Babies are at risk of dying of rickets, a disease thought eradicated decades ago, because mothers and pregnant women are not being advised of the need for vitamin D supplements, according to experts.
Noah Thahane died last year at the age of six months from heart failure. It was a consequence of rickets, caused by a severe deficiency of vitamin D, the so-called sunshine vitamin. Experts at the University of Birmingham say his death was entirely preventable and are calling for all babies to be supplemented from birth and for mandatory monitoring by GPs and other NHS staff. Pregnant women must all be advised about the need for vitamin D and take supplements, they say.
“I’m very concerned that what we see is only the tip of the iceberg,” said Dr Wolfgang Högler, consultant endocrinologist at Birmingham Children’s Hospital. “There are many more cases that we don’t know about.”
There are guidelines for NHS staff, who should tell every pregnant woman that she should take vitamin D and every mother that she should give it to her baby, “but sadly we know it doesn’t work,” said Högler. “Most – 85% – of all parents don’t even know the programme exists. Noah’s mum is one of those. She was completely unaware that she was supposed to give it to the baby.”
The department of health says every baby should get daily doses of vitamin D from the age of six months and those who are breastfed should have it from birth, because formula milk has it added. The guidance is outdated and confusing, say the researchers.
Högler says all babies should have it from birth and those not taking it should be picked up when babies are given their vaccinations. “Why are we preventing infections but not preventing rickets in the same way?” he asked.
The paper Högler co-authored describes three cases of babies of aged six months or less who became very ill because of lack of vitamin D in the journal BMC Pediatrics . The other two recovered. All were born to women of black, Asian and minority ethnic origin. Dark skin and a lack of sunshine – either because of living in a northerly climate or through covering up – reduces the amount of vitamin D that the skin produces. So does a lack of calcium in the diet.
The UK has a “vitamin D winter” – insufficient sunshine for dark skins in particular to make the vitamin – for six months of the year. “It is no surprise,” says the paper, “that the cases we report presented in early spring.”
Noah’s mother Beverley said her son, who was of African descent, had been suffering unexplained seizures. In January last year, he had a cardiac arrest at home and doctors were unable to save him.
Thahane, 37, a hospital clerical officer from Telford, Shropshire, said: “I was utterly heartbroken when Noah died and horrified to learn that Noah’s death could have been entirely prevented.
“I had not been informed of the need for infant vitamin D supplementation, or that we were at greater risk due to having dark skin, and I had no idea how catastrophic the effects of a vitamin deficiency can be.”
Rickets was eradicated from the UK during the second world war when food was fortified with vitamins. Since that stopped, it has returned but largely under the radar, says Högler. He believes that the surest way to keep babies safe would be to fortify food once more.
“It is the most elegant and the cheapest way,” he said. “We could put a safe amount of vitamin D into food and particularly foods that high-risk groups eat.”
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