Vitamin D In Kids: Pediatrician Warns About The Hidden Winter Deficiency

As winter sets in for many parts of the world, parents tend to focus on protecting their children from the cold. Bundling up is essential for warmth, but it inadvertently prevents exposure to a critical health resource: sunlight. Vitamin D, often called the "sunshine vitamin," plays a pivotal role in children's growth, immune health, and skeletal development. However, winter's shorter days and limited outdoor activities exacerbate an already pressing global issue: vitamin D deficiency.

Dr. Kushal Agrawal, MD Pediatrics and Head of the Department of Pediatrics, says, "Vitamin D deficiency is a concern that grows with the winter season since sunlight exposure, which is needed for the synthesis of this essential nutrient in the body, is limited during this season. Without the adequate amount, children risk weakened bones, delayed development, and compromised immunity.

Vitamin D is necessary for healthy growth from infancy up to adolescence. It is needed for the mineralization of bone, regulation of calcium and phosphorus levels, and development of cells that help the body fight infections. Its deficiency in childhood may cause rickets, which creates deformities in bones, as well as impact cognitive growth and mental health.

According to global health data, more than one billion people, children included, suffer from a vitamin D deficiency. Vitamin D deficiency is not specific to developing countries, as it is also present in industrialized countries. Vitamin D deficiency arises as a result of dietary habits, urban living, and restricted sunlight exposure in those developed countries.

Winter poses special challenges for achieving adequate vitamin D levels. With colder months comes reduced UVB radiation, overcast skies, and shorter daylight hours that lower the skin's ability to produce vitamin D. For children, who are often kept indoors or heavily clothed to protect against the cold, this means even less exposure to sunlight.

Parents must make this balancing act of shielding children against cold and sun-exposing them to the warmth adequately. Sunlight is nature's best vitamin D provision and even small dosages that can be done when out in mid-morning or early afternoon suffice", asserts Dr. Agrawal.

The RDA of vitamin D for children and teens is comparable to that of adults. In infants, though, needs are lower as they're based on achieving a serum level above 20 ng/mL (50 nmol/L) to promote healthy growth.

However, many specialists claim that these recommendations are conservative and not enough for maintaining optimal vitamin D levels. Pediatricians usually recommend that children have a combination of natural sunlight, diet, and supplements to ensure adequate amounts, especially during winter.

Sources of Vitamin D for Children

Though sunlight is the best source of vitamin D, dietary and supplementary sources are important during winter. According to Dr. Agrawal:

Let children play outside during mid-morning or early afternoon when UVB rays are most effective. "Make sure they get at least 15–20 minutes of sun exposure on uncovered skin areas like the face, hands, or arms," he advises.

Add foods such as oily fish (salmon, trout), fortified milk, cereals, and some egg yolks to the diet of a child. However, due to these foods alone, hardly any daily intake of vitamin D can be obtained from them.

For children who spend little time outdoors or reside in places where winters are extreme, supplementation may be essential. Pediatrics usually prescribe vitamin D3 supplements based on the child's age and his or her requirements.

Expose children to limited amounts of sun without sunscreen for the duration of vitamin D production to occur. Following the brief exposure, use sunscreen on them.

Despite its importance, maintaining optimal vitamin D levels is challenging for many families. Factors like skin pigmentation, geographic location, and dietary restrictions can complicate efforts. Additionally, vitamin D deficiency is often underdiagnosed, as symptoms like fatigue, muscle pain, or frequent infections may be attributed to other causes.

Increasing awareness among parents about vitamin D, especially during the winter season, is an essential step. Regular check-ups of their children at pediatricians, planning their diet, and outdoor activities are some of the steps that can fill this gap," says Dr. Agrawal.

As a parent, preventive measures are vital to maintain the vitamin D levels of your child. Get in touch with your pediatrician to evaluate the requirements of your child and establish a personalized plan. Be it through sun exposure, changes in diet, or supplements, ensuring that your child maintains adequate vitamin D levels could protect his growth and immunity during the colder months.

Dr. Agrawal concludes, "Vitamin D is not merely a nutrient; it forms the very foundation of health for your child. Prevention during winter can protect the little one from the subliminal threats of deficiency and set the foundation of a healthy future.

Vitamin D deficiency is a global problem with significant health implications for children, especially during winter. Understanding its importance and taking actionable steps can ensure that children thrive even during the coldest months of the year. The "sunshine vitamin" might just be the key to keeping your child's health glowing, no matter the season.

Vitamin D Metabolism and Guidelines for Vitamin D Supplementation. Clin Biochem Rev. 2020.

Vitamin D: Fact Sheet for Health Professionals. NIH Office of Diatary Supplements