Regarding the supplementation of vitamins A and D, listen to the latest expert opinions

Vitamin A and vitamin D are two fat-soluble vitamins that are closely related to children's health. Adequate vitamin A and vitamin D nutrition has a positive effect on children's early development and disease prevention and treatment. Deficiency and insufficiency will affect children's health. There are many different opinions on whether to supplement vitamin A, vitamin D, or vitamin AD, and how to supplement. Let's share with you the latest expert consensus published in the first issue of "China Journal of Child Health" in 2021~

Based on the results of the Chinese Residents’ Nutrition and Health Status Monitoring (2010-2013), the vitamin A deficiency rate among children aged 3-5 years in my country was 1.5%, the marginal vitamin A deficiency rate was 27.8%, the vitamin D deficiency rate was 8.9%, and the vitamin D insufficiency rate was 43.0%.

What are the reasons for vitamin A and vitamin D deficiency in Chinese children? Generally speaking, it is due to a decrease in effective supply or an increase in demand. Specifically, it includes insufficient perinatal storage; rapid growth and development; insufficient nutrition supply; the impact of diseases; and interference from drugs.

The dangers of vitamin A and D deficiency

Vitamin A deficiency is harmful to children's health: slowed growth, repeated disturbances, anemia, severe deficiency can lead to night blindness, dry eyes, corneal ulcers, and even blindness, dry skin, keratinization of hair follicles, mucosal dysfunction, and abnormal humoral immunity and cellular immunity.

Vitamin D deficiency is harmful to children's health: for example, rickets, tetany, laryngeal spasm, decreased peak bone mass during adolescence, increased risk of osteoporosis in adulthood, increased risk of respiratory tract infections, intestinal inflammation, allergies and asthma, and affects insulin synthesis, secretion and sensitivity.

Prevention and supplementation of vitamin A deficiency:

① Breastfeeding: Add vitamin A promptly after birth.

② Adding complementary foods: Guide children to eat more foods rich in vitamin A as early as possible: Vitamin A is abundant in animal foods (such as milk, eggs, animal offal), dark vegetables and fruits (pumpkin, carrots, broccoli, spinach, mango and orange, etc.).

③ Vitamin A supplement: After birth, infants should be supplemented with 1500-2000IU/day of vitamin A and continue to supplement until 3 years old; premature infants, low birth weight infants, and multiple births should be supplemented with 1500-2000IU/day of oral vitamin A preparations after birth, and the upper limit should be supplemented in the first 3 months, and the lower limit can be adjusted after 3 months; children with recurrent respiratory tract infections should be supplemented with 2000IU/day of vitamin A to promote the recovery of infectious diseases in children, while improving immunity and reducing the risk of recurrent respiratory tract infections; children with chronic diarrhea should be supplemented with 2000IU/day of vitamin A to replenish the vitamin A consumed during diarrhea, which is beneficial to the recovery of diarrhea symptoms and reduces the risk of diarrhea; children with iron deficiency anemia and those at high risk of iron deficiency should be supplemented with 1500-2000IU/day of vitamin A to reduce the risk of iron deficiency and improve the treatment effect of iron deficiency anemia; children with other chronic diseases suffering from malnutrition often have vitamin A deficiency at the same time, so it is recommended to supplement vitamin A 1500-2000IU/day will help improve the nutritional status of children, reduce the risk of vitamin A deficiency, and improve the prognosis of chronic diseases.

Prevention and supplementation of vitamin D deficiency:

① Outdoor activities: Take the baby outdoors as early as possible, gradually reaching 1-2 hours a day, preferably in diffuse light, with exposed skin and no glass blocking the view; babies under 6 months old should avoid direct sunlight; children should pay attention to sun protection during outdoor activities to prevent skin burns.

②Dietary intake: Guide children to eat more calcium-rich foods, such as milk, dairy products, soy products, seafood, etc.

③ Vitamin D preparations: Newborns should start supplementing vitamin D as soon as possible after birth, 400-800 IU per day; starting from one week after birth, premature infants, low birth weight infants, and multiple fetuses should take 800 IU/day of oral vitamin D preparations, and switch to 400 IU/day of oral vitamin D preparations after 3 months; if premature infant formula is used, oral vitamin D preparations 400 IU/day can be taken; children with recurrent respiratory tract infections should be supplemented with 400-800 IU/day of vitamin D to promote disease recovery, improve immunity, and reduce the risk of recurrent respiratory tract infections; children with diarrhea should be supplemented with 400-800 IU/day of vitamin D to replenish the vitamin D consumed during diarrhea, which is beneficial to the recovery of diarrhea symptoms and reduces the risk of diarrhea; it is recommended that children with iron deficiency anemia and high risk of iron deficiency should be supplemented with 400-800 IU/day of vitamin D to reduce the risk of iron deficiency and improve the treatment effect of iron deficiency anemia; children with chronic diseases such as malnutrition are recommended to supplement with vitamin D 400-800 IU/day will help improve the nutritional status of children, reduce the risk of vitamin D deficiency, and improve the prognosis of chronic diseases.

④ Other situations: Premature infants, low birth weight infants, macrosomia, children who have little outdoor activities, and children who grow too fast should take calcium supplements as appropriate based on their dietary calcium intake while taking vitamin D preparations to meet the recommended nutrient requirements.

Author: Xia Lulu

Reviewer: Yang Wenli