Growing children need lots of energy and nutrients to support their growth and development and a good routine can help them to meet these requirements. Eating together as a family can support children to learn about and enjoy food. Offering three main meals, breakfast, lunch and tea is a great way of planning the variety of foods to offer children across the week. There will, of course, be some days that children eat well and other days when they show less interest in the food on offer. It is normal for children’s appetite to vary across the week.
Snacks provide another opportunity to top up on energy and nutrients but these should also be planned for example, in the morning and afternoon. Avoid letting the children graze on snacks across the day as they are then less likely to enjoy their main meals and may have less variety of foods. You can visit our blog for lots of more information on planning snacks for your little ones here!
Does my child need a multi supplement?
Most children will get all the nutrients they need by having a varied and balanced diet and will not need a multi supplement. If you are worried about your child’s diet it’s important in the first instance to speak to your GP, health visitor or dietitian/nutritionist. There is one vitamin that all families should consider taking as a supplement regardless of your food choices and that is vitamin D. Vitamin D is found in some foods and amazingly the body can make it when our skin is exposed to sunlight. However, in the UK there are many factors that impact on our vitamin D levels which means we have guidance from Public Health England on taking a vitamin D supplement.
Why is vitamin D important?
We need vitamin D to help the body absorb calcium and phosphate from our diet as these minerals are important for healthy bones, teeth, and muscles. A lack of vitamin D, known as vitamin D deficiency, can cause bones to become soft and weak, which can lead to bone deformities, muscle weakness, and falls. In children, a lack of vitamin D or calcium can lead to rickets. In adults, a lack of vitamin D or calcium can lead to osteomalacia, which causes bone pain and tenderness.
Sources of Vitamin D?
In the UK, we get most of our vitamin D from sunlight exposure from around late March/early April to the end of September. At this time of year, most people can make enough vitamin D from being out in the sun daily for short periods with their forearms, hands or lower legs uncovered and without sunscreen It’s not known exactly how much time is needed in the sun to make enough vitamin D to meet the body’s requirements. This is because there are a number of factors that can affect how vitamin D is made, such as skin colour or how much skin you have exposed. It is important to remember that children under 6 months of age should be kept out of direct strong sunlight and children and young people need their skin protecting between March and October in the UK by covering up with suitable clothing, spending time in the shade (particularly between 11 am to 3.00 pm) and wearing sunscreen.
Most people get little vitamin D from their diet as only a few foods naturally contain the vitamin. Foods naturally-rich in vitamin D include:
- egg yolk
- oily fish such as salmon, mackerel, herring and sardines
- meat, fat, liver* and kidney
- Infant formulas and toddlers milk have added vitamin D however, it is not advised that parents rely on toddler milks for their child to receive vitamin D and they should speak to their HV firstly.
*Liver is unsuitable for infants under six months and should be limited to once per week when children are over six months of age.
Vitamin D supplement recommendations
As it can be difficult to get enough vitamin D from the sunlight and from our diet Public Health England has issues guidance on vitamin D supplements to help us to meet our daily requirements:
- All infants should be given a daily vitamin D supplement of 8.5-10 mcg from birth until one year old, unless they have more than 500ml of formula milk a day (this has Vitamin D added to it)
- Children aged one to four years should be given a daily vitamin D supplement of 10 mcg
- All adults including pregnant and breastfeeding women, and children over four, should consider taking a daily Vitamin D supplement of 10mcg, particularly through the winter months.
When choosing supplements speak to you pharmacist who will be able to advise you on choosing that meets your families requirements. A recent study found that a large number of supplements did not contain the recommended amount of vitamin.
Always follow manufactures instructions and keep to the dose recommended on the label, and be careful not to give your child 2 supplements at the same time.
- Do not add to food or drink that will be heated as this can destroy the vitamins
- Follow guidance in relation to use by dates as the vitamin content will vary after this
- The drops are preferential to the vitamin syrups or chewable tablets
Vitamin D and Covid-19
As part of the Government’s response to Covid-19, Public Health England has re-issued the existing advice on vitamin D on the NHS.UK website. The advice has not been issued about preventing Covid-19 or mitigating its effects, but because of vitamin D’s important role in keeping, bones, teeth and muscles healthy. A lack of Vitamin D can lead to bone deformities, rickets, in children and bone pain, osteomalacia, in adults. What are Public Health England advising:
- The Government is currently advising people to stay at home. For most people this will mean being indoors for much of the day, which could result in not getting enough vitamin D from sunshine exposure. The body creates vitamin D from direct sunlight on the skin when outdoors during the spring and summer.
- Existing public health advice is that if your not going outdoors, you should consider taking a daily supplement containing 10 micrograms of vitamin D. Public Health England recommend that while the stay at home measures are in place, everyone follows this advice (including children, pregnant and breastfeeding women and older people).
- There is already advice in place for all breastfed babies to be given a supplement containing 8.5 -10 micrograms of Vitamin D.
- You can buy Vitamin D supplements from most pharmacies and supermarkets. Please dont buy more than you need.
Vitamin D and Healthy Start
Healthy Start is a UK-wide government scheme which aims to improve the health of pregnant women and young families on benefits or low incomes. Beneficiaries are sent vouchers that can be used to buy liquid cow’s milk, plain fresh or frozen fruit and vegetables, and infant formula milk, plus coupons that can be exchanged for free vitamins (for pregnant women, new mums and children).
Women more than 10 weeks’ pregnant, and families with children under four years old, qualify for Healthy Start if the family is receiving:
- Income Support, or
- Income-based Jobseeker’s Allowance, or
- Income-related Employment and Support Allowance, or
- Child Tax Credit (but not Working Tax Credit unless the family is receiving Working Tax Credit run-on only*) AND an annual family income of £16,190 or less in 2013/14. Women also qualify for the whole of their pregnancy if they are under 18 when they apply, even if they don’t get any of the above benefits or tax credits
Healthy Start can help families with their weekly food shop by adding nutritious foods to their basket! Healthy Start also contributes to families weekly budgets. Families will receive:
- Healthy Start Food Vouchers – Pregnant Women will receive 1 voucher per week worth £3.10, infants 0-12 months 2 vouchers per child per week worth £6.20 and children 1-4 years 1 vouchers per child per week worth £3.10
- Healthy Start Vitamins
Access to food and vitamin vouchers will support families to eat more fruits and vegetables and to meet the recommendations for Vitamin D. You can visit the Healthy Start website to check you qualify by answering a few short questions.
Early years staff who would like to support families to meet their vitamin D requirements and increase the uptake of Healthy Start should book our training module ‘Vitamin D – a healthy start‘ for up to date evidence based advice.