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Pediatrics at HSS

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Kids Need to Get their Ds

Are Kids getting enough Vitamin D?

We all know getting enough Zs — a good night's sleep — is essential for chidren's health. It turns out that getting their Ds — as in vitamin D — is just as important. Pediatric nurse practitioner, Danielle Gorelick says she's seeing increasing numbers of kids with a vitamin D deficiency, and that can affect their bones.

“This is a critical vitamin because it works with calcium to help strengthen and maintain healthy bones. If vitamin D levels are too low, calcium can't be absorbed," Danielle explains. "It's an under-recognized problem in this country. Studies show that many children and teens are not getting enough of this essential vitamin, putting them at greater risk for a fracture.”

Sometimes called the "sunshine vitamin," vitamin D is produced by the skin when exposed to sunlight. In the winter months, less ultraviolet light reaches us, so if we're counting on sun exposure to get sufficient vitamin D, we're out of luck.

Milk and fortified foods, including orange juice and some cereals, can also provide vitamin D. But kids would have to consume a whole lot of these foods to get the "D" they need, and that's often not possible, according to Danielle.

"A big misconception among parents is that their child's bone health is being protected by all the calcium they're getting from foods such as yogurt and cheese," she says. "Although they are getting an abundance of calcium in their diet, if they're not drinking several glasses of milk every day and are not spending a lot of time in the sun, chances are they're not getting enough vitamin D to support bone health."

Dr. Shevaun Doyle, a pediatric orthopedic surgeon at HSS, points to other factors contributing to vitamin D deficiency. “One reason is that kids are spending more time indoors on their computer, playing video games or watching TV. When children do go outdoors, many parents have them wear sunscreen to protect against skin cancer, and this can impede the absorption of vitamin D," she notes. "Athletes who train indoors, such as gymnasts and swimmers, often appear to have great strength, endurance and health, but they may also be at risk for vitamin D deficiency because they train primarily indoors."

To make matters worse, young people generally don’t drink enough milk, which contains more vitamin D than any other food, and kids may not be taking a daily multivitamin.  All of these factors contribute to low levels of this important vitamin, and the result is a higher risk of breaking a bone in a fall or other injury.

Fractures and Vitamin D

"When there is a vitamin D deficiency, some children may take longer to heal their fractures, or they may re-fracture a bone or have another fracture down the road,” Dr. Doyle says. That's what happened to Steve, one of her patients. The athletic 12 year-old was the picture of health, participating in a variety of sports and on the track team. His mother made sure he ate a healthy diet. Before he broke his arm, no one could imagine he had a vitamin deficiency.

When Steve fractured his arm twice within six months, Dr. Doyle suspected that a low vitamin D level was the culprit. She ordered a blood test and her suspicions were confirmed. The news took Steve's mother completely by surprise, as he had always eaten lots of Greek yogurt and other healthy foods.

Dr. Doyle prescribed a vitamin D supplement, and Steve's levels came up to normal. Problem solved, to everyone's relief.

Building healthy bones, which continues to age 30, is great motivation to ensure adequate vitamin D intake. But if that's not reason enough, the deficiency has also been linked to other health problems.

The solution is often relatively simple. Danielle recommends that parents who are concerned talk to their child's doctor, especially if a youngster is a picky eater or avoids dairy products. A vitamin D supplement or multivitamin may be advised to help ensure your kids get the vitamins and minerals they need.