Separating reliable medical information about vitamins from media hype about the latest "immune-boosting anti-oxidants" isn't easy, even for health professionals. That's why it's critical for all parents to know some medically sound facts about three key vitamins that might even save a child's life.
1) Vitamin D
Consider the shocking cases of two children recently treated at my institution— an infant admitted with sudden convulsions, and another toddler who one day was unable to walk. Both of their conditions could have been prevented with a simple supplement: Daily vitamin D drops.
Like a banker controlling cash flow from an account, vitamin D regulates calcium levels in the blood by withdrawing or depositing the mineral in the body to maintain a stable supply. Without enough vitamin D, the body undergoes a sort of financial panic where calcium levels can fluctuate wildly, which leads to seizures in babies or rickets (a bone-softening disorder) in older children.
There are several reasons why children are often low in vitamin D. Last year, researchers in Iowa reported that up to three-quarters of all breast-fed infants are deficient in vitamin D, since maternal milk is relatively low in vitamin D. Anecdotal evidence suggest the problem has been worsening recently, since many mothers are also deficient (and thus, can't pass along enough to their developing babies during pregnancy). There has also been an increase in widespread use of sunscreen on babies, which markedly reduces the body's ability to make the vitamin naturally. This is especially a problem for dark-skinned children, who need more sunlight than fair-skinned kids to make the vitamin. (Most cases of severe deficiency occur in children of color.)
In 2003, the American Academy of Pediatrics (AAP) took action by recommending that all breastfed infants, and all other children that drink less than a gallon of formula or milk per week, get daily vitamin D supplements. Unfortunately, some interpreted this policy as a criticism of breast-feeding. For example, La Leche League issued an ominous press release indicating vitamin D supplements could cause "harmful alterations of the infant gut or increased risk of infection." Perhaps as a result of these kinds of unsubstantiated worries, the journal Pediatrics reported that only half of physicians were recommending daily vitamin D for breast-feeding infants by 2004.
The first key lesson: According to the AAP, breastfed infants—especially those of color—should get daily vitamin D drops to prevent serious conditions like seizures or rickets.
2) Folic Acid
As someone involved in the care of women with high-risk pregnancies, I've seen many heartbreaking birth defects in developing fetuses which involve the nervous system or the heart. Technically, these conditions are called "neural tube defects" and "conotruncal cardiac defects," and the saddest thing is that many are preventable with prenatal vitamins, which are full of folic acid. When taken properly, prenatal vitamins stop up to 85 percent of neural tube defects and 50 percent of certain heart defects.
While most woman know about these vitamins, they don't know that prenatal vitamins are most effective if taken before becoming pregnant.
I recently saw the Oscar-nominated Juno, an otherwise enjoyable movie that unfortunately perpetrated the misunderstanding. When Juno discloses her pregnancy to Allison Janney, who plays her mother, Janney responds supportively by making a doctors' appointment and tells Juno to begin prenatal vitamins. I wanted to yell in the crowded theater, "It's too late!"
The human spinal cord and heart form in the first few weeks after conception—thus, defects happen before most women even realize they are pregnant. So taking prenatal vitamins once a woman is already pregnant, like Juno, does nothing to prevent birth defects. You have to take them for several weeks before becoming pregnant. That's a problem since most American pregnancies, like Juno's, are unplanned.
Many grains today are fortified with folic acid, but for complicated reasons, not enough is added to prevent most birth defects even in women who eat grains regularly. That's why the March of Dimes, Centers for Disease Control, and other groups advise almost all menstruating women to take a daily vitamin that containing folic acid.
A helpful note: Folic acid is found in almost any commercial multivitamin, not just "prenatal" vitamins that a gossipy busybody might stumble across in your cabinet.
The second lesson: To prevent the most common major birth defects, health authorities recommend that menstruating women should take daily folic acid even if they are not planning a pregnancy.
3) Iron
Finally, many parents know to hold off on cow's milk until a baby's first birthday, since cow's milk contains very little iron, which babies need to make blood cells. Breast milk contains adequate iron, but most infants today get weaned to formula by the time they're 6 months old. Confronted by a dizzying array of formula choices, up to one-third of parents choose "low iron" formulas, often from unfounded fears that iron causes constipation.
According to studies, infants who are fed low iron formulas are 30 times more likely to develop iron-deficiency, which can lead to anemia, which can lead to problems with cognitive development. Since 1999, the AAP has called on manufacturers and parents to avoid giving low iron formulas to babies, to no avail. (Every now and then, a pale toddler at my hospital shows up so iron-deficient from improper feeding that the blood practically looks like pink lemonade, instead of a rich crimson. Rarely, these children even need emergency transfusions.)
The third lesson: The AAP recommends that any formula given to your baby should be iron-fortified. Once your child weans from breast milk and/or formula to cow's milk, ensure your toddler gets a balanced diet that's high in iron.
Most parents do a good job of nourishing their infants teaching skills for lifelong healthy eating. With these extra tips about vitamin D, folic acid, and iron, you'll be even more prepared to give kids a healthy start.
The opinions expressed in this article are those of the author and do not necessarily reflect the opinions of iVillage.
Dr. Darshak Sanghavi is assistant professor of pediatrics at the University of Massachusetts Medical School and the author of A Map of the Child: A Pediatrician's Tour of the Body. His Web site is DarshakSanghavi.com