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Do you want to give children vitamin AD?

 Last Update: 2021-06-28
 Source: Internet
 Author: User

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Many people know that a certain amount of vitamin D should be supplemented every day as soon as possible after the baby is born.
However, many infant vitamin D supplements on the market are packaged with vitamin A, and vitamin AD is also sold in pharmacies
.
Many people said that I read online and said that excessive vitamin A may lead to poisoning, and vitamin A is not supplemented abroad
.

However, recently there is a hot topic on the Internet that "Chinese babies are more suitable for AD supplementation
.
" This makes many parents a little dizzy
.

Should I give my baby vitamin D or AD? Will vitamin A supplementation be poisonous? Is it really good to take vitamin AD? Today we will talk about vitamin AD
.

Do children need vitamin D supplements?

The answer is: need
.

Vitamin D plays a major role in the process of bone growth and metabolism by regulating the balance of calcium and phosphorus, and may also play an important role in the regulation of the immune system
.
Vitamin D can be produced by the body's exposure to sunlight.
It can also be obtained from fish oils, eggs, and fortified foods, but these methods are not very good
.

Babies have low levels of vitamin D storage at birth, and they rely on breast milk, sunlight, or complementary foods to take in vitamin D in the first few months
.
As the vitamin D level in breast milk depends on the vitamin D level in the mother’s body, it is usually low.
For infants growing in high latitudes, exposure to sunlight may be restricted, or affected by cultural or other factors, infants are particularly susceptible Vitamin D deficiency
.
Vitamin D deficiency in infants can cause bone deformation (rickets), convulsions, and breathing difficulties
.

China’s infant and young child feeding guidelines suggest that a baby can start to supplement with 310 micrograms (400IU) of vitamin D every day after birth
.

Do children need vitamin A supplements?

Vitamin A is essential to support the rapid growth of babies and children and help fight infections
.
Insufficient vitamin A intake can lead to vitamin A deficiency, which can cause visual impairment, manifest as blindness, or increase the risk of morbidity and death from childhood infections, and may also aggravate the impact of HIV infection
.
World Health Organization data: About 190 million preschool children are affected by vitamin A deficiency.
Most of them live in Africa and Southeast Asia
.

0-6 months baby

The World Health Organization's "Guidelines for Vitamin A Supplementation for Infants and Young Children aged 1-5 Months" pointed out: Currently, the World Health Organization does not recommend vitamin A supplementation for children aged 1-5 months as a public health intervention to reduce morbidity and mortality
.
Mothers should continue to be encouraged to continue breastfeeding within 6 months of postpartum to ensure the best growth, health and development of their babies
.

So many people think that newborn babies don’t need supplementation
.
In fact, it ignores the fact that breast milk may still lack VA
.

In fact, there is a follow-up in the WHO report: the level of vitamin A stored in newborns is usually low, and it depends on external sources for supplementation.
The most important source is breast milk
.
In areas where vitamin A deficiency and/or malnutrition are common, infants may not receive enough vitamin A through breast milk due to the mother’s poor nutritional status
.

China's data shows that the vitamin A level of Chinese breast milk samples is at a low level in the world
.
Because many of our mothers do not have enough nutrition
.

The latest research results in 2016 show that the average daily intake of vitamin A for lactating mothers in China is only 50% of the recommended intake, and the average daily intake of calcium is also significantly insufficient
.
A test result of breast milk samples taken from 15 days to 3 months postpartum in many countries in the world showed that the average concentration of vitamin A in breast milk was 297~825 μg/L, and the average concentration of meta-analysis was 444.
0±114.
6 μg/L.
Among them, Chinese breast milk The vitamin A content of the sample was the lowest at 297 μg/L, while the vitamin A content in breast milk reported in China was even lower (100~200 μg/L)
.

Therefore, based on the average milk volume of healthy newborns and infants in China, it is difficult to meet the daily vitamin A nutritional requirements of newborns and infants by relying solely on breastfeeding
.

Therefore, babies within 0-6 months of age can also supplement VA appropriately, at least, mothers should pay attention to supplement VA
.

Baby after six months

The World Health Organization's "Guidelines for Taking Vitamin A Supplements for Infants and Young Children aged 6-59 Months" pointed out: It is recommended that children aged 6-59 months take high-dose vitamin A supplements in areas where vitamin A is generally deficient
.
For infants from 6 months to 11 months, 100,000 IU (30 mg) of vitamin A is taken orally once
.
For children aged 12 to 59 months, take 200,000 IU (60mg) of vitamin A every 4 to 6 months
.
This intervention should be used in conjunction with other strategies to increase vitamin A intake, such as increasing dietary diversity and fortifying vitamin A in some processed foods
.

Areas where vitamin A is generally deficient refer to areas where the prevalence of night blindness is higher than 1%, or where vitamin A deficiency among children aged 2-6 years reaches more than 20%
.
For each child, the World Health Organization's definition of vitamin A deficiency is that serum retinol is less than 0.
70μmol/l
.

From the survey in China, the situation of subclinical vitamin A deficiency or insufficiency in children in China is still severe, especially in poor rural areas.
It is mainly concentrated in children aged 0-6 years.
Among them, neonatal and infant subclinical vitamin A deficiency is relatively high.
Generally, we still need to pay attention to it
.

A map of children’s vitamin A deficiency in my country from 2006 to 2016 (data source comes from nearly 20 epidemiological data, covering epidemiological data from 18 provinces)

Of course, the baby six months after the start of eating food supplement, food is still the best source of vitamin A
.

However, among natural foods, animal liver is the most abundant source of vitamin A.
However, because the liver is a detoxifying organ, it is easy to accumulate heavy metals, so it is not suitable to eat more.
Moreover, animal liver has a big taste and many babies don't like to eat it
.
Other yellow-green vegetable foods do not contain vitamin A, but carotene.
Carotene needs to be converted into the human body before it can become vitamin A.
The conversion efficiency is not only low, but also difficult to evaluate.
The general conversion rate is Only 1/24-1/12, it is not easy to get enough vitamin A through this kind of food
.

Therefore, it is also possible to supplement vitamin A appropriately
.
China has also evaluated the recommended intake (RNI) and the maximum tolerable dose (UL) of vitamin A.
As long as it is between this amount, it is considered safe
.

Eating vitamin AD can cause VA poisoning?

Regarding concerns about babies’ vitamin A poisoning, in fact, the WHO report has clearly pointed out: For babies under 6 months of age, there is sufficient evidence that vitamin A at a dose of 50,000 IU is safe; for vitamin A deficiency In regions, some side effects may occur within 48 hours after taking 100,000-200,000 IU of high-dose vitamin A, but these side effects are usually mild, transient, and will not have long-term effects
.
Possible side effects include protruding halogen door in some babies whose halogen door is not yet closed, and nausea in some older children
.

The common vitamin AD in our market, the content of vitamin A in the two doses of 0-1 year old and over 1 year old is 1500IU and 2000IU respectively, and one tablet can meet the requirement of the recommended amount of RNI
.
The poisoning risk dose of vitamin A is 300,000 IU.
To reach the poisoning dose, you need to take 150-200 capsules at a time
.

Therefore, there is basically no risk of overdose, and there is no need to worry even if you accidentally take it by mistake or take too much
.
From the perspective of risks and benefits, the benefits of taking vitamin AD are also greater than the risks
.

Reference materials:

[1] Cao Yanmei, Liu Huaqing, Feng Yahong, et al.
Epidemiological characteristics of rickets in children under 3 years old in 27 provinces and cities in my country from 2005 to 2012 [J].
Chinese Journal of Child Health Care, 2012, 20(11): 1008-1010.

[2] Chinese Residents' Dietary Guidelines 2016

[3] Tan Tibetan, Ma Guanfu, Lin Liangming, et al.
Investigation of serum vitamin A levels in children aged 0-6 in my country [J].
Chinese Children's Health Miscellaneous

Chin, 2002, 10(5):303-306.

[4]Xi Yongyi, Zheng Xiufen, Ye Jian, et al.
Research progress of vitamin D receptors[J].
Journal of Dalian Medical University, 2004, 26(3): 227-230.

[5] Wang Zhixu
.
Management of fat-soluble vitamin intake in women and children

[6]Zhang Yanqiu.
Prospective observation on the dietary status of lactating mothers, the nutrient content of breast milk and the level of infant growth and development.
Master's thesis of Pediatrics, Shandong University School of Medicine.
2016.

[7] Vitamin and mineral requirements in human nutrition.
WHO.
2004.

[8] World Health Organization "Guidelines for Vitamin A Supplementation for Infants and Young Children aged 1-5 Months"

[9] World Health Organization "Guidelines for Taking Vitamin A Supplements for Infants and Young Children aged 6-59 Months"

[10] Map of subclinical vitamin A deficiency in China-MedSci.
cn-Metz Medicine

[11] Lin Liangming, Liu Yulin, Ma Guanfu, et al.
Investigation of vitamin A deficiency in children under six years of age in China [J].
Chinese Journal of Preventive Medicine, 2002, 36(5): 315-319.
DOI:10.
3760/j:issn: 0253-9624.
2002.
05.
008.

[12]Jin Chunhua, Wang Xiaoyan, Zhang Lili, et al.
Analysis of the status quo of fat-soluble vitamins A, D and E in healthy children[J].
Chinese Journal of Clinical Nutrition, 2016, 24(6): 349-353.
DOI: 10.
3760/cma.
j .
issn.
1674-635X.
2016.
06.
005.

[13] Zhang Yu, Liu Xiaobing, Yang Lichen, et al.
Vitamin A nutritional status of urban children aged 6-17 years in China from 2010 to 2012[J].
Chinese Journal of Preventive Medicine, 2017, 51(2): 117-120.
DOI: 10.
3760 /cma.
j.
issn.
0253-9624.
2017.
02.
004.

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