Feeding FAQ: 24+ months – General Nutrition

I’ve read about vitamin drops for babies, though my child has never taken them. He’s older than one, but I wondered if it’s worthwhile starting them now. If so, how long should I give them to him?

Yes, it is definitely still worthwhile starting the vitamin drops. They help babies and young children in the UK to get enough of three key vitamins: A, C and D. While vitamin A intake is lower than recommended in many UK children, and vitamin C plays a role in the absorption of iron (the lack of which is a factor in iron-deficiency anaemia in about 12% of UK toddlers), it’s vitamin D that has brought the issue of vitamin drops to the forefront right now. There has recently been growing recognition that some babies, toddlers and pregnant women (and even a proportion of other adults) are not getting enough vitamin D. As I discussed in my December article on ContentedBaby.com, the difficulty with vitamin D is that little of it comes from our diet; most of it is made in our skin after exposure to sunlight. This makes it easier to understand how vitamin D deficiency could happen in the climate of the UK, particularly the higher incidence in Northern areas, but low vitamin D levels are also increasingly seen in the US and even in sun-rich Australia. Several factors have been put forward, particularly less outside play for children (and adults!), and more use of sunscreen and sun avoidance. Skin with darker pigment absorbs less sunlight, thus making less vitamin D, which explains why low vitamin D levels are more of a problem for people with darker skins. And in the UK the sun is only strong enough to generate vitamin D in our skin between April and September, thus we must build up enough stores during these months to last through the rest of the year. While this sounds difficult, it’s simply a matter of gentle sun exposure to the face and hands for a half hour a few times a week.

The reason health experts get concerned about vitamin deficiencies is because vitamins are essential for bodies to grow and, in children, develop properly. Vitamin D is needed for a variety of functions including normal bone development, and a condition called rickets (in which bones do not grow properly) can result from children not getting enough vitamin D. In the late 1800s about two of every three UK children were affected by rickets, but it has been thought of as quite rare in modern times. However health experts are worried about a recent increase in rickets, mostly but not all among Asian and Afro-Caribbean children in the North of the UK. For this reason vitamin D supplements are particularly important for people from these ethnic groups.

Because we get little vitamin D through food there has been a call from an expert in the field, Professor Simon Pearce of Newcastle University, for milk in the UK to contain added vitamin D to benefit anyone not getting enough vitamin D. In meantime, the NHS recommendation is that children continue to take a supplement containing vitamins A and D until the age of five. These are available at child health clinics and are free in the UK for children up to age four in families receiving certain state benefits. Incidentally The American Academy of Paediatrics has also recently brought in a recommendation that children over the age of two months should have vitamin D supplements in the US.

And a note for mums: a time when you are feeding a toddler is also a time when many women plan to become pregnant again. A study published late last year in the British Journal of Nutrition found that most pregnant women in Northern Ireland had inadequate levels of vitamin D in their blood. If this carries through to after the birth, it may mean lower vitamin D levels in breast milk and therefore lower vitamin D levels for breast-fed babies as well. Thus, I’d recommend pregnant women who do not spend much time in the sun should discuss supplements containing vitamin D with their healthcare provider. You may also want to think about supplements for elderly relatives who may not be able to get out into the sunlight, or those who cover their skin for religious reasons, therefore getting little sun on their skin.

For more information on vitamin supplements, see the NHS Healthy Start vitamin website on www.healthystart.nhs.uk