Rickets (Vitamin D Deficiency) Cases Rising

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August 27, 2000 | 44,908 views

Rickets appears to be on the rise, particularly in African-American children, according to a new report. Rickets is a disorder most commonly caused by vitamin D deficiency that results in soft, malformed bones, and muscle weakness.

At the time of diagnosis, most of the infants were growth retarded in both height and weight with nearly one-third being severely growth retarded. Many of the infants also had bow legs and bone fractures, common problems with untreated vitamin D deficiency.

"We support Breastfeeding as the ideal nutrition for babies and children but recommend supplementation of all dark-skinned, breast-fed infants and children with 400 IU of vitamin D per day, starting at least by 2 months of age," the researchers conclude.

Many Breastfeeding advocates are justifiably defensive of any perceived defamation of Breastfeeding, and therefore disagree with the assertion that vitamin D supplementation is required in a breastfed baby. However addressing this issue, accompanying editorial states:

A second objection may actually derive from our very appropriate advocacy for human milk as a "perfect food." For some, the need for supplementation may imply nutritional inadequacy. As emphasized above, however, calciferol (vitamin D) is in no sense a nutrient, but rather the precursor of a steroid hormone that is not naturally present in any infant food. Classifying the antirachitic substance in cod liver oil as a vitamin was an unfortunate historical error that has become too ingrained to correct.

If one views calciferol in this light, then it is not necessary to consider human milk "deficient." Instead, the provision of supplemental calciferol can be looked on as ensuring an adequate substrate for a hormone whose normal production has been adversely affected by the realities of modern living conditions. Human milk is, indeed, the "perfect food" for infants. Unfortunately, neither it nor any unsupplemented food or formula can prevent climate, latitude, smog, economic factors, or religious practices from coming between infants and sunshine.

Journal of Pediatrics August 2000; 137: 153-157.

This is an important article for me as it completely updated my view about vitamin D. I had always wondered why this was the ONLY vitamin that breast fed babies need (only if they are not regularly exposed to sunshine). The answer is that Vitamin D is NOT a vitamin but a steroid hormone precursor that is NOT naturally present in food. This explains why the most perfect food on the planet for humans, human breast milk, is "deficient" in vitamin D.

Vitamin D is one of the only supplements that a breast-fed baby will need, but this is only if the baby is not exposed to sunshine. The darker the skin of the baby the more sun exposure will be required for the baby to generate enough vitamin D. Even if the child does not develop rickets, less than optimal bone development and other problems will occur without adequate vitamin D. Typically parents are so concerned about calcium for proper bone growth and health, but in most cases the vitamin D is far more important.

Certain drugs have also been shown to interfere with vitamin D absorption and metabolism, including cholestyramine (Questran), Dilantin, and phenobarbital.

Additionally, because vitamin D is a fat-soluble vitamin, any drug or substance that interferes with fat absorption may cause problems, as may a low-fat diet.

A much less common type of rickets is caused by phosphate depletion and was reported on previously in the newsletter.

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