An increasingly popular vitamin with a candy-like appearance could pose a huge health risk for kids if not taken correctly
A vital vitamin that many parents give to their children could lead to neurological irritability, nausea, vomiting, or abdominal pain if the correct dose isn’t taken. The increasingly popular food supplement could be a health risk to young children – if taken in significant quantities.
Vitamin D supplements for children are becoming increasingly attractive due to their colourful packaging and candy-like appearance. However, an analysis by Test-Achats, a Belgian non-profit consumer organisation which promotes consumer protection, reveals that some products have excessively high concentrations – and parents should be aware of the risk of overdose.
The difficulty in distinguishing between these supplements and sweets can also be risky, as children might “help themselves to more [vitamins] when parents aren’t watching”. Additionally, these gummy vitamins “contain sugar and sweeteners, which we advise against, especially for children”, the organisation stated to RTFB.
Some freely available vitamin D supplements are easily overdosed. In a recent analysis, Test-Achats examined 37 vitamin D supplements intended for children aged 0 to 6 years. Except for one, all are freely available. More than a third are problematic, including gummies, tablets, and drops, due to excessively high vitamin D concentrations.
Dr Amaury de Meurichy is a specialist in paediatric nutrition. He explained the risk of vitamin D overdose, which he said can “can lead to significant side effects in children”. He said: “(Too much) Vitamin D will cause too much calcium absorption in the blood. This can manifest as neurological irritability, nausea, vomiting, or abdominal pain”.
The analysis is based on the recommendations of the Superior Health Council (SHC), which sets the daily vitamin D intake for a child at 400 units (10 µg = 10 micrograms). The SHC also pointed out another potential issue about the food supplement in that “some also contain allergens, which can be problematic for young children.”
According to the Poison Centre, “75% of calls related to vitamin D incidents involve children under the age of 15”. Most see dietary supplements as sweets or drink prescribed vitamin D bottles.
But don’t panic, according to Dr Amaury de Meurichy; overdose only occurs “when taking two to ten times the maximum recommended dose over a prolonged period”. This daily habit should not be stopped, but it is better to consult a healthcare professional to monitor the amounts of vitamins given to your child.
The best option recommended is to consult a health professional to check the quantities of vitamins your child is taking. Medicines prescribed by a doctor aim to treat or prevent diseases through metabolic actions. Food supplements may provide a concentrated source of some vitamins, but do not treat or cure disease.
The general advice regarding vitamin D for children is to ‘use medicines and not food supplements to prevent the risk of overdose’. Cases of vitamin D overdose have recently been reported in young children (following the use of food supplements fortified with this vitamin) by ANSES, the French Health Products Safety Agency.
These cases present as hypercalcaemia (excessive calcium in the blood), which can have serious consequences on the kidneys, such as lithiasis or nephrocalcinosis (calcium deposition in the kidneys).
In response to this, ANSES, the French Health Products Safety Agency (ANSM), paediatric scientific societies, the National College of Midwives and French poison control centres are alerting healthcare professionals and parents to the risk of overdose associated with giving vitamin D supplements to children, especially infants.
To prevent this risk, they are asking healthcare professionals and parents to opt for medicines rather than food supplements, check the doses administered (verify the amount of vitamin D per drop) – and avoid combining different products containing vitamin D.
Risks associated with Vitamin D and food supplements
The use of vitamin D supplements in children is not without risk, for the following reasons:
- The vitamin D concentration per drop can be very high (up to 10,000 IU) and there is sometimes no recommended dose according to age.
- Possible dosage errors when switching from a medicine to a food supplement, or when changing to a different food supplement
- The large number of products on the market with different concentrations/doses, sometimes under the same brand (products with different names leading to a risk of confusion, or even dose accumulation, if products containing vitamin D are combined)
- The presence in the food supplement of other vitamins (e.g. vitamin K, for which there is no recommendation for daily administration to children) or calcium in high doses (aggravated risk of kidney damage such as lithiasis/nephrocalcinosis).
This is backed up by NHS England, advice on their website states: “Do not take more than 100 micrograms (4,000 IU) of vitamin D a day as it could be harmful. This applies to adults, including pregnant and breastfeeding women and the elderly, and children aged 11 to 17 years.
“Children aged 1 to 10 years should not have more than 50 micrograms (2,000 IU) a day. Infants under 12 months should not have more than 25 micrograms (1,000 IU) a day. Some people have medical conditions that mean they may not be able to safely take as much. If in doubt, you should consult your doctor.”
However, the NHS also advises this on their website – for “people at risk of vitamin D deficiency”. The following information is taken from the NHS England pages here.
NHS advice states that: “Some people will not make enough vitamin D from sunlight because they have very little or no sunshine exposure.”
The Department of Health and Social Care recommends that adults and children over 4 “should consider taking a daily supplement containing 10 micrograms of vitamin D throughout the year” if they:
- Are not often outdoors – for example, if they’re frail or housebound
- Are in an institution such as a care home
- If they usually wear clothes that cover up most of their skin when outdoors
- If a person/child has dark skin – for example you have an African, African-Caribbean or south Asian background – they may also not make enough vitamin D from sunlight.
Further NHS advice for infants and young children: “The Department of Health and Social Care recommends that babies from birth to 1 year of age should have a daily supplement containing 8.5 to 10 micrograms of vitamin D throughout the year” if they are breastfed, formula-fed and are having less than 500ml (about a pint) of infant formula a day – as it’s important to note that infant formula is already fortified with vitamin D.
NHS England recommends that “children aged 1 to 4 years old should be given a daily supplement containing 10 micrograms of vitamin D throughout the year. They add that “you can buy vitamin D supplements or vitamin drops containing vitamin D (for under 5s) at most pharmacies and supermarkets” but it is recommended to consult a health practitioner if you are unsure of the safe dose that you or your children may need.
Vitamin D helps regulate calcium in the body, as well as phosphate amounts. Both calcium and phosphate help to keep bones, teeth and muscles healthy. The body makes vitamin D from sunlight when skin is exposed to the sun outdoors, but during the autumn and winter (in the UK) people generally don’t get enough vitamin D from the sunlight. A small number of foods also provide vitamin D, these include red meat, oily fish, egg yolks and fortified cereals.
