Vitamin D In Kids: Pediatrician Warns About The Hidden Winter Deficiency

Updated Dec 20, 2024 | 07:00 AM IST

SummaryVitamin D deficiency during winter can weaken children’s immunity, bones, and growth. Pediatricians emphasize sunlight, fortified foods, and supplements as essential for maintaining optimal health and development.
Image Credit: Canva

Image Credit: Canva

As winter sets in for many parts of the world, parents tend to focus on protecting their children from the cold. Bundling up is essential for warmth, but it inadvertently prevents exposure to a critical health resource: sunlight. Vitamin D, often called the "sunshine vitamin," plays a pivotal role in children's growth, immune health, and skeletal development. However, winter's shorter days and limited outdoor activities exacerbate an already pressing global issue: vitamin D deficiency.

Dr. Kushal Agrawal, MD Pediatrics and Head of the Department of Pediatrics, says, "Vitamin D deficiency is a concern that grows with the winter season since sunlight exposure, which is needed for the synthesis of this essential nutrient in the body, is limited during this season. Without the adequate amount, children risk weakened bones, delayed development, and compromised immunity.

According to global health data, more than one billion people, children included, suffer from a vitamin D deficiency. Vitamin D deficiency is not specific to developing countries, as it is also present in industrialized countries. Vitamin D deficiency arises as a result of dietary habits, urban living, and restricted sunlight exposure in those developed countries.

Winter poses special challenges for achieving adequate vitamin D levels. With colder months comes reduced UVB radiation, overcast skies, and shorter daylight hours that lower the skin's ability to produce vitamin D. For children, who are often kept indoors or heavily clothed to protect against the cold, this means even less exposure to sunlight.

Parents must make this balancing act of shielding children against cold and sun-exposing them to the warmth adequately. Sunlight is nature's best vitamin D provision and even small dosages that can be done when out in mid-morning or early afternoon suffice", asserts Dr. Agrawal.

How Much Vitamin D Do Kids Need?

The RDA of vitamin D for children and teens is comparable to that of adults. In infants, though, needs are lower as they're based on achieving a serum level above 20 ng/mL (50 nmol/L) to promote healthy growth.

However, many specialists claim that these recommendations are conservative and not enough for maintaining optimal vitamin D levels. Pediatricians usually recommend that children have a combination of natural sunlight, diet, and supplements to ensure adequate amounts, especially during winter.

Sources of Vitamin D for Children

Though sunlight is the best source of vitamin D, dietary and supplementary sources are important during winter. According to Dr. Agrawal:

1. Encouraging Outdoor Play

Let children play outside during mid-morning or early afternoon when UVB rays are most effective. "Make sure they get at least 15–20 minutes of sun exposure on uncovered skin areas like the face, hands, or arms," he advises.

2. Adding Vitamin D-Rich Foods

Add foods such as oily fish (salmon, trout), fortified milk, cereals, and some egg yolks to the diet of a child. However, due to these foods alone, hardly any daily intake of vitamin D can be obtained from them.

3. Vitamin D Supplements

For children who spend little time outdoors or reside in places where winters are extreme, supplementation may be essential. Pediatrics usually prescribe vitamin D3 supplements based on the child's age and his or her requirements.

4. Safe Sun Exposure Practice

Expose children to limited amounts of sun without sunscreen for the duration of vitamin D production to occur. Following the brief exposure, use sunscreen on them.

Challenges in Managing Vitamin D Deficiency

Despite its importance, maintaining optimal vitamin D levels is challenging for many families. Factors like skin pigmentation, geographic location, and dietary restrictions can complicate efforts. Additionally, vitamin D deficiency is often underdiagnosed, as symptoms like fatigue, muscle pain, or frequent infections may be attributed to other causes.

Increasing awareness among parents about vitamin D, especially during the winter season, is an essential step. Regular check-ups of their children at pediatricians, planning their diet, and outdoor activities are some of the steps that can fill this gap," says Dr. Agrawal.

Why Proactive Parenting is Necessary for Winter Wellness?

As a parent, preventive measures are vital to maintain the vitamin D levels of your child. Get in touch with your pediatrician to evaluate the requirements of your child and establish a personalized plan. Be it through sun exposure, changes in diet, or supplements, ensuring that your child maintains adequate vitamin D levels could protect his growth and immunity during the colder months.

Dr. Agrawal concludes, "Vitamin D is not merely a nutrient; it forms the very foundation of health for your child. Prevention during winter can protect the little one from the subliminal threats of deficiency and set the foundation of a healthy future.

Vitamin D deficiency is a global problem with significant health implications for children, especially during winter. Understanding its importance and taking actionable steps can ensure that children thrive even during the coldest months of the year. The "sunshine vitamin" might just be the key to keeping your child's health glowing, no matter the season.

Dr Kushal Agrawal is MD pediatrics, HOD Department of Pediatrics KVR Hospital, Uttarakhand, India

Vitamin D Metabolism and Guidelines for Vitamin D Supplementation. Clin Biochem Rev. 2020.

Vitamin D: Fact Sheet for Health Professionals. NIH Office of Diatary Supplements

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Real Life Story: Doctor Explains 'Worst Pregnancy Complication' That Led To A 33-Year-Old Woman’s Tragic Death

Updated May 13, 2025 | 04:00 PM IST

SummaryAmniotic fluid embolism (AFE) is a rare but deadly pregnancy complication causing immune reaction, cardiac collapse, and severe bleeding. It affects 1 in 40,000 pregnancies.
Real Life Story: Doctor Explains 'Worst Pregnancy Complication' That Led To A 33-Year-Old Woman’s Tragic Death

Credits: Canva and Instagram

Among the many rare conditions which are life-threatening, Dr Sermed Mezher, a doctor based in London, a medicine physician and a content creator shared a video explaining 'one of the worst pregnancy complications'.

He says, "There's been a very public case of a 33-year-old woman, who sadly passed away from an exceptionally rare complication of pregnancy recently."

What Are The Facts?

It is called an amniotic fluid embolism, or AFE, which is a rare, but extremely dangerous childbirth complication, he explains. It happens when amniotic fluid, fetal cells, or other debris enter the mother's bloodstream, triggering a severe and sudden immune response. This can lead to rapid cardiovascular collapse, respiratory failure, and life-threatening bleeding due to disseminated intravascular coagulation (DIC), he explains.

He says that it is most difficult to manage this complications during delivery, "as it is when part of the actual amniotic fluid that surrounds the baby or some fetal cells actually get into the maternal bloodstream and spreads to the rest of the body." It causes the whole systems inflammatory allergic reaction.

Why Is It So Difficult To Manage?

He shares that it is because, at this stage multiple systems can start failing at the same time. It leads to cardio respiratory collapse, oxygen levels start plummeting, blood pressure starts falling, and also causes excessive bleeding of something called DIC.

DIC is where clotting factors are all being used up in the blood, and the patient can have seizures at the same time.

He, however does mention that it is an incredibly rare complication, which affects only 1 in 40 to 50,000 pregnancies, between 11 and 43% of mothers not making it through the complication.

What Is AFE?

As per the National Library of Medicine, it is a rare but serious condition with high mortality and morbidity rates and is the second leading cause of peripartum maternal death. It occurs when amniotic fluid enters the maternal bloodstream.

Cardiovascular collapse is often the first sign of amniotic fluid embolism (AFE). It is typically followed by activation of the clotting and fibrinolytic systems, which may lead to disseminated intravascular coagulation. Since no specific test exists, AFE is diagnosed based on clinical assessment.

What May Increase Your Chance of AFE?

  • Advanced maternal age (being older than 35 during pregnancy)
  • Expecting multiples (twins, triplets or more)
  • Fetal distress (changes to the fetal heart rate)
  • Issues with the placenta like placental abruption
  • Preeclampsia or eclampsia
  • Polyhydramnios (too much amniotic fluid)
  • Cervical tears
  • Labor induction medications or procedures
  • Having a C-section delivery
  • Operative assisted deliveries (forceps delivery or vacuum extraction)

Are There Any Symptoms?

Signs and symptoms of AFE develop suddenly and quickly, and often they are similar to that of other ordinary complication of pregnancy, which makes it difficult to detect the condition.

However, these could be the following symptoms:

  • Shortness of breath or difficulty breathing
  • Sudden drop in blood pressure
  • Pulmonary edema (fluid in your lungs)
  • Abnormal heart rate
  • Bleeding from your uterus, C-section incision or IV (intravenous) sites
  • Fetal distress
  • Agitation, confusion or sudden anxiety
  • Chills

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Supermom Syndrome Is Making You Sick- How To Set Boundaries And Be Healthy?

Updated May 11, 2025 | 09:00 PM IST

SummaryConstantly striving to be a “supermom” can severely impact a mother’s physical and mental health, leading to chronic stress, burnout, sleep issues, hormonal imbalance, and increased risk of anxiety or depression.
Supermom Syndrome Is Making You Sick- How To Set Boundaries And Be Healthy?

Credits: Health and me

Have you ever looked at your mom and wondered, how does she do it all? From managing the morning chaos, handling work deadlines, remembering every birthday, to ensuring there’s always food on the table—mothers seem like they have some kind of superpower. And on Mother’s Day, while we shower them with love, flowers, and breakfast in bed, it’s also worth asking: at what cost does she wear this invisible cape?

Behind the warm hugs and tireless dedication lies a reality that’s often overlooked—the silent burnout that builds from trying to live up to the impossible expectations of being a “supermom.” While the world applauds her multitasking skills, very few pause to ask how she’s actually doing. Are we celebrating mothers for who they truly are, or for how well they perform under relentless pressure?

This Mother’s Day, let’s talk about the health impact of this “supermom syndrome” that’s romanticized in culture but often harmful in reality. Let’s explore how setting boundaries isn’t about stepping back, but stepping into a healthier, more sustainable version of motherhood. Because honoring mothers means more than a single day of appreciation—it means empowering them to reclaim their well-being every day.

In many homes around the world—and particularly in culturally rooted societies like India—the image of a “supermom” is not just admired, it’s expected. She is the orchestrator of meals, emotions, and milestones, all while excelling at work and showing up with poise and grace. But behind this high-functioning façade lies a serious health concern. Burnout.

“Motherhood is beautiful, but it isn’t a performance,” says Dr. Tonmoy Sharma, psychiatrist and global mental health expert. “When mothers are forced to meet unrealistic expectations day after day, they begin to internalize that they’re never doing enough—and this leads to chronic stress and exhaustion, which we now recognize as maternal burnout.”

The Health Toll of Being a Supermom

The silent pressure to ‘do it all’ is all too familiar. Mothers often find themselves navigating a never-ending checklist—well-fed children, a clean house, a successful career, cultural obligations, and emotional caregiving—while silently ignoring their own needs. Unlike dramatic breakdowns, burnout among mothers often manifests subtly.

“It doesn’t always look like a breakdown,” explains Dr. Sharma. “Sometimes, it’s emotional numbness, irritability, or a persistent sense of guilt. These are signs that the brain is overwhelmed, and the nervous system is under constant pressure.”

Long-term exposure to this stress cycle is linked to a higher risk of anxiety, depression, heart disease, and sleep disorders. Emotionally, it disconnects mothers from their children and partners, and ironically, undermines the very caregiving they work so hard to provide.

Cultural Conditioning and the Pressure to Overgive

In traditional Indian households, the mother’s identity is often intertwined with sacrifice. She is applauded for putting her family before herself, even when it means suppressing her exhaustion or mental health.

“Culturally, Indian mothers are conditioned to see overexertion as devotion. But we’re now seeing how this norm is unsustainable—and even harmful,” says Dr. Sharma.

This culture of martyrdom leaves little room for vulnerability or self-care, and many mothers suffer in silence. Asking for help is stigmatized. Rest is viewed as laziness. Saying ‘no’ is considered defiance.

Why Saying ‘No’ is Saying Yes to Health?

One of the most powerful steps a mother can take toward her mental and physical well-being is learning to set healthy boundaries. And it begins with understanding that saying “no” doesn’t equate to failure—it signifies awareness.

“Setting boundaries doesn’t mean abandoning your family. It means showing up for them in a way that is more sustainable and emotionally healthy,” notes Dr. Sharma.

That might mean communicating your needs more clearly, declining obligations when your energy is depleted, or asking for help with household responsibilities. Small actions—like taking 15 minutes in the morning for a cup of tea or letting someone else take the lead on bedtime—can begin to shift the dynamic.

How to Start Healing from Burnout?

Self-care isn’t just a trend—it’s a mental health strategy. And for mothers battling burnout, it’s crucial. Start small. Give yourself permission to leave tasks undone. Prioritize sleep. Take walks. Journal your thoughts. Most importantly, connect with someone who will listen without judgment.

“Mothers need to know that their worth isn’t based on how much they do for others. Protecting your mental health teaches your children that self-worth and well-being go hand in hand,” says Dr. Sharma.

Beyond individual strategies, the solution lies in societal and familial shifts. That includes partners sharing the invisible labor of parenting, communities that encourage rest without guilt, and workplaces that understand the invisible workload carried by mothers.

“The idea that mothers must carry it all is outdated and damaging,” Dr. Sharma adds. “What we need are healthier systems that value emotional safety, shared responsibility, and genuine support.”

If you’re reading this with a knot in your stomach, exhausted from trying to do it all—take a breath. You’re not weak, you’re not falling short. You’re just a person navigating one of life’s most complex roles.

Being a strong mother doesn’t mean sacrificing yourself entirely. It means knowing when to pause, reset, and say, “I need help.” That’s not failure—that’s resilience. As Dr. Sharma concludes, “Real strength is about honoring your limits, not erasing them.”

Dr. Tonmoy Sharma is a Psychiatrist and CEO & Founder at Merlin Health in India

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Why Some Babies Walk Later Than Others? Your Baby’s First Steps Are Coded In Their DNA

Updated May 9, 2025 | 09:00 PM IST

SummaryA baby’s first steps are more than a milestone—they reflect brain development and are influenced by genetics, with DNA accounting for nearly 25% of walking age variation.
Why Some Babies Walk Later Than Others? Your Baby’s First Steps Are Coded In Their DNA

Credits: Canva

Every parent waits eagerly for the day their child takes those wobbly first steps. For many, it's more than just a motor milestone—it’s symbolic of growth, independence, and progress. While the typical age range for walking spans from 8 to 24 months, the reason why some children walk earlier than others has remained an enigma—until now.

New research from a team of scientists across the University of Surrey and the University of Essex, published in Nature Human Behaviour, reveals that genetics may be a key player in determining when babies begin to walk. The study, one of the largest of its kind, analyzed genetic data from over 70,000 infants and found that nearly a quarter of the variation in the age at which children begin to walk can be explained by their DNA.

The onset of walking, termed Age of Onset of Walking (AOW) is widely recognized as a clinical marker for brain and behavioral development. Researchers conducted a genome-wide association study (GWAS) that examined the DNA of infants from four major European-ancestry cohorts, including the United Kingdom Medical Research Council, the Netherlands Twin Register, and the Norwegian MoBa cohort.

What they uncovered was striking- 2,525 significant genetic variants were associated with AOW, of which 11 loci remained statistically robust. Among these, certain genes were found to be strongly expressed in the brain, particularly in areas responsible for motor control like the cortex, cerebellum, and basal ganglia.

Further analysis revealed that walking later but still within the typical developmental window—was genetically linked to higher cognitive performance and reduced risk for ADHD. This suggests that a child who walks later might actually be developing brain functions that support focus and learning.

Why Walking is More a Brain Activity than Muscle?

The act of walking involves a complex interplay between muscles, balance, sensory feedback, and brain coordination. The study showed that many of the genes related to delayed walking were also enriched in processes involving neuron generation and neurogenesis—the very building blocks of brain function.

Interestingly, the researchers also identified overlaps between walking onset genes and those associated with autism, intellectual disability, and educational attainment. This does not mean that walking later is a cause for concern; rather, it highlights how intertwined motor milestones are with broader neurological development.

Moreover, the polygenic scores—an estimate of genetic predisposition—were found to correlate with brain volume and cortical folding patterns in neonatal MRI scans. This reinforces the notion that motor development may reflect deeper, genetically driven processes within the brain.

Is Late Walking a Warning Sign?

While delayed walking can sometimes point to developmental disorders, most late walkers fall within the wide spectrum of normal development. According to Professor Angelica Ronald, a senior researcher on the study, “Only a minority of late walkers have underlying neurological abnormalities. In most cases, the timing is just one part of the child’s individual developmental rhythm.”

Still, the 18-month mark remains an important pediatric checkpoint. Children who haven’t begun walking independently by then may benefit from a medical evaluation to rule out conditions like cerebral palsy, muscular dystrophy, or developmental coordination disorder.

Although genetics play a significant role, they are only one part of the story. Environmental influences—such as nutrition, gestational age, opportunity to practice movement, and cultural norms—also shape when a child learns to walk. For instance, children in cultures that emphasize early motor training often walk sooner, regardless of genetic predispositions.

Moreover, the researchers noted that their findings, while robust, were limited to populations of European ancestry. Future studies including diverse populations will help uncover whether these genetic markers are universally applicable or ethnicity-specific.

This study provides more than just a scientific breakthrough—it offers reassurance. Your baby’s timeline isn’t a race, and walking “late” might simply reflect a different kind of neurological development in progress.

Recognizing Baby Walking Styles

Babies have their own unique walking styles, and many are completely normal as their muscles and bones develop:

The Toddle: A wide-legged, deliberate style that becomes smoother over time.

The Cowboy: Bow-legged with knees apart and ankles together—a temporary phase.

The Duck: “Out-toeing” or “in-toeing” where toes point outward or inward; usually resolves with growth.

Toe Walking: Walking on tiptoes, common in early stages of walking.

Tips to Encourage Your Baby to Walk

Alongside a baby’s first smile and first word, those very first steps are a big deal. For many parents, it's an eagerly awaited milestone—camera in hand, ready to capture the magic. But behind those few wobbly steps lies months of motor development: sitting, rolling, crawling, and standing. And as this moment approaches, it’s natural to wonder—are they walking differently than other kids? Is there a way to help them along?

Here are six practical and parent-approved tips to gently support and encourage your baby’s walking journey:

1. Let Them Go Barefoot

While baby shoes are adorable, barefoot is best during those initial walking phases. Walking is a complex task, requiring your baby’s bones, tendons, and muscles to adjust and work in sync. Bare feet help your child better sense their footing and improve balance—crucial in building confidence and coordination.

2. Use Toys as Motivation

Encouragement can come in the form of fun! Hold out a toy—or even the irresistible TV remote—just out of reach to motivate your baby to take a few steps. Position yourself strategically and cheer them on as they inch closer.

3. Create a Furniture Path

Turn your living room into a mini obstacle course by placing pieces of furniture close together. This gives your little one a safe way to “cruise” from one surface to another. As they gain confidence, increase the gap between objects to gradually build strength and independence.

4. Check the Flooring

Slippery surfaces can make walking harder. Avoid glossy tiles or slick laminates early on. Opt instead for carpeted areas or lay down rugs and yoga mats for better grip and safety while they’re learning.

5. Pick the Right Push Walker

Choose a push-along walker like a trolley with blocks inside, instead of a sit-in, wheeled version. The American Academy of Pediatrics (AAP) has recommended banning sit-in baby walkers due to safety concerns. Push-along types support forward movement while helping babies develop stability and control.

6. Steady and Encourage Them Emotionally

Support matters. Position your baby against a stable surface and sit opposite them. Gently encourage them to move forward. Keep the mood upbeat with claps, songs, and smiles. Remember, babies mirror emotions—your confidence and joy fuel theirs. A tumble or two is normal—what matters is consistent encouragement.

When to Talk to Your Pediatrician?

Not all differences are concerning, but you should consult a doctor if you notice:

Asymmetry: One foot dragging, or one side moving differently than the other.

Frequent Falls: Some tripping is normal, but consistent stumbles could signal an issue.

Signs of Pain: Limping or discomfort while walking shouldn’t be ignored.

So the next time you're asked, “Is your baby walking yet?”, you can confidently say, “Not yet—and that's perfectly fine. It’s in their DNA.”

Walking is not just a physical milestone—it’s a reflection of both genetics and neurodevelopment. With nearly 25% of walking-age variability explained by genetic factors, science is now rewriting the way we understand infant development, one step at a time.

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