Vitamin D Deficiency in Children: Causes, Signs, and Treatment in India

It seems paradoxical — India is a sun-rich country, yet Vitamin D deficiency is estimated to affect 50–90% of Indian children in some regions. How does this happen, and what can you do about it?

Why Are So Many Indian Children Vitamin D Deficient?

• Darker skin produces less Vitamin D from sun exposure, requiring longer sun time
• Modern urban lifestyles: children spend most of the day indoors (school, home), and when outside, are often covered up or using sunscreen
• Air pollution in cities reduces ultraviolet light reaching the ground
• Vegetarian diets are low in Vitamin D-rich foods (fatty fish, egg yolk, liver)
• Breast milk contains very little Vitamin D — exclusively breastfed infants need supplementation

Signs and Consequences of Vitamin D Deficiency

Mild to moderate deficiency often has no obvious symptoms — it is found on routine blood tests. Severe deficiency causes rickets in infants and young children:

• Bowing of legs (genu varum)
• Delayed tooth eruption
• Soft skull bones (craniotabes) in infants
• Swelling at wrists and ankles
• Increased risk of fractures

At all ages, Vitamin D deficiency contributes to frequent infections, muscle weakness, fatigue, and poor bone density.

How Much Sun Exposure Is Enough?

For children in India, about 20–30 minutes of sun exposure to the arms and legs between 10 AM – 2 PM, at least 3–4 times per week, is generally sufficient for Vitamin D production. However, in practice, this is often not achievable for urban children.

Vitamin D Supplementation

The IAP recommends Vitamin D supplementation for all exclusively breastfed infants starting in the first days of life until they are getting adequate dietary intake. Older children with confirmed deficiency are given therapeutic doses of Vitamin D, followed by maintenance supplementation.

Food sources with Vitamin D include: egg yolks, fatty fish (salmon, mackerel, sardines), Vitamin D-fortified milk, and fortified cereals.

"Vitamin D is not just a 'bone vitamin' — it plays a role in immune function, muscle health, and brain development. Every breastfed infant in India should be receiving a Vitamin D supplement."

Dr. Sushma B screens for and manages Vitamin D deficiency as part of routine paediatric care at Sri Anand Child and Neuro Center, Chanda Nagar. Call +91 90633 66983.