Two senior paediatric pathologists say they have discovered vitamin D deficiency in a significant number of children who have died of Sudden Infant Death Syndrome (SIDS)- cot deaths.The two doctors, Dr Irene Scheimberg and Dr Marta Cohen, say that vitamin D deficiency and associated diseases such as the bone disease rickets could also explain deaths that are often thought to be suspicious.
Both doctors believe their findings merit further investigation and research.
The findings in children from London and Yorkshire followed the discovery by Dr Scheimberg in 2009 of congenital rickets in a four-month-old baby whose parents had been accused of shaking him to death.
Chana Al-Alas,19, and Rohan Wray, 22, were acquitted of murdering their son Jayden after the jury learned that his fractures, supposedly tell tale signs of abuse, could have been caused by his severe rickets. Dr Scheimberg also discovered rickets in Jayden’s mother.
In London, Dr Scheimberg discovered vitamin D deficiency in a further 30 cases. Vitamin D deficiency was found to be a cause of death in three cases. Cardiomyopathy, a disease of the heart muscle, was discovered in two small babies. A third died of hypocalcemic fits, a condition of low serum calcium levels in the blood caused by vitamin D deficiency.
Vitamin D deficiency was a co-existing finding in the sudden and unexpected deaths of eight children, so-called Sudden Infant Death or Sids; in five children with bronchial asthma and another five with combined bacteria-polyviral or polyviral infections. Two of the babies, including baby Jayden, also had rib fractures.
In Yorkshire, Dr Cohen found moderate to severe levels of vitamin D deficiency in 45 children, mostly infants aged less than 12 months, who died of natural causes. Of the 24 sudden infant deaths Dr Cohen investigated from this group, 18 – or 75% – were deficient in vitamin D.
Dr Scheimberg said severe vitamin D deficiency could make the bones of small babies very brittle and capable of fracture with little or no real force.
Dame Sally Davies Chief Medical Officer was quoted as “We need to investigate the vitamin D levels of these children carefully and the circumstances in which the bones fracture,” she explained.
“Obviously if you have bones that fracture easily then they will fracture easily they will fracture with any normal movement like trying to put a baby grow on a baby you will twist their arm. In a normal child you won’t produce anything. But in a child whose bones are weakened and [who have] an abnormal cartilage growth area, then it’s easier for them to get these very tiny fractures or even big fractures.”
Vitamin D is actually a hormone, and endocrinologists are experts in how the body is regulated by the hormone excreting glands – or endocrine organs.
Stephen Nussey is professor of endocrinology at St George’s Hospital at Tooting in south London. He believes that, despite repeated government recommendations on vitamin D supplementation, vitamin D deficiency is still not being taken sufficiently seriously by the authorities.
“Lizards are quite like humans in their vitamin D. Their dietary intake is pretty low and they need to have sun exposure and you need to have a light in the enclosure in which you keep your lizard of the right wavelength.
“If you don’t have one of those lights your reptile will get osteomalacia [adult rickets] very similar to humans. I guess the RSPCA would quite rightly prosecute you if you didn’t give your reptile vitamin D.
“But there’s no action taken against you if you don’t give it to your daughter. So that rather illustrates the importance placed on vitamin D for your reptile rather than giving it to your daughter.”
Earlier this week, the chief medical officer for England, Dame Sally Davies, wrote to doctors, nurses and other health professionals advising them to consider vitamin D supplementation for certain at risk groups, including pregnant mothers.
“We know a significant proportion of people in the UK probably have inadequate levels of vitamin D in their blood. People at risk of vitamin D deficiency, including pregnant women and children under five, are already advised to take daily supplements. Our experts are clear – low levels of vitamin D can increase the risk of poor bone health, including rickets in young children,” she explained.
“Many health professionals such as midwives, GPs and nurses give advice on supplements and it is crucial they continue to offer this advice as part of routine consultations and ensure disadvantaged families have access to free vitamin supplements through our Healthy Start scheme.
“It is important to raise awareness of this issue, and I will be contacting health professionals on the need to prescribe and recommend vitamin D supplements to at risk groups.