How to supplement vitamin D in children

  Vitamin D deficiency rickets used to be a disease that seriously endangered the health of children in my country, and it was one of the “four preventions” of children. For children, vitamin D supplementation is particularly important. A few days ago, the Editorial Board of the Chinese Journal of Pediatrics, the Child Health Group of the Pediatric Branch of the Chinese Medical Association, issued the “Practice Guidelines for Clinical Issues Related to Vitamin D Nutrition in Children in China” (hereinafter referred to as the “Guidelines”), which answered how children should supplement vitamin D.
   Vitamin D supplementation begins a few days after birth.
   Vitamin D is an essential fat-soluble vitamin known as the anti-rickets vitamin, but the biological role of vitamin D has expanded from bone health to systemic health. Wang Wen, a nutrition physician in the Nutrition Department of Henan Provincial People’s Hospital, said that vitamin D can promote the absorption of calcium and phosphorus in the intestine, maintain normal blood calcium and blood phosphorus levels, ensure bone health and normal neuromuscular function; prevent and treat osteoporosis, reduce Fracture risk; may increase muscle strength, relieve pain in joints and surrounding soft tissues, and reduce risk of falls.
   There are three sources of vitamin D: sunlight exposure, natural foods, and supplements (fortified foods, dietary supplements, pharmaceuticals). It is mentioned in the “Guide” that sunlight exposure is an important way for the body to obtain vitamin D, but attention should be paid to safety when exposed to sunlight. The American Academy of Pediatrics recommends that infants younger than 6 months should avoid direct sunlight, wear appropriate protective clothing and hats, and advise against prolonged exposure to the sun to prevent sun damage to the body.
   Because not all infants have enough time outdoors, the Guidelines recommend vitamin D supplementation for both breastfed and formula-fed infants, starting within days of birth.
   Vitamin D3 preparations are recommended to be preferred.
   Vitamin D mainly includes vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Among them, ergosterol present in plants can be converted into vitamin D2 by ultraviolet irradiation; vitamin D3 can be synthesized from 7-dehydrocholesterol present in animal skin by ultraviolet irradiation.
   It is mentioned in the “Guidelines” that daily oral vitamin D supplementation is recommended, and vitamin D3 preparations are preferred. Vitamin D supplements are divided into ordinary vitamin D and active vitamin D. Active vitamin D is an effective drug for the treatment of osteoporosis. It is not recommended for children to choose this type of vitamin D.
   There are two types of vitamin D drops for infants and young children on the market: capsule type and liquid dosage form. Generally, the content of 1 capsule is 400 IU, and the content of 1 ml of liquid dosage form is also 400 IU. For details, please read the label and use it according to the dosage. It is important to note that it is to be distinguished from vitamin AD drops, which contain vitamin A, to avoid overdose. In addition to daily oral vitamin D supplements, foods rich in vitamin D can also be added to the diet, such as fish, liver, egg yolks, etc. The “Guidelines” recommend that dietary calcium intake should be ensured while supplementing vitamin D. Dairy is the best source of calcium, and milk contains calcium and is easily absorbed.