Vitamin D Deficiency in children –
not so sunny after all…
By Mirielle Schreuders
“Using sunscreen correctly can prevent sunburn and is believed to protect against SCC. Using sunscreen has not, however, been shown to prevent melanoma or BCC”
The American Academy of Pediatricians, 2011.
We constantly see the scenario of children covering themselves (or their parents doing the job) with sunscreen, long sleeve tops, playing under umbrellas and shade, staying indoors during the day, avoiding the sun like it has terrible, horrible evil rays…
Now, this information may be controversial and as a parent, it is important to be aware of skin cancer and skin damage prevention, but hear me out. I have some important information to share with you and I feel that my qualifications and experience in this field of medicine grants me the opportunity to put forth opinions and current research about vitamin D, sun exposure and children’s health, that you may not have come across before.
I am sure you are doing the best possible job you could do in raising your children in a healthy manner. These days, parents are very educated and they have a better idea on child rearing than our previous generations. Our children are also becoming smarter, with knowledge available at their fingertips at any given time.
As a caring parent, I know you would want to know if you may be doing more harm than good with constant application of sunscreen that is heavily based on chemical protection and complete avoidance of sunlight when your children are outside. FYI, concerns have been raised about systemic absorption of sunscreen. Sunscreen ingredients have been detected in breast milk. Skin permeability, particularly in pre-term infants is also of concern. Children’s skin is quite different from that of adults and may not be suitable for topical ingredients until after age 2, when a barrier function has further developed.
The effect of over protection from the sun in Australia and New Zealand (and even other countries) is showing some dire consequences for our children. Vitamin D deficiency has remerged as a significant pediatric health concern, with the major cause being reduced synthesis of vitamin D3. These lower levels of vitamin D3 within our children’s bodies are manifesting as rickets (a disease where the bones have poor calcification or mineralisation, causing fractures and bone tenderness), dental problems, muscle weakness, as well as having associations with seizures (caused by low levels of calcium in the blood), poorer immune function, dis-regulation of cellular differentiation and regulation, type one diabetes and also asthma.
This seems to be quite an array of serious health conditions and disorders that vitamin D can play a significant role in preventing, treating or assisting in managing. So why aren’t we more informed about its vital role in children’s well being?
Remember the slip slop slap campaign that was launched in the 1980’s in Australia? This media advertising started the ball rolling with providing the public with better education on preventing sunburn. This worked. People started to be more sun-smart and cautious. Time goes by, more campaigns around sun protection were promoted. Many of our community members started to hear about people being diagnosed with melanomas and other forms of skin cancer. Melanoma is a horrific form of skin malignancy and I have seen many patients have small melanomas operated on, only to lose a very large area of tissue, to ensure safest skin margins around the lesion.
The more we heard about melanoma, the more we started to hide from the sun. Melanoma is deadly and I certainly support safe sun exposure, but the important word here – ‘balance’ – has long been disregarded. Here’s the irony! A beautiful balance of light exposure without the excessive protection on our skin at the right time of day is actually protective of melanoma prevention. True. In addition, there are cases of melanoma that have appeared on areas of the body that have not had sun exposure, so the correlation between melanoma and sun exposure is not always so decisive.
Getting back on track, however, research suggests that many parents and general practitioners have a worrying lack of knowledge about vitamin D3 levels and children’s health. Serum 25-OHD (blood test) provides the best indicator for vitamin D3 status. A reading of 25-50nmol/L suggests mild deficiency, 12.5-25nmol/L suggests moderate deficiency and any reading under 12.5nmol/L concentration is a severe deficiency. Normal levels would be above 50nmol/L, with many integrative and functional medicine practitioners recommending 75nmol/L as being optimal (some suggesting even higher for superior immune health).
So how can you increase your child’s vitamin D levels? The Royal Children’s Hospital recommends infants need 400iu per day, while children and adolescents need 400-600iu per day. It is difficult to obtain adequate levels from our diet, but fatty fish and mushrooms can provide a limited amount of a form of D.
Of course, the best way to boost D levels is sunlight. Sun exposure for just 30 minutes (without SPF) will generate between 20,000 – 30,000 iu of vitamin D. The body will only store what it needs, so there is no chance of excess. You can see how natural light is a winner.
If you feel your family may be deficient in vitamin D, perhaps have your levels checked. Speak with a trusted Integrative Medical GP or an advanced Naturopath to see how supplementing could assist in keeping your family as healthy as possible.
In the future, I can truly see the tables turn on our current attitude to sun exposure. I can see children and parents actually having ‘sun time’ by not abusing the skin, but basking in the natural and healthy light of the sun to naturally stimulate our bodies protective and innate system.
Mirielle is a nurse clinician with over 15 years of industry experience. She has worked and volunteered within private practice and hospital settings, as well as lectured and trained others in dermal science. Her focus is helping patients and clients of all ages take the best care of their skin. She runs a Dermal Clinic in Mornington, Victoria. For more information, visit https://www.facebook.com/dalaserclinic/ or www.dalaserclinic.com.au