Here's the latest expert advice to help your kids safely get the vitamin D they need

By Avril Roberts
 
The idea of following recommendations for daily sunscreen application from six months of age, and considering the time kids spend indoors basking only in the light of a computer or TV screen, is making many parents wonder how much vitamin D their kids can possibly get – and how. Some experts help to address these concerns for parents.

Kids coming up short
The first question is who should worry? In Canada, it's mainly breastfed and darker-skinned infants (many from major cities, like Toronto and Ottawa), and infants living in the North (above 55 degrees latitude) who are at highest risk of vitamin D deficiency, suggests Dr. Leanne Ward, a pediatrician and researcher at the Children’s Hospital of Eastern Ontario in Ottawa, who led a recent study on rickets in infants and young children. Sunscreen isn’t the issue for them, but rather the lack of vitamin D intake in the diet. Also, the mother’s own vitamin D status matters, “because babies receive their vitamin D initially from mom in her third trimester,” says Dr. Ward. “Vitamin D from mothers last only a few weeks until the baby’s own vitamin D stores have to kick in.”

The need for vitamin D
Kids (and adults) primarily need vitamin D for long, strong and healthy bones. "You need a critical amount of vitamin D to have normal amounts of calcium in the blood. And that calcium is necessary for normal bone growth and strength," says Dr. Ward. "Children who are missing that critical amount of vitamin D can develop rickets or softening of the bones and a failure of the bones to grow in length."

Why US Kids Are D-ficient
With kids spending less time outdoors and drinking less milk, a new US study published in the July issue of the American Journal of Clinical Nutrition shows that over half of healthy children have lower than recommended vitamin D levels. Analyzing blood samples from nearly 400 kids, aged 6 to 21, findings reported that low-vitamin D levels were evident in African-American children, children over age 9, and those who didn't get much vitamin D in their diet. Winter also led to a drop in vitamin D stores in over two thirds of kids.Vitamin D may have additional health benefits, suggest preliminary findings, such as preventing osteoporosis, helping immune function, and possibly playing a role in preventing diabetes, multiple sclerosis and some cancers. "Those aspects, however, are still under investigation and remain speculative at this point," Dr. Ward cautions.

Just the right amount of sunlight
For half of the year, kids older than infants and toddlers, possibly get more sun exposure than you realize, just from being outdoors, even for a little while. "Even if you put sunscreen on your kids, they’re still going to get some vitamin D from the sun because sunscreen doesn’t last forever," says Dr. Ian Landells, a pediatric dermatologist in St. John’s, Nfld. and clinical assistant professor at Memorial University.

However, increasing sun exposure isn’t the way to go, especially in winter. "You’re not exposed to enough sun in winter to top up your vitamin D levels," says Dr. Landells. As well, it just takes one bad sunburn to tip the balance toward skin cancer. "Some types of skin cancers are related to the chronic, cumulative exposure to ultraviolet radiation. Other types are more related to just one big blast," he says.

Making sure they get enough
There are a few ways to make sure kids meet their vitamin D needs:

Soak it up Small amounts of sun exposure without sunscreen, about 15 minutes of sun on the back of the hands and face, three to four times a week, is enough to maintain adequate vitamin D levels during spring and summer, says Dr. Landells. Kids with darker skin need more time in the sun because melanin (skin pigment) filters out the UV radiation that stimulates skin's vitamin D production.

Eat it "It’s important to get vitamin D from good dietary sources," says Susan Whiting, professor of nutrition at the University of Saskatchewan in Saskatoon. "However, there’s not as much vitamin D in our food supply as we thought." The best recourse is to seek out those few dietary sources of vitamin D and, for good measure, throw in a supplement. Whiting recommends serving kids vitamin D-fortified orange juice, egg yolks, and oily fish like sardines and herring. Other food sources include milk, salmon, tuna, and fortified margarine

Pop it The Canadian Pediatric Society recommends that all breastfed infants start on a supplement (drops) containing 400 international units (IU) of vitamin D daily within the first two weeks of life. This doubles to 800 IU of vitamin D, between October and April, for breastfed babies living in the North. All other children require 400 IU daily, which can be obtained through diet and/or supplements. Children’s multivitamins and fish liver oils often contain vitamin D, so check the labels.