Doctors and health experts worldwide agree that vitamin D is one of the most important natural vitamins the human body needs from birth. However, despite its importance, dietary sources of vitamin D are limited, making supplementation essential for newborns. According to pediatric care guidelines, infants should receive vitamin D in specific doses from birth to ensure proper growth and development.
In a special interview with Nadormagazine, Dr. Marwa Abdel Rahman, a clinical nutrition consultant, explained why symptoms of vitamin D deficiency may appear in children even when they receive daily supplements.
What is Vitamin D?
Vitamin D, often called the “sunshine vitamin,” becomes active in the body when exposed to sunlight. Sunlight, especially during mid-morning and late afternoon, helps convert a chemical in the skin into its active form, calciferol. Therefore, exposing infants to indirect sunlight daily is important.
Vitamin D exists in two forms:
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Vitamin D2: Found in plants and yeast; used in high-dose supplements.
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Vitamin D3: Found under the skin; produced with sunlight exposure and also present in limited foods such as fish liver oil, egg yolk, fatty fish, and animal liver.
When Should a Baby Start Receiving Vitamin D?
Newborns have stores of iron and vitamins from the mother during pregnancy, but vitamin D levels are low in breast milk. Experts recommend giving newborns 400 IU of vitamin D daily, starting from birth. Premature babies (“preemies”) require special attention, and supplementation may start earlier.
For babies fed with formula, vitamin D is already included in the formula, so supplementation may begin slightly later compared to breastfed infants.
Signs of Vitamin D Deficiency in Children
Symptoms can appear before the age of two, and include:
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Fatigue and low activity: The child may seem unusually tired or inactive compared to peers.
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Delayed growth: Slow development of teeth and motor skills (crawling, standing, walking).
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Increased susceptibility to infections and frequent illnesses.
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Behavioral issues: Studies (e.g., University of Michigan) show that children with low vitamin D are more likely to exhibit aggressive behavior, mood swings, depression during adolescence, and anxiety.
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Advanced deficiency symptoms: Muscle and bone pain, bowing of the legs, weak muscles, difficulty lifting the head as an infant.
Why Deficiency Symptoms Appear Despite Daily Supplementation
Even when children receive daily vitamin D supplements, deficiency symptoms may occur due to several factors:
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Inadequate dosage adjustment: As children grow, their vitamin D needs increase, especially after age two, due to rapid bone growth.
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Lack of sunlight exposure: Daily exposure of at least 30 minutes with uncovered shoulders, arms, and legs is necessary for the skin to convert vitamin D to its active form.
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Excess body fat: Obesity can prevent proper absorption of vitamin D, as fat stores the vitamin, reducing its availability in the bloodstream.
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Poor diet: Children who receive vitamin D supplements but eat foods low in vitamin D (e.g., non-fortified milk, few eggs or fish) may still develop deficiency.
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Digestive issues: Conditions like lactose intolerance, malabsorption, or intestinal disorders can prevent vitamin D absorption.
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Genetic factors: Some children have genetic variations affecting vitamin D metabolism and absorption, which can only be diagnosed through specialized medical tests.
Recommendations for Parents
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Continue daily vitamin D supplementation as prescribed.
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Ensure adequate sunlight exposure for your child.
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Adjust dosage as the child grows, under medical guidance.
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Include dietary sources of vitamin D after age two: fortified milk, fish, egg yolk.
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Consult a pediatrician if deficiency symptoms appear despite supplementation, to check for absorption or genetic issues.
By understanding these factors, parents can ensure their children receive sufficient vitamin D for healthy growth, strong bones, and overall well-being.
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