Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

This week, Pediatrician Dr. Joanna Dolgoff explains how you can find out if your child is vitamin D deficient.

joannadolgoff Joanna Dolgoff, M.D.
  • BA Molecular Biology, Princeton, Graduated Cum Laude
  • MD, NYU School of Medicine
  • Pediatric internship and residency at Presbyterian Children’s Hospital of New York
  • 5 years private practice in Pediatrics
  • CBS News Online correspondent: childhood obesity expert
  • Child & Adolescent obesity and weight management expert
  • Website:Online Weight Management Program
  • Twitter:@joannadolgoffmd
  • LinkedIn Profile
  • Contact: via email from website

Question: How do I know if my child has vitamin D deficiency?

Answer:

New studies are proving that vitamin D is an important nutrient that can help prevent many diseases such as cancer, depression, diabetes, hypertension, osteoporosis, chronic fatigue, autoimmune diseases and cardiovascular disease.

There are a few different ways to get vitamin D.  Vitamin D may come from foods or vitamin supplements; vitamin D can also be made by the skin when it is exposed to ultraviolet rays (UV light).

Vitamin D deficiency is often missed because there are no real symptoms associated with it.  Rickets and osteomalacia (softening of the bones) are the most common signs of vitamin D deficiency but there is no way for parents to tell if their child is suffering from these illnesses.  The only way to prove that your child is vitamin D deficient is by completing a blood test which screens for a particular form of vitamin D, called 25-hydroxyvitamin D (25(OH)D).

Think that name sounds complicated?  Unfortunately, many doctors do too.  In fact, doctors often order the wrong blood test when assessing vitamin D levels.  Be sure to ask for 25(OH) D blood test not 1, 25-dihydroxy-vitamin D (aka calcitriol).  With such complicated names, it is no wonder that such mistakes are made!

Vitamin D deficiency exists when 25(OH) D levels fall below 25 ng/mL.  Levels may vary depending on time of year, direct sunlight exposure, skin color and vitamin D consumption.  Levels should be between 50 – 80 ng/mL year-round for both children and adults.

As a doctor, I am finding more and more children with low levels of vitamin D, mainly because kids are spending less time in the sun.  These days, toddlers are more often inside watching TV than playing outside.  And if they are in the sun, they are lathered with sun block, which reflects the sun’s rays and decreases vitamin D formation.  Obviously, sunscreen is important and should not be avoided!  But it does lead to lower levels of vitamin D. Also, many toddlers do not get enough vitamin D to meet their needs since there are limited food sources of high vitamin D content.

The current recommendation is 400 IU per day in the form of of vitamin D3 (cholecalciferol).    New studies are showing that higher levels may be needed to prevent the diseases discussed above.  Many are now recommending 1,000 IU per day in the form of vitamin D3 (cholecalciferol).  If your child doesn’t get this amount of vitamin D in his diet, you may want to consider a multivitamin that contains vitamin D.

©2009 Littlestomaks.com. All Rights Reserved
Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

13 comments

  1. Alina

    What are some food sources of vitamin D that can offered to toddlers?

  2. Alina

    What are some food sources of vitamin D that can offered to toddlers?

  3. Joanna Dolgoff MD

    Foods that contain Vitamin D include fortified milk, fortified yogurt, fortified breakfast cereals, wild salmon, canned tuna, cod liver oil, sun-dried shitake mushrooms and egg yolks. I think the fortified milk, yogurt and breakfast cereals will work best for a toddler!

  4. Joanna Dolgoff MD

    Foods that contain Vitamin D include fortified milk, fortified yogurt, fortified breakfast cereals, wild salmon, canned tuna, cod liver oil, sun-dried shitake mushrooms and egg yolks. I think the fortified milk, yogurt and breakfast cereals will work best for a toddler!

  5. In addition to foods, you can also give your kids juice with high amounts of vitamin D. Our client First Juice (http://www.firstjuice.com) has a juice that is high in vitamin D and also half the sugar than most juice, in addition to vegetables, making it a great choice for those concerned with vitamin D deficiency and childhood obesity.

  6. In addition to foods, you can also give your kids juice with high amounts of vitamin D. Our client First Juice (http://www.firstjuice.com) has a juice that is high in vitamin D and also half the sugar than most juice, in addition to vegetables, making it a great choice for those concerned with vitamin D deficiency and childhood obesity.

  7. Tia Nabeul

    My Child has matured now,since her childhood she was not a healthy weight,It is not gentical..Im very worried,she is now turning 20.
    her weight is 36kgs.
    She has a proper diet,eats well.
    yet doest not gain much weight.her height is regular.5’3″
    im concerned for her well being.
    when she was 6yrs she was 20kgs.
    untill she was the age of 9.
    her weight increased due to her height.
    She is now depressed and hopeless as she feels that she will never gain weight,her friends make fun of her,call her flat all round as she has not gained much of breast size or a bottom.
    I want my only daughter to be happy again.
    Please Advice.
    Any test I shud consider?A diet?Supplements?
    we have taken her to the doctor.several Doctors.each examination leads to say shes fine.everythings ok.just her weight low.
    she has had blood tests,liver metablolism,etc etc..
    thanks,
    Best Regards
    Mrs.Nabeul

  8. Tia Nabeul

    My Child has matured now,since her childhood she was not a healthy weight,It is not gentical..Im very worried,she is now turning 20.
    her weight is 36kgs.
    She has a proper diet,eats well.
    yet doest not gain much weight.her height is regular.5’3″
    im concerned for her well being.
    when she was 6yrs she was 20kgs.
    untill she was the age of 9.
    her weight increased due to her height.
    She is now depressed and hopeless as she feels that she will never gain weight,her friends make fun of her,call her flat all round as she has not gained much of breast size or a bottom.
    I want my only daughter to be happy again.
    Please Advice.
    Any test I shud consider?A diet?Supplements?
    we have taken her to the doctor.several Doctors.each examination leads to say shes fine.everythings ok.just her weight low.
    she has had blood tests,liver metablolism,etc etc..
    thanks,
    Best Regards
    Mrs.Nabeul

  9. ch

    What is a safe level of vitamins D and A to give a 31 month child that weighs about 40 pounds? Thanks.

  10. ch

    What is a safe level of vitamins D and A to give a 31 month child that weighs about 40 pounds? Thanks.

  11. Pingback: Ask The Expert - Breastfed Children and Vitamin D | LittleStomaks

  12. Pingback: Five for Fridays - Reader Comments | LittleStomaks

  13. HollyangelmummyKieser

    Hi can anyone help, my daughter is 3 years old and has suffered knee pains and toe pains and foot pains since she could stand up unaided, she screams in so much pain sometimes she gets the pain at least twice a day, her lower motor skills arent very good she still walks up and down the stairs like a toddler with always one foot first not the normal one than the other, she cant ride trike, she will be 4 in august, i have noticed that her knee caps are slightly inwards but dont know if this is the problem she still walks very toddler like, i have taken her to the doctors but they say its growing pains, i told him i didnt think so as she has had pain everyday for nearly 3 years, he finally sent her to physio and they said her muscles were a bit tight and noticed it was mainly in her right knee and foot, and said to stop physio as it wasnt helping her, she had blood test done which showed her vitamin D level was 34, she has had test for arthritis and it has come back normal, shes just had an MRI scan on her right knee and foot, and were waiting for the results but if these come back normal i dont know what to do, i hate seeing my little girl in so much pain like this, its stopping her doing alot of things, i have also noticed that she sometimes walks on her tip toes and when i asked her why she said it doesnt hurt as much. 
    i would be grateful for anyones in put. 

Comments are closed.