Mums-to-be not Getting Vitamin D Advice
The results of a new survey of over 1,000 members of the 'Mumsnet' online community, sponsored by Internis, have been announced. The survey asked mums about vitamin D, including sources of information, their knowledge around potential deficiency and whether or not they made any use of supplements.
The UK's Chief Medical Officers (CMOs) have highlighted the increasing problem of vitamin D deficiency in the UK along with the increase in rickets (bone malformation in children) that could result. The CMOs wrote to all general practitioners in 2012 noting that:
- . All pregnant and breastfeeding women should take a daily supplement containing 10µg of vitamin D, to ensure the mother's requirements for vitamin D are met and to build adequate fetal stores for early infancy
- . All infants and young children aged 6 months to 5 years should take a daily supplement containing vitamin D in the form of vitamin drops, to help them meet the requirement set for this age group of 7-8.5 micrograms of vitamin D per day. However, those infants who are fed infant formula will not need vitamin drops until they are receiving less than 500ml of infant formula a day, as these products are fortified with vitamin D. Breastfed infants may need to receive drops containing vitamin D from one month of age if their mother has not taken vitamin D supplements throughout pregnancy
Dr Christine Burren, Consultant Paediatric Endocrinologist at the Bristol Royal Hospital for Children said: "Our lifestyle and climate mean that many of us do not manufacture enough of our own vitamin D and yet dietary sources are limited. Current Public Health Guidance indicates that all infants and children up to 5 years of age are advised to take a Vitamin D supplement. The availability of an accurately formulated, licensed drops formulation is relevant and very useful for this age group".
Despite this the Mumsnet survey revealed that 59% of mums received no information on vitamin D from any source, including from healthcare professional sources. 86% of mums didn't know the correct dose of vitamin D supplementation with some suggesting a dose 60 times higher than the actual recommendation.
Probably because of media coverage many mums do use vitamin D supplements, however 86% of these were obtaining those supplements from off-the-shelf, non-prescription sources.
Justine Roberts, Mumsnet CEO said:
"It's clear from the discussions on Mumsnet that lots of mothers aren't sure about whether or not they need to give their babies Vitamin D. It's a concern to hear that off-the-shelf vitamins don't necessarily include the recommended dose for babies; as with all medical matters, the best advice is to speak to a healthcare professional."
In comparison to prescription only medicines, the under-regulated, off-the-shelf products have been shown to include variable content of vitamin D, with consistent inaccuracies in the stated dosing, not only between batches, but also between pills from the same pack.
Dr Brian Curwain, pharmaceutical consultant, commented: "Unlicensed supplements are not subject to strict regulation of their manufacturing; they are known to vary in composition and quality "
As well as rickets in children, low vitamin D levels can result in bone pain and tenderness in adults (known as osteomalacia). During pregnancy and breast feeding the mother's body is challenged to provide her own vitamin D needs as well as those of her developing fetus or young baby.
For new-borns and older infants who are breast-fed or partially breast-fed, vitamin D is essential to absorb calcium and build strong bones and teeth. A mother's milk does not provide enough by itself; therefore, this at-risk group should be prescribed licensed vitamin D drops.
Too much vitamin D can also be dangerous causing a range of symptoms such as nausea and/or vomiting, poor appetite or loss of appetite, excessive thirst, passing urine often, constipation or diarrhoea, abdominal pain, muscle weakness or pain, confusion, tiredness. In very extreme cases kidneys and joints can be damaged.
GP, Dr Dawn Harper, commented, "The survey results suggest a gap in communication between healthcare professionals and their patients. There has been a huge government push for increased awareness about vitamin D; it's everywhere in the news, and yet, mothers still seem confused."
"Pregnant and breastfeeding women and young children are among the population's most vulnerable and 'at-risk' groups. It is essential that GPs educate their patients about the importance of vitamin D and the pitfalls of self-medication with non-prescription vitamin D products."
Vitamin D has several important functions in the body. For example, it helps regulate the amount of calcium and phosphate in our bodies, nutrients which are needed to keep our bones and teeth healthy. It is also responsible for intestinal absorption of iron, magnesium and zinc and a lack of it can lead to bone deformities such as rickets in children and bone pain and tenderness as a result of a condition called osteomalacia in adults.
Dietary sources of vitamin D are limited. The main natural source is from the action of sunlight on skin. However, from mid-October to the beginning of April in the UK there is no ambient ultraviolet sunlight of the appropriate wavelength. During this time, the population relies both on body stores from sun exposure in the summer and dietary sources to maintain vitamin D levels.