VITAMIN D FOR BABIES

Why is vitamin D important for your baby’s health and development?

Low levels of vitamin D are widespread and this is recognised as a significant health problem due to the importance of vitamin D for many aspects of health (1).  Best known is the role of vitamin D in helping the body to absorb calcium and build strong, healthy bones and teeth. Insufficient vitamin D in infancy can lead to poor bone mineralisation and in an increasing number of cases, rickets, where the bones become misshapen. The peak age for rickets to occurs is 3 to 18 months old, partly due to the need to keep babies out of direct sunlight to avoid skin damage, and partly due to a high metabolic demand due to rapid growth. However, vitamin D deficiency can occur months before there are any observable signs (9).   Infants who are exclusively breastfed but who do not receive supplemental vitamin D or adequate sunlight exposure are at increased risk of developing vitamin D deficiency. Although breast milk provides the best nutrition overall for babies during the first year, a mother’s vitamin D levels may not be high enough to meet both her and her baby’s needs, or the baby may not be able to consume a high enough volume of milk to get sufficient vitamin D (9).

As well as being crucial for bone health, Vitamin D is also very important for the development of strong, healthy muscles (3) and immune function (2).  For example, there is an association between lower vitamin D levels and atopic dermatitis (eczema) in babies and small children (10).  Insufficient vitamin is also associated with a lowered immune response to infections (4).  Several studies have found links between low vitamin D levels and the development of respiratory infections in infants and young children (11).

Owing to the importance of vitamin D for healthy development, the Department of Health and NHS recommend that breast-fed babies from birth to 1 year of age should be given a daily supplement containing 8.5 to 10 micrograms (400iu) of vitamin D to make sure they get enough vitamin D, whether or not their mother is taking a vitamin D supplement.  Formula-fed babies should not be given a vitamin D supplement until they're having less than 500ml (about a pint) of infant formula a day, as infant formula is fortified with vitamin D (8). 

Health benefits of vitamin D

• Helps the body absorb calcium to build strong bones and teeth
• Important for muscle development
• Support healthy, balanced immune function
• Lower risk of eczema for infants with sufficient vitamin D
• Fewer respiratory and other infections in infants with sufficient vitamin D

References

1. Roberto Antonucci, Cristian Locci, Maria Grazia Clemente, Elena Chicconi and Luca Antonucci (2018) Vitamin D deficiency in childhood: old lessons and current challenges. Journal of Pediatric Endocrinology and Metabolism V31 (3) DOI: https://doi.org/10.1515/jpem-2017-0391  Published online:  05 Feb 2018 https://www.degruyter.com/view/journals/jpem/31/3/article-p247.xml 
2. Armin Zittermann and Jan F. Gummert (2010) Nonclassical Vitamin D Actions Nutrients 2010, 2, 408-425; doi:10.3390/nu2040408 https://www.mdpi.com/2072-6643/2/4/408/htm 
3. Girgis CM, Clifton-Bligh RJ, Hamrick MW, Holick MF, Gunton JF. The roles of vitamin D in skeletal muscle: form, function, and metabolism. Endocr Rev 2013;34:33–83.
4. Saggese G, Vierucci F, Boot AM, Czech-Kowalska J, Weber G, et al. Vitamin D in childhood and adolescence: an expert position statement. Eur J Pediatr 2015;174:565–76.
5. Dogru M, Kirmizibekmez H, Yesiltepe Mutlu RG, Aktas A, Ozturkmen S. Clinical effects of vitamin D in children with asthma. Int Arch Allergy Immunol 2014;164:319–25.
6. Camargo CA Jr, Ganmaa D, Sidbury R, Erdenedelger Kh, Radnaakhand N, et al. Randomized trial of vitamin D supplementation for winter-related atopic dermatitis in children. J Allergy Clin Immunol 2014;134:831–5.
7. Urashima, M.; Segawa, T.; Okazaki, M.; Kurihara, M.; Wada, Y.; Ida, H. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am. J. Clin. Nutr. 2010.
8. https://www.nhs.uk/conditions/pregnancy-and-baby/vitamins-for-children/ (Advice correct as at 16th June 2020)
9. Carol L. Wagner, Frank R. Greer (2008) Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents Pediatrics Nov 2008, 122 (5) 1142-1152; DOI: 10.1542/peds.2008-1862 
10. Wang, L‐C, Chiang, B‐L, Huang, Y‐M, Shen, P‐T, Huang, H‐Y, Lin, B‐F. Lower vitamin D levels in the breast milk is associated with atopic dermatitis in early infancy. Pediatr Allergy Immunol. 2020; 31: 258– 264. https://doi.org/10.1111/pai.13179
11. Zisi, D., Challa, A., & Makis, A. (2019). The association between vitamin D status and infectious diseases of the respiratory system in infancy and childhood. Hormones (Athens, Greece), 18(4), 353–363. https://doi.org/10.1007/s42000-019-00155-z