Vitamin D: Vitamin Of The Year Part 2

Vitamin D is clearly important. And like I said earlier this week, it is getting all sorts of attention. Two studies from this week have captured my attention.
I don’t think this vitamin D thing is a fad. The new (2008) recommendations for 400 International Units (IU) of daily Vitamin D in infants and children represent evolution in our understanding how we can protect and prevent illness in infants and children. It’s not that Vitamin D is more important than other vitamins, it’s just that Vitamin D is more likely to be absent in children than the others. New data this week suggests that delivering mothers (the ones with the big belly about to birth) who live in the city (are out in the great outdoors less) are more Vita D deficient that we thought. Another study finds that supplementing all infants, no matter what they eat, is essential in providing them the vitamin D they need. Vitamin D is synthesized in your body when you get some good sun (above) or from fortified foods in your diet including milk, cereal, formula or eggs and fatty fish. During the winter, getting those rays of sun is more difficult. And it’s more difficult all year long in infants who we say shouldn’t be in the sun whatsoever. So we have to ingest it. Take a look at this data and rationale for all of the D-detail.
Watch the video at the bottom of this post, too…
Highlights of Study on Urban Moms and Their Babies:

• Babies and mothers are linked in their vitamin D deficiency, but not perfectly in a 1:1 relationship. Meaning, although some babies who were born to moms with Vita D deficiency were at greater risk, not all babies were vitamin D deficient if their moms were (only 44% of babies born to deficient moms were deficient themselves).
• Overall, 58% of newborns and 36% of moms were vitamin D deficient. This is far greater than recent data that about 1/5 or 20% of children are deficient.
• These urban dwellers: 38% of infant newborns were severely deficient while 23% of moms were found to be severely deficient. Maybe because they are outside less
• Risks for Infants for Vita D Deficiency:
  • Winter birth (Oct to March), black race, maternal obesity
• Ways to protect against Vitamin D deficiency:
  
  • Take prenatals! Pregnant moms (and their babies) who took prenatal vitamins in 2nd and 3rd trimester were less likely to have deficiency. Pregnant moms who took prenatals in the 3rd trimester only were likely to have better vita D levels but their babies were likely to be deficient.
  • Get outside and have an egg sandwich. Moms who were outside 1 hour a day, drank milk, and ate eggs did far better.

I used to tell families that giving vitamins to children who eat a diverse diet was unnecessary.
Now I say something different.
The 2008 AAP Policy Statement on Vitamin D outlines infant, children, and adolescent needs for vitamin D to prevent Rickets.
Per these recommendations, pediatricians have only counseled moms who were breast feeding to supplement their babies.
Another study published this week found that we’re doing a bad job following through on the recommendations from the AAP. And that even babies eating formula likely to need vitamin D every day.
Highlights on Adherence To 2008 Recommendations Is Poor:

• Breastfeeding is the ideal form of infant feeding but puts babies at higher risk for Vitamin D deficiency. Mom simple don’t excrete enough vitamin D in breast milk for an infants requirement.
• The only way for infants to get vitamin D (because they don’t go into the sun) is from their diet.
• The majority of all babies in the Unites States are vitamin D deficient. Overall they found that only 11-25% of infants under 1 year of age met the 2008 recommendations for daily intake of Vitamin D.
• Compliance with the 2008 Recommendations was poor:
  • In breast fed babies: only 5-13% of babies got enough D
  • In Mixed fed babies (formula and breast milk): only 9-14% of babies got enough D
  • In Formula fed babies: only 20-37% got enough D

This was a newsflash to me.  I had not previously advised families feeding their babies formula supplement to supplement with vitamin D. Now I will. To get the vitamin they need, a baby has to consume about 32 oz of formula.  And not all babies will drink up to a liter of formula! Some may not get there until about 4-6 months of age.
Translation: all babies should be getting a supplement of 400 IU of Vitamin D a day. Every day.
Ways to get your baby 400 IU of Vitamin D: (all are over-the-counter)

• 1 mL (cc) of complete infant vitamin, like Polyvisol
• 1 mL of a triple vitamin (A, D, and E)
• 1 mL of a Vitamin D infant drop

Older children need 400 IU of vitamin D as well.  These come in yummy gummy form. Adults may need more (some say up to 2000 IU daily).
F awaits his little chewy sunshine each night before he brushes his teeth. Easier than a trip to Hawaii and a sunburn. Come on up to the stage, Vitamin D.  This is it, your moment of glory. You’ve won Vitamin of the Year. With science to prove it.

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