Have you heard about the possibility of vitamin D supplementation and reducing risk in babies?
Given 10% of babies in the first year of life can have food allergies, and the mighty efforts to introduce allergens in a timely manner in the first 10-12 months of age to reduce allergies, the addition of a vitamin D supplement to help reduce allergy developments garnered a lot of interest.
This blog is the latest update on vitamin D supplementation in babies looking through the lens of allergy risk.
New research findings will see this blog updated so a revisit will keep you up to date with the latest findings on vitamin D and babies.
Babies and Reducing Development of Food Allergies
Reducing the risk of babies developing food allergies through timely introduction of food allergens directly to babies has seen a complete reversal from delaying introduction to the more modern evidence based approach of ensuring introduction of the major allergens into the babies' diets from 4- 10/11 months, with 12 months concluding this window of opportunity.
Much emphasis has been placed on nuts (especially peanuts) and eggs, and although some allergens such as wheat may be less impacted by time of introduction into the diet, all the top allergens are included in this recommendation.
Other simple measures which may reduce development of allergies in babies are being investigated through a variety of research, and includes vitamin D, the focus of this blog.
Risk of vitamin D deficiency in babies
Vitamin D has an important in making sure your body absorbs available calcium in the gut, as needed, and thus plays a really important role in bone health.
Vitamin D also has a lot of really other important roles apart from bone health which includes roles in the immune system, and support for supplementation in a wide range of medical issues.
In countries where sun exposure is limited, including Great Britain, and Northern European countries and Canada, the recommendation is for daily supplementation of vitamin D to ensure adequate vitamin D status.
This is not a recommendation based on allergy prevention but on risk of deficiency.
In countries where vitamin D deficiency risk in babies is less, for example in countries like Australia where sunlight exposure is likely more adequate and accessible, vitamin D supplementation for babies is not routinely recommended.
In the more sunny countries countries, some babies can be at riskof vitamin D deficiency and require vitamin D supplementation.
Babies at higher risk of vitamin D supplementation include
babies with dark skin: The melanin in the skin acts as a natural sunscreen and increases the time needed in the sun to make vitamin D naturally.
Babies (breast fed) rarely exposed to the sun (note: too much sun can be harmful to baby's skin)
Babies (breastfed) whoosh mothers have a low vitamin D level
Babies (breast fed) who have one or more of the above factors
Testing your own vitamin D status and if you are deficient, supplementing to reach normal levels can help pass on the vitamin D your baby.
Breast feeding provides so many benefits for your baby, and is set up by nature for the passing on of vitamin D from your body to your baby through breast milk.
Vitamin D in foods.
Vitamin D is low in most foods, the small amounts of foods containing some vitamin D include foods from animals (due to their vitamin D content): some milks, eggs, fish and foods with vitamin D added: margarines and some cereals.
The one non animal al or non fortified food containing vitamin D is mushrooms, the vitamin D being D2 rather than the D3 in animal foods.
Vitamin D2 may not be as affective as vitamin D3 in raising blood vitamin D levels. Wild mushrooms or mushrooms irritated with UV will have higher D2 levels than mushroom grown in the dark and not irritated with UV.
Which brings us to the sun...the sun is the major provider, as in fact, vitamin D is not really a vitamin but a pre- hormone. It is not at all surprising that not many foods are rich in vitamin D.
Luckily we have vitamin D supplements!
If you baby is at risk of having a low Vitamin D level, recommendations in Australia is for 400 IU (International Units) daily for 4-12 months of age (2).
Does vitamin D reduce allergies in babies?
Supplementing babies with vitamin D to reduce allergies has been hitting the air ways in recent years, with many studies underway to assess if vitamin D has a possible role in this space.
This notion is tantalising as not only is it a simple action with potentially excellent benefits but is based on some previous findings:
Low vitamin D status during the first few years of life has also been associated with
increased risk of
asthma,
eczema,
wheezing,
allergic rhinitis,
and respiratory infections
and food allergies (3).
These findings are ASSOCIATIONS only and does not mean that a low vitamin D causes these issues. Just that they can both happen together.
A recent review of research (a systematic review and meta analysis which looks at the findings of the higher quality research available and is considered a high level of evidence) looking specifically at vitamin D in pregnant women, infants and children up to 5 years of age and allergy development found that vitamin D supplementation does not decrease rick of allergy development in babies and children.
Of course there are issues with some of these studies, which is why further research and reviews of this research may provide better clarity on this issue.
It should be noted, that too much vitamin D is known to cause issues, which highlights that care should always be taken when supplementing with vitamins and minerals.
Vitality Study (Australian Study)
A well known Australian study called the VITALITY study is following fully breastfed babies aged 6–8 weeks, provided with either vitamin D (daily 400 IU vitamin D3) or no vitamin D for 12 months (Clinicaltrials.gov ID: NCT02112734) (4).
The researches are mainly looking for an impact on the number of babies who develop an allergy at 1 year of age (via challenges) . This is the 'main outcome'.
The 'secondary outcomes' that the researchers are looking at include the rate of low respiratory tract infections, food sensitization, physician-diagnosed asthma, and vitamin D deficiency.
There are no published results released with this study as of August 2023.
As it stands: vitamin D supplementation in pregnancy and babies is not recommended to reduce allergy development, but is recommended if there is a risk of deficiency. Let's see what research like the Australian Vitality study and others will have to say about this exciting area.
Original article: 16/5/22
References
(1) 1. Melbourne T. Kids Health Information : Vitamin D. Rch.org.au. https://www.rch.org.au/kidsinfo/fact_sheets/Vitamin_D_low/. Published 2022. Accessed May 16, 2022.
(2) 2. Clinical Practice Guidelines : Vitamin D deficiency. Rch.org.au. https://www.rch.org.au/clinicalguide/guideline_index/Vitamin_D_deficiency/. Published 2022. Accessed May 16, 2022.
(3) Luo, Chao; Sun, Yaning; Zeng, Zuojing; Liu, Ying; Peng, Shunlin Vitamin D supplementation in pregnant women or infants for preventing allergic diseases: a systematic review and meta-analysis of randomized controlled trials, Chinese Medical Journal: February 5, 2022 - Volume 135 - Issue 3 - p 276-284
doi: 10.1097/CM9.0000000000001951
(4) Mailhot G, White JH. Vitamin D and Immunity in Infants and Children. Nutrients. 2020;12(5):1233. Published 2020 Apr 27. doi:10.3390/nu12051233
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