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Last Updated: Thursday, 21 June 2007, 23:12 GMT 00:12 UK
Children 'put at risk of rickets'
Vitamins (Science Photo Library/Charles Bach)
Vitamin D supplements are recommended for high-risk groups
Children are being put at risk of rickets because policies on vitamin D supplements are not been adhered to, experts have warned.

Doctors in Dundee write in the British Medical Journal that they recently diagnosed five infants with rickets - which can stop bones forming properly.

The government recommends that pregnant women should use vitamin D supplements.

Babies from Asian, African, Afro-Caribbean or Middle Eastern backgrounds are particularly at risk.

The paediatricians at Ninewells Hospital in Dundee said none of the mothers of the five children they had recently diagnosed had received vitamin D supplements.

We're failing ethnic groups by not reinforcing the public health message
Dr Scott Williamson

They warned parents were unaware of the risk because it was rarely mentioned by GPs or health visitors.

Government recommendations state that pregnant and breastfeeding mothers should take vitamin D supplements.

They are also recommended for infants in high-risk groups.

The main source of vitamin D is through ultra-violet radiation in sunlight, although it can also be found in certain foods.

It is crucial for the absorption of calcium, which is key in the formation of healthy bones. Deficiencies can lead to rickets, poor tooth formation, stunted growth and general ill health.

People with darker skin are at greater risk of vitamin D deficiencies because increased pigmentation reduces the capacity of the skin to manufacture the vitamin from sunlight.

'Ignorance'

Dr Scott Williamson, specialist registrar at Ninewells hospital, said there was a lack of awareness in primary care.

"If you try to find official government advice, it's not that easy to find," he said.

"It may be the government needs to better disseminate the guidance.

"There does seem to be a bit of ignorance - for instance people don't realise you're more at risk of getting rickets if you're breastfed.

"Also we're failing ethnic groups by not reinforcing the public health message."

Vitamins are provided for free under the Healthy Start initiative, which is aimed at low income families on Income Support, Jobseeker's Allowance or Child Tax Credits.

They are also provided free to pregnant women under the age of 18 years but Dr Willamson said GPs should be prescribing the vitamins (which can also be bought from the chemist) for all pregnant women.

Dr Tony Williams, consultant in neonatal paediatrics at St George's Hospital in London, said that when rickets occurred in babies, it was a sign that the mother was deficient in vitamin D during the last few months of pregnancy.

"The policy for many years has been that women should receive vitamin D supplements during pregnancy but hardly any do," he said.

But he said antenatal guidance from the government's drugs watchdog NICE had concluded that it was not necessary and this had added to the confusion.

The Scientific Advisory Committee on Nutrition recently published advice supporting supplementation.




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