Vitamin and lodine deficiencies in children

Here's a look at some of the vitamin and iodine deficiencies in children and ways how parents can deal with it.

By Dr Santha Narayanan

Vitamin and lodine deficiencies in children


Nutrition intake is the key determinant of a child’s survival, growth and development. Different nutrients are required to carry out the normal vital functions of the body.

Nutrients inadequate amounts are required to perform their specific functions; their deficiency leads to changes in the body, producing clinical features.

The body’s needs change as it grows and babies have different nutritional needs compared to that of elders and pregnant women.

The signs and symptoms of nutritional deficiency are mainly:

    • Loss of appetite
    • Growth retardation
    • Skin and mucous membrane changes
    • Impaired learning
    • Weakness
    • Confusion
    • Loss of memory
    • Psychosis
    • Peripheral oedema, etc

Human milk has a unique nutrient profile which is the ideal food for neonates and infants. After a certain age, though, if milk is not supplemented with other foods, it could lead to deficiencies of iron, zinc, Vitamin K and Vitamin D.

Causes of deficiency

Our food is not what it used to be. It is more processed, sugar-laden, nutrient deficient, chemically loaded and damaging to our system.

In today’s fast-paced world, there is not enough time to sit down and have a meal. The influence of T.V, busy parents, skipping meals due to lack of time, the changing tastes of children due to western influences, several fast food outlets, unhealthy eating practices, ignorance of our own nutritional requirements and the nutritional content and values of the foods we eat, are all contributing factors to nutritional deficiencies.

The most common deficiency diseases we see in our day to day practice are the vitamin, mineral and protein deficiencies. In this issue, we will be highlighting vitamin and iodine deficiencies and the benefits if taken in adequate quantity.

Vitamin A: 

It is found in malnourished children and in children with inadequate intake of Vitamin A. It is a fat soluble vitamin.

Benefits

It is essential to prevent eye problems that could lead to blindness.

Symptoms of deficiency

    • Abnormal visual adaptation to darkness
    • Dry skin, dry hair
    • Broken fingernails
    • Decreased resistance to infection are the first signs of Vitamin A deficiency
    • Bitot’s spots, white flake-like lesion seen on the dry Conjunctiva are usually seen during the last stages. It can also lead to Night Blindness.

Factors influencing Vitamin A depletion

    • Iron deficiency affects Vitamin A uptake
    • In Protein Energy Malnutrition, Vitamin A is depleted
    • Poor intake of Vitamin A-rich foods
    • Early weaning from breast milk

Food sources

Carrot, broccoli, sweet potato, butter spinach, pumpkin, liver of beef, pork, chicken, fish, turkey including cod liver oil, deep yellow-orange vegetables and fruits.

Vitamin B1 (thiamine)

Benefits

    • Supports production of Hydrochloric acid for the digestive system.
    • Promotes mental alertness and memory.
    • Needed for blood cell formation.
    • Crucial for healthy nervous system.
    • Needed for normal muscle tone of the heart, stomach and intestines.
    • Critical for carbohydrate metabolism and energy production.

Symptoms of deficiency

Deficiency leads to Beri Beri. The symptoms for Beri Beri include:

    • Excessive fatigue
    • Muscle weakness
    • Loss of appetite
    • Loss of sensation in hands and legs
    • Recurrent aphthous ulcers (or) oral ulcers
    • Stunted growth
    • Forgetfulness (or) mental confusion
    • Severe deficiency leads to dementia

Food sources

Mushrooms, sunflower seeds, vegetables, asparagus, broccoli, sprouts, lettuce, spinach, tomato, animal liver, egg yolk, fish lean meat, nuts, chickpeas, dhal, soya bean, rice bran, wheat germ, whole grain, unpolished rice and oatmeal.

Vitamin B12 (cobalamin)

Benefits

    • Essential for red blood cell production
    • Needed to make DNA
    • Required for healthy nerve function

Symptoms of deficiency

    • Sore tongue
    • Weight loss and loss of appetite
    • Loss of balance, palpitation
    • Memory loss, dementia

Food sources

Dairy products, egg yolk, kidney, meat, sea foods

Vitamin D

Benefits

    1. Maintains right level of calcium in blood
    2. For growth and development of bones/teeth
    3. Builds bone density
    4. Stimulates production of insulin
    5. Protects against cancer and heart disease

Symptoms of deficiency

    • Rickets, skeletal deformities
    • Increased risk of diabetes due to insufficient insulin produced
    • Hypocalcaemia - muscle cramps, twitching of nerves and muscles

Food sources

Fish liver oils, animal liver, egg yolk, milk fortified with Vitamin D, sweet potatoes.

Iodine

Benefits

Iodine is needed for Thyroid hormone and as this cannot be made by the body, it has to be supplemented.

Symptoms of deficiency

    • Thyroid gland enlargement (Goitre)
    • Hypothyroidism
    • Mental retardation
    • In pregnant women, this leads to miscarriages, stillbirth, pre-term delivery, congenital anomalies of babies.
    • Congenital hypothyroidism in children is a preventable cause of
    • mental retardation if the mother takes adequate Iodine during pregnancy.
    • Cretinism is a severe form of hypothyroidism which produces short stature, mental retardation, brain damage spasticity.
    • Treatment for thyroid deficiency Iodine supplements, multivitamins containing Iodine and fortifying food with Iodine

Food Sources

Dairy products, fortified salt, breads, eggs, seafood, meat (Excess intake causes hyperthyroidism, though this is less common than hypothyroidism)

Vitamin B2 (Riboflavin)

Benefits

    • Healthy vision
    • Alleviate eye fatigue
    • Energy production
    • Helps prevent migraines
    • Required for production of antibodies
    • Needed for red cell formation
    • Maintains levels of other B12 Vitamins
    • Important for foetal development during pregnancy
    • Lowers risk of cardiovascular disease

Symptoms of deficiency

    • Dermatitis - peeling of skin around nose
    • Cracks around corners of mouth or lips
    • A sore throat, sore tongue

Food sources

Beans, chicken, eggs, dairy products, fish lean meat, vegetables, asparagus, broccoli, brussels sprouts.

Vitamin B6 (Pyridoxine)

Benefits

    • Helps immune system to produce antibodies
    • Help produce energy
    • Protein metabolism
    • Essential for new cell formation and growth
    • Promotes healthy skin
    • Helps treat depression
    • Controls blood levels of homocysteine -prevents heart attack, stroke

Symptoms of deficiency

    • Eczema (or) Dermatitis
    • Cracks or sores on lips or mouth
    • Inflammation of mucous membranes of mouth and tongue
    • Leg cramps

Food sources

Bananas, chickpeas, potatoes, raw rice,bran, spinach, turnip, greens, yeast, eggs, chicken, garlic, nuts, vegetables such as asparagus, broccoli, brussel sprouts, cabbage, carrots, cauliflower, wheat germ and whole grains.

In conclusion, we need to provide children with a balanced diet that includes a minimum of 3-4 servings of fruits and vegetables every day. Early recognition and treatment of nutritional deficiencies will help the children lead happy and healthy lives. In the next issue, we will be highlighting the effects of mineral and protein deficiencies. 



Dr Santha Narayanan is a practising paediatrician from Chennai.