“D” is for Darn Strong Bones

Vitamin D has become the reigning monarch of vitamins in the press lately. This vitamin is fat-soluble and does not get into breast milk as easily as some might think. Therefore, exclusively breast fed babies usually have too little of this vitamin necessary to contribute to the formation of strong bones. A quick trip through the chemical process shows that Vitamin D travels through the bloodstream to the liver and from there goes to the kidneys and different areas in the immune system to finally get converted into calcitriol, the regulator hormone in the body for calcium and phosphate. These two chemicals in the proper concentrations cause normal mineralization and growth in bone. If there isn’t enough Vitamin D available then bones become thin and brittle and possibly deformed (bowed), otherwise known as Rickets.

Vitamin D can enter the body through a variety of foods and vitamins or can be produced through sun exposure. A chemical normally in the skin, when stimulated by sunlight forms fat-soluble Vitamin D, which is then transported by the bloodstream as described earlier. However, there are some things to take into consideration: the concentration of the sun varies dramatically in all parts of the world and throughout the year; this can create a lack of consistency with your child’s Vitamin D intake. Similarly the darker the color of the skin, the less absorption of sunlight, while exposure to too much sunlight can lead to burns and possibly skin cancer in later years. And with all the hype of sunscreen, you could potentially be defeating the absorption of sunlight into the skin with each ware, therefore limiting Vitamin D production.

So what can a parent do to ensure their children get the proper amount of Vitamin D for health? Oral vitamins are a good solution. The newly recommended dosage is 400 IU (international units) per day. The liquid drops for babies don’t taste great, but still should be given. Combination vitamin drops are fine so long as they have the 400 IU per dropper Vitamin D. Chewable vitamins should also have the proper amount of Vitamin D. Older children, teens and yes, you adults should be taking vitamins with D and Calcium if you are not drinking 30 ounces of milk a day. Adults show the effects of low Vitamin D in their bones through osteomalacia and musculoskeletal pain. Practically no baby or child will eat the foods rich in Vitamin D such as fish of all sorts (sardines, catfish, salmon, tuna in oil, mackerel and eel are the richest), mushrooms (ha!), a lot of whole eggs (15-20) at daily, and fish oils such as cod liver oil (yuck). In many “Western” countries, dairy products such as milk, margarine enriched flour and breads are fortified with Vitamin D and marked as such.

So, read labels and make the proper amount of Vitamin D daily a priority in your family’s diets.

By Bruce Gach, M.D. 

Bruce is the managing partner of Livermore-Pleasanton-San Ramon Pediatrics Group. He is a Board Certified practicing pediatrician with over 30 years of experience caring for children. He has served on numerous committees dealing with child health and development.  www.livermorepleasantonpeds.com