of calcium and related symptoms of intoxication such as loss of appetite, nausea, vomiting, drowsiness, anxiety, weakness, constipation, irregular heartbeat, and even clouding of consciousness, and calcium precipitation in the kidneys. Therefore, taking high doses of vitamin D without the supervision of a doctor is harmful. The recommended daily need should be met, and it should be replaced with appropriate treatment if there is a deficiency.

What are the mistakes in vitamin D use in children and babies?

Due to the increasing popularity of vitamin D in recent days, uncontrolled use of vitamin D has unfortunately increased. Since vitamin D is a vitamin that is stored in fatty tissue, its excessive use causes intoxication. For this reason, the appropriate dose should be taken under the supervision of a doctor. At the same time, the amount of vitamin D in the product used is important. Because the dose amount of each product in the form of drops and sprays is different. This appropriate dose of the appropriate product should be used.

There are many vitamin D options on the market. How should choices be made? Can you list the criteria in items?

In particular, vitamin D products with clean content such as BHA, which do not contain preservatives, chemicals, or sweeteners, should be preferred. According to the age of the baby, a choice should be made by asking the doctor which product will be more convenient to use, whether it is a drop or a spray. Since the dose of vitamin D in the drops or sprays of each brand is different, it should be used by taking into account the dose prescribed by the doctor.

How to use vitamin D in children and babies? At what hours? With meals? Between meals?

Daily vitamin D supplementation can be preferred in the morning, but it is not necessary, and it can be given at any time of the day. Generally, there is no harm in giving it alongside food.

Since our source of vitamin D is the sun, staying in the sun for 10-15 minutes at noon without applying sunscreen is sufficient to meet our daily vitamin D needs, especially in summer. It should not be forgotten that it is necessary to wait a few hours after sunbathing for the absorption of vitamin D synthesized in the skin, then not to take a shower immediately, and not to apply anything to the skin.