What sort of parents would we be if we knew our children were at danger of vitamin deficiency and did nothing about it? And, to make matters worse - when the solution to the problem is free to all? Well, unfortunately that's the situation across the UK with millions of families with young children. Those millions of families are missing out on free vitamin supplements either because they just don't know they are entitled to them or that their children need them- as a result children all over the UK are suffering with Vitamin D deficiency, rickets and seizures.
Historically we Health professionals thought everyone would produce enough vitamin D in their skin via sunlight and from eating foods which contain vitamin D. Now we know that's just not the case and children especially are falling short of their vitamin D needs. We are seeing more cases of rickets and other signs of vitamin D deficiency in our youngest children. In some areas it's thought up to 75% of children are vitamin D deficient (1). So what's the answer? Some think we should add vitamin D it to every day foods like milk or cereals, others say we need to change our advice about protecting children's skin from the sun? Some people think we should do both of these- but while the legislators make up their minds, there's a simpler answer- What about giving children a vitamin D supplement?
The Government recognised the need for action, when in 2006 it launched the Healthy Start scheme. Healthy Start includes the provision of FREE vitamin drops containing Vitamin D for children from families receiving a benefits - yet only a tiny minority, as few as 2% of eligible families take advantage vitamin drops- why? Well, I believe that Nurses, doctors and health visitors are simply not getting the message across to parents that children need to take a daily supplement of vitamin D.
And a number of studies have identified these obstacles to the uptake of Healthy Start vitamin drops (1,2):
• The scheme is complicated and badly organised
• Health professionals have poor awareness of the scheme and don't talk to parents about it
• Health professionals do not routinely explain to parents that their children need a vitamin D supplement- regardless of Healthy Start eligibility
• Parents have poor awareness of the need for vitamins supplements for their children
Why children need vitamin D supplements.
Historical data shows that in the early 1990s half of young children were not getting enough of vitamins A or D- more recently vitamin A intakes have improved and are being met by diet but Vitamin D intakes remain poor- and they are not likely to improve.
It's a big challenge for anyone to get enough vitamin D because:
• Few foods naturally contain vitamin D (the best sources being oily fish and egg yolk)
• By law Vitamin D only has to be added to spreads, cow's milk alternatives and infant formulas. Unlike other countries we do not routinely add vitamin D to staple foods like milk and cereals in the UK.
• Up to 90% of vitamin D comes from exposure to sunlight and is produced in the skin. It's estimated that we would need to be exposed to sunlight for 20-30 minutes a day to produce the required amount of Vitamin D.
When children fall short of their vitamin D requirements they can become deficient and develop serious health problems like hypocalcaemic seizures and rickets- diseases which were considered long gone after the Victorian era. Not anymore, since 2001 these health problems have been seen in greater numbers year on year culminating in 2007 when the Governmental food and nutrition advisory body COMA changed direction and issued new advice about vitamin D:
COMA recommends almost ALL children need Vitamin D supplements:
• All infants should receive vitamin supplements unless they consume more than 500ml of vitamin D fortified formula daily
• Breastfed babies over 6 months need supplements, and those under 6 months should have supplements if the mothers vitamin status is not certain
• Children over 1 year should have supplements unless their diet contains regular vitamin D sources and they are regularly exposed to sunlight
• Children at risk of deficiency , those living in the north of the UK, those from Asian and Islamic families, poor eaters should take vitamin supplements until the age of 5
To find out how to register and claim Healthy Start vouchers check out the Healthy Start website www.healthystart.nhs.uk/
And, to find where you can exchange vouchers for vitamin drops in your area, enter your postcode on this website:http://www.nhs.uk/Service-Search/Healthy-start-vitamins/LocationSearch/348
Families not eligible for the free children's vitamin drops can buy them over the counter at pharmacies. You need to look for a children's supplement providing between 7.5ug and 10ug of Vitamin D daily. The cost of the drops is around £2.00 for an eight week supply.
In the long term, of course we need more cohesive awareness raising campaigns around children's vitamin drops. We need to train health visitors, practice nurses and GPs to routinely talk to parents about using supplements. This all takes time- the reality is if we wait for these initiatives and/or the Government to make a decisions about adding vitamin D to more foods it will be too late for a generation of children.
Don't be in any doubt. If you know a child under 5- Ask if they are given vitamin D supplements- if they're not, make sure their carer knows that they should be. It's so simple and will save more children from needlessly having their bones broken and reset to repair the damage of rickets and vitamin D deficiency.