VITAMIN content of breast milk is not sufficient for the development of infants. The only vitamin that the baby should take as a supplement is vitamin D. Kadıköy Şifa Suadiye Polyclinic Child Health and Diseases Specialist Günay Ermergen describes the problems and treatment modalities of vitamin D deficiency in children.
Functions of vitamin D in the body; It regulates the absorption of Ca and P from the small intestine, affects bone growth, hardening and repair, regulates low blood Ca levels in kidney diseases, and provides normal development and growth of bones and teeth in infants and children. It prevents rickets and controls bone development with Ca. It plays an important role in the growth of cells and in the regular function of muscle and nervous systems. Lowers high blood pressure. Recent research has shown that vitamin D has a protective effect against cancer of the large intestine, bone, skin, breast and increases immunity to tuberculosis. Two studies conducted in the USA have shown that the risk of large bowel cancer is reduced by 66% and the risk of breast cancer by 50%. Although our country has a geography that provides plenty of use of the sun, unfortunately vitamin D deficiency is still an important and serious health problem affecting pregnant women and adolescents as well as their babies.
Therefore, the health ministry in 2004, he launched "Like Turkey" campaign in 2005. "prevention of vitamin D deficiency in infants and maintenance of bone health," he added program. As part of the ubu smiling future with vitamin D ”project, which will last until 2010, 1 million vitamin D syrup will be distributed each year.
Vitamin D is one of the fat-soluble vitamins. It's mostly found in two ways. One of them is active ergosterol, calciferol and ergocalciferol, known as vitamin D2, found in irradiated yeasts. Active 7 dehydrocholesterol and cholecalciferol, also known as vitamin D3, are produced by contact with sunlight on human skin and are mostly found in fish oil and egg yolk. It is stable to heat and resistant to cooking. Taking high amounts may cause toxic reactions.
Vitamin D is very important for strengthening the bones and especially the teeth. The only source of ultraviolet in nature is the sun. Although vitamin D in breast milk is more easily absorbed (the amount of vitamin D in breast milk is 12-60 IU), it does not meet the 400 IU daily needs of the baby.
Especially mothers and children with vitamin D deficiency need supplementation. The fetus needs vitamin D from the mother's stores. The fetus stores vitamin D in various tissues as well as it can manage itself for a while after birth. If vitamin D stores are not sufficient in the mother, the baby is born either deficient in vitamin D or stored insufficient vitamin D. In this case, if enough vitamin D is not taken after birth and not exposed to sufficient sunlight, it increases the risk of rickets due to vitamin D deficiency. Other conditions that should be considered for vitamin D intake are; children living in inadequate areas of sunlight, people who get inadequate food and burn excess calories, women over 55 and especially postmenopausal women, breastfeeding, pregnant women, alcohol and drug users, chronic disease, long-term stress, recent surgery ...
The main source of vitamin D is sunlight. Sunbathing meets 80% of the daily requirement, mostly found in fatty fish, liver, egg yolk, cheese, butter, milk and mushrooms. When the sun's rays do not come upright, sunbathing of arms, legs and face for about 15 minutes a day provides vitamin D daily. However, it should be noted that the glass does not transmit UV rays.
In cases where the child does not get enough vitamin D, signs of vitamin D deficiency occur called rickets. Rickets is bone disease caused by insufficient mineralization of growing bone. The mineralization defect that develops after completion of bone growth is called osteomalacia. The main minerals that provide bone mineralization are CQ and P. Vitamin D provides sufficient amount of these minerals in body fluids and tissues. Vitamin D is first processed in the liver, then in the kidney, and becomes effective after it has been activated.
Rickets is a disease of developing countries. Vitamin D deficiency develops especially in brown-fed infants who are fed with milk and during periods of rapid growth. In premature infants, vitamin D deficiency is seen in the early period as they are born with incomplete storage and grow rapidly. Congenital rickets is seen in infants of malnourished mothers who do not benefit from the sun adequately. Apart from inadequate intake, rickets may also develop in diseases of liver and kidneys that impair the activation of vitamin D, disorders of intestinal absorption or the use of certain anticonvulsant drugs.
Rickets is most commonly seen between 3 months and 2 years. During infancy, softening of the bones of the head, the width of the bone, the formation of rosary beads at the junction of the cartilage in the ribs, collapse of the rib cage, expansion of the wrists and ankles. There is delay in teething, late sitting and late walking. Due to hypotonia in the muscles, the abdomen is swollen and spread sideways (frog's belly). Sweating and respiratory infections are prone. The head is larger than the body and shows flattening in the lying direction. When the child begins to walk, the child develops brackets legs. In severe cases, contractions occur due to low calcium in the blood. Vitamin D supplements for treatment. Vitamin D can be given in daily or single depot dosage form.
The calcium supplement should also be added. The dose of vitamin should be determined by the doctor. During infancy, 400 units per day should be given for at least 1 year.
Vitamin D intoxication occurs if a high dose of vitamin D is taken outside the doctor's recommendation. Findings due to vitamin D intoxication occur due to high data in Ca in blood. It depends on the excess enzyme of Ca in the intestines. Ca has effects on nerves, heart, muscles, digestive system and kidneys. Intoxication may include symptoms such as fatigue, nausea, vomiting, loss of appetite, constipation, abdominal pain, ulcers, excessive thirst, severe muscular weakness, blurred consciousness, hypotonia, hypertension, renal failure, and heart rhythm deterioration.