Vitamin D: too much? too little?

Get your daily dose of D

How much vitamin D is recommended for kids? Dr. Lai contributed to this week’s Children’s Hospital of Philadelphia Health Tip of the Week post “Vitamin D Supplements: What Parents Should Know.”

Julie Kardos, MD and Naline Lai, MD
© 2019 Two Peds in a Pod®

Your mother was right! Health tips from mom

Do you ever wonder if some of the health advice your mom gave you growing up was actually correct?

On this Mother’s Day, we credit those moms who really do know a thing or two about child health.

1- Give your child chicken soup when she is sick.
There is merit to chicken soup. Children need to drink extra fluids when they are sick. Fevers, coughs, diarrhea, vomiting, and infections all can contribute to dehydration. Chicken soup is a great tasting fluid, has electrolytes (salt), and the vegetables that you cook in it leak all of their vitamins into the soup. Basically this is homemade “smart water” heated up. An added bonus: the chicken gives kids protein they need to fight infection.

If your child does not like chicken soup, you can hydrate them with water, apple juice, or milk (yes, kids can drink milk even if they have a cough or a fever).

2-Wear your gloves.
Moms do know how to dress kids for cold weather. Gloves are important because fingertips are at risk for frostbite. So are noses, but you can’t put gloves on that appendage.

3- Give honey for a cough.
We have written about this before- honey beats out placebo and even cough medicine in a few studies of parents’ perception of children’s sleep when sick with a cough. You can put it into tea, warm or cold milk, or give it straight off a spoon. Just be sure to brush their teeth afterward. And we remind you to NOT give honey to babies younger than one year of age because of concern for infant botulism.

4- Get some Vitamin D.
While we advise sunscreen for when your kids play outside, she is right that vitamin D , which comes from sun exposure and certain foods, is important. It not only contributes to bone health, but also modulates the immune system. Just focus on providing vitamin D-containing foods rather than tanning sessions.

5- Turn that music down. High frequency hearing loss is related to exposure to loud noises over time.

6- Take that out of your mouth!
“That” might refer to toys or a kids’ own fingers. Babies and toddlers, of course, developmentally need to mouth objects as part of exploration, and some soothe their gums while teething as they chomp on their fingers or on large, non-chokable toys. Your job is constant supervision to prevent them from placing small chokable or toxic objects (button batteries) into their mouths. Unfortunately, older kids have been known to put necklace beads, coins, game pieces, and their own fingers in their mouths. Some bite their nails or suck their thumbs. Your mom was right when she told you to “take that out of your mouth” in effort to avoid germ spread and to avoid choking.

7- Your nose is runny because it’s cold outside. While kids can’t catch a cold virus from cold temperatures, cold temperatures can cause a nose to run. This phenomenon, dubbed vasomotor rhinitis, occurs when the vessels in the nose dilate and cause congestion.

8-Take a nap.
Just like a little exercise goes a long way to improving health, a little nap can go a long way to restoring your energy level. Young kids tend to give up naps anywhere from 2 to 5 years old. If they are sleeping well overnight and are not sleepy during the day, they don’t need naps anymore. However, sometimes even after they give up nap time, kids fall behind on sleep: from illness, from a later bedtime due to a social event, or homework. A short nap can help them catch up on sleep and thus improve their mood and help their brains retain new knowledge. Just be aware that if you let your child nap for too long or too close to bedtime, they might have difficulty falling asleep that night which can put them in a vicious sleepy cycle.

Happy Mother’s Day – may you moms get a nice little nap today!

What’s New in Children’s Vitamin D and Calcium Requirements

The American Academy of Pediatrics has increased the recommended daily requirement for Vitamin D in children and adolescents to 400 IU (international units), based on studies of decreasing bone density in kids. This is equivalent to 32 ounces of milk per day. This is TOO MUCH milk for anyone other than an older formula-fed baby who has not yet started solids foods. All breastfed babies, babies on formula AND solid foods, and all other children and teens should be given a vitamin D supplement such as Tri-Vi-Sol or a chewable children’s vitamin. Read the labels: look for “Vitamin D—400 IU.” The goal is to prevent rickets (a bone disease that results in brittle bones) and to make sure growing bones reach their maximum potential for strength. Vitamin D is also important for other body systems such as the immune system.

Interestingly, 15 to 30 minutes of direct sunlight per week is all kids need to absorb enough vitamin D through skin. However, concern for increased risk of skin cancer from cumulative sun exposure means that kids are absorbing less vitamin D from sunlight because we parents are so good at applying sunscreen. Also, especially in winter months, children spend more time playing inside than playing outside.

Calcium requirements vary somewhat by age but generally can be met with 16 to 24 ounces (2-3 cups) of milk, or less if kids consume other calcium containing foods such as cheese, yogurt, broccoli, sweet potatoes, fortified cereals, or a supplement. The milligram (mg) requirements are around 500mg for toddlers, 800mg for children and 1200-1500mg for kids 11-18 years. To give you an idea of how to visualize this amount, one cup of milk contains 300mg of calcium. When you read food labels that report calcium as a percent of daily requirement, know that the “standard” for food labels is set as 1000mg. So if a yogurt container reports “25% of daily calcium requirement” you assume that the yogurt contains 250mg of calcium (25% of 1000mg).

So continue to have your kids Drink Milk! But remember to give them a Vitamin D supplement as well.

For more interesting tidbits about milk, please refer to our blog post: “Got Milk? Dispelling Myths About Milk”