A common vitamin that many parents administer to their children could potentially cause neurological irritability, nausea, vomiting, or abdominal pain if not given in the correct dosage. The increasingly favoured food supplement could pose a health risk to young children if consumed in large amounts.
Vitamin D supplements for children are becoming more popular due to their vibrant packaging and sweet-like appearance. However, an analysis by Test-Achats, a Belgian non-profit consumer organisation promoting consumer protection, reveals that some products contain excessively high concentrations - and parents should be mindful of the risk of overdose.
The challenge in differentiating between these supplements and sweets can also be hazardous, as children might "help themselves to more [vitamins] when parents aren't watching". Moreover, these gummy vitamins "contain sugar and sweeteners, which we advise against, especially for children", the organisation stated to RTFB.
Some over-the-counter 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.
All are readily available with more than a third having the potential to be problematic, including gummies, tablets, and drops, due to excessively high vitamin D concentrations.
Dr Amaury de Meurichy, a specialist in paediatric nutrition, highlighted the risk of vitamin D overdose, which he said can "can lead to significant side effects in children". He explained: "(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 raised another potential concern about the food supplement, noting 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." Children can mistake dietary supplements for sweets or drink prescribed when it comes to vitamin D bottles nor supplements.
However, there's no need to panic, according to Dr Amaury de Meurichy; an overdose only occurs "when taking two to ten times the maximum recommended dose over a prolonged period." This daily dietary aid should not be stopped, but it is advisable to consult a healthcare professional to monitor the amounts of vitamins given to your child.
The top recommendation is to seek advice from a healthcare professional to ensure your child is receiving the correct amount of vitamins. Medicines prescribed by doctors are designed to treat or prevent diseases through metabolic actions, and while food supplements can offer a concentrated source of certain vitamins, they do not cure or treat diseases.
The general guidance for children's vitamin D intake is to 'use medicines and not food supplements to prevent the risk of overdose'. The French Health Products Safety Agency, ANSES, has recently reported cases of vitamin D overdose in young children due to the use of fortified food supplements.
These instances result in hypercalcaemia (excessive calcium in the blood), which can have severe effects on the kidneys, such as lithiasis or nephrocalcinosis (calcium deposits in the kidneys).
In light of this, ANSES, the French Health Products Safety Agency (ANSM), paediatric scientific societies, the National College of Midwives, and French poison control centres are warning healthcare professionals and parents about the risk of overdose when giving vitamin D supplements to children, particularly infants.
To mitigate this risk, they advise healthcare professionals and parents to choose medicines over food supplements, monitor the doses given (check the amount of vitamin D per drop) - and avoid mixing different products that contain vitamin D.
The utilisation of vitamin D supplements, particularly for children, carries certain risks, including:.
- Vitamin D levels per drop can be exceptionally high, reaching up to 10,000 IU, and often lack age-appropriate dosage recommendations.
- Potential errors in dosing when transitioning from a prescription medication to a food supplement or when swapping between different supplement brands.
- A plethora of available products with varying concentrations and doses, sometimes even under identical brand names, which can lead to confusion or inadvertent accumulation of doses, especially if multiple products containing vitamin D are used concurrently.
- Food supplements may also contain additional vitamins, such as vitamin K, which does not have a daily recommendation for children, or they might include high amounts of calcium, increasing the risk of kidney issues like lithiasis/nephrocalcinosis.
NHS England corroborates this cautionary stance, advising on their website: "Do not take more than 100 micrograms (4,000 IU) of vitamin D a day as it could be harmful. This also 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 (including children) will not make enough vitamin D from sunlight because they have very little or no sunshine exposure - in the UK, this is especially the case during during the autumn and winter (October - March).
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 plays a crucial role in regulating calcium and phosphate levels in the body, both of which are essential for maintaining healthy bones, teeth and muscles. The body produces vitamin D when the skin is exposed to sunlight outdoors, but during autumn and winter in the UK, people generally don't get enough vitamin D from sunlight.
A few foods also provide vitamin D, including red meat, oily fish, egg yolks and fortified cereals.
