Q How can I make sure my child gets enough vitamin D without getting sunburn?
Adequate vitamin D intake is important for bone health. A severe deficiency in vitamin D can result in rickets which, though less prevalent than in the past, continues to be reported in the United States. Emerging information indicates that there is a potential role of vitamin D for immunity maintenance and prevention of such diseases as autoimmune disease, cancer and diabetes.
There are limited natural dietary sources of vitamin D and historically, the main source of vitamin D was through production in the skin after exposure to UV-B light. The amount of vitamin D that can be generated this way is dependent on a multitude of factors both specific to the environment (cloud cover, latitude, season) as well as specific to an individual (skin pigmentation and extent of UV protection via sunscreen and protective clothing).
Because so many variables exist, it is virtually impossible to accurately predict how much vitamin D a specific person is able to synthesize. This difficulty, coupled with the realization that sun exposure is a major risk factor for skin cancer and therefore unprotected sun exposure should be minimized, prompted the American Academy of Pediatrics to recently update its recommendation for getting an adequate amount of vitamin D through fortified (i.e. milk) and nonfortified (i.e. egg- yolk, liver, codliver oil) foods or via supplementation.
To prevent vitamin D deficiency in healthy infants, children and adolescents, a vitamin D intake of 400 IU is recommended. Breastfed infants should take a liquid vitamin preparation of 400 IU. Nonbreastfed infants as well as older children who are getting less than 1 liter of vitamin D fortified formula or milk should also receive a supplement in the same amount. Adolescents who do not receive 400 IU through vitamin D fortified milk (each 8 ounces contains 100 IU) or from vitamin D fortified or containing foods should also receive a vitamin D supplement.
Dr. Cynthia Amitin,
Cross Keys Pediatrics, Baltimore
Q Now that marijuana has captured my preteen’s attention on the news lately, what is the best thing to tell him about why he shouldn’t smoke it?
There are a number of reasons not to smoke marijuana:
1. Smoking anything is damaging to the human body, and marijuana is no exception. Simply put, it isn’t good for you, and it doesn’t make sense to do something that is harmful to your body.
2. Obviously, it’s illegal and one runs the risk of getting caught and prosecuted.
3. It alters the way the brain works (as do other substances, such as alcohol) such that one does things that one wouldn’t do if not affected by the chemical. One is also not able to do things that otherwise they could do, such as control machinery (i.e. cars) safely.
4. Lastly, it creates a situation that can (admittedly not always) lead to use of more potent and dangerous chemicals.
Dr. Charles Shubin,
Director of Pediatrics, Mercy FamilyCare
Q What is a good age to introduce my son to sports? My neighbor’s son started playing soccer at 3, but that seems a little young.
There is no great answer to this one. Young children should always be encouraged to be active and play outside, but the age to start team sports should depend on the developmental ability of the child. While some 3 year olds are able to pay attention, follow instructions, and understand rules of a game (usually the ones with older siblings), many cannot. A 3 year old who is more interested in playing with the grass than the ball will not enjoy a team sport. There is no evidence that supports starting at a younger age will produce a better result, so let your child guide you. When your child shows interest in playing and plays well with other children, feel free to enroll them in a recreational program — it doesn’t matter if they are 3 or 6.
Dr. Scott Krugman,
Chairman, Department of Pediatrics, Franklin Square Hospital Center
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