Vitamin D and B12 Deficiency in Indian Children — Why It Happens and What Foods to Give

Dr. Sandip Gupta

This video opens with a real case: a mother came saying her child is the shortest in class and eats everything, yet the height is not increasing. On testing, a vitamin D deficiency was found. The parents were shocked — their child plays outdoors in the sun. This video explains why that happens and what to do about both vitamin D and B12. How common it is: 90% of children in India have vitamin D deficiency, despite there being no shortage of sunlight. And in vegetarian families, 95% of children have B12 deficiency. Why sunlight isn't enough: Vitamin D is made in the skin from UVB rays in sunlight, and UVB is strongest between 11 am and 2 pm — exactly when children are at school or indoors and adults are at the office, because that sun is harsh. Most of us take early morning or late evening sun, which doesn't have as much UVB. Indian skin has more melanin, the pigment that darkens skin colour, and melanin also blocks UVB rays. Indians need roughly two to three times as much sun exposure as people in Western countries to make the same amount of vitamin D. What deficiency causes: Not just reduced height, but also effects on immunity, and allergy problems in children get worse with vitamin D deficiency. Vitamin D from birth to 1 year: Give 400 international units daily, using a vitamin D drop that contains 400 IU, given as 1 ml. Breast milk does not contain sufficient vitamin D — it is complete otherwise, but not for this — and even after solids start between 6 and 12 months, the full requirement is not met from food. What real sun exposure would require: Sun between 11 am and 3 pm, with 35 to 40% of body surface area exposed (arms, legs, head uncovered), no sunscreen, four to five times a week. Practically this is not feasible in India because of the risk of heat stroke, sunburn and heat rashes. Vitamin D foods: Egg yolk – the yellow portion has good vitamin D. Boiled egg yolk can be started after 7 months, beginning with half to one spoon; a child above 1 year can have a whole egg. Mushrooms – important for vegetarian families. Cook good quality mushrooms well, slowly if you like, which improves vitamin D absorption. Can be given to children above 1 year. Fish – fatty fish. In India, rohu, ilish (hilsa), mackerel (bangda) and sardine contain vitamin D. Can be given to children above 1 year, well cooked and mashed — always remove the bones so they don't get stuck in the child's throat. Milk and milk products – milk and curd can provide vitamin D through fortification. When buying, check for the F+ mark, which is mandatory by FSSAI and means vitamin D fortification has been done. Many oils are also fortified and carry the F+ mark. Liver in meat – contains a good amount of vitamin D. Vitamin B12: Even more important than vitamin D for children, because it is essential for brain development. It forms the myelin sheath of our nerves, which helps in nerve conduction and is very important for brain functioning. 95% of children in vegetarian families are deficient, because B12 is found only in animal foods. Non-veg sources: mutton, chicken, eggs. Vegetarian sources are limited to milk and milk products — curd, cheese, paneer, chaach, and a small amount in milk. A practical tip: For children from vegetarian families, when the doctor prescribes iron supplementation, he prescribes an iron supplement that contains B12, so the child gets both together. If you are from a vegetarian family, ask your pediatrician for an iron supplement with B12 attached. Tea and coffee reduce B12 absorption: Never give tea or coffee immediately before or after food. In fact, no child under 10 years needs tea or coffee at all. The celebrity height secret: Comparing celebrities' children — their height is often more than their parents'. The secret is that they pay close attention to their children's protein intake. Height depends on bone length, and bones need protein along with calcium. Protein is again very deficient in the Indian diet. To meet protein needs, give children nuts powder, milk, curd and eggs; non-vegetarian families can also give chicken and mutton. The doctor has made a full protein guide — comment "protein" to receive it. Relevant for: parents whose child's height is not increasing or who is the shortest in class; parents surprised by a vitamin D deficiency report despite the child playing outdoors; parents asking why Indians get vitamin D deficiency despite sunlight; parents asking what time of day sun exposure actually helps; parents of vegetarian families worried about B12 and brain development; parents asking which foods contain vitamin D and B12; parents asking about the F+ fortification mark on milk, curd and oil; parents asking when egg yolk, mushroom or fish can be started; parents asking about iron supplements combined with B12; and parents asking whether tea and coffee affect nutrient absorption in children. Disclaimer: This video is for general information and educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Every child is different — please consult your pediatrician before starting any supplement or new food, and for testing and treatment if you suspect a deficiency in your child.