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Keep Tabs on Your Child’s Health With These Tips From Our Experts

Keep Tabs on Your Child’s Health With These Tips From Our Experts

Here’s how to lower your child’s risk of health issues, starting in pregnancy.

Q: Should I take vitamin D while I’m pregnant? And should I give a supplement to my two-year old? I hear conflicting reports on how necessary it is. — Claudia H., Mill Valley, CA

A: Vitamin D deficiency is common in pregnant women, and if you have low levels that translates to low vitamin D levels in your fetus and your newborn. Research shows the deficiency may interfere with fetal development of bones, lungs and the immune system and lead to a newborn with reduced growth and a greater chance of respiratory problems.

According to the American College of Obstetricians and Gynecologists, women who are vegetarians, have limited sun exposure and are members of ethnic minorities, especially those with darker skin, are at greatest risk for D-ficiency.

As for whether you should take supplements or supplement your toddler, there are two new studies in the JAMA journal Pediatrics that are useful guides—but talk with your obstetrician and your toddler’s pediatrician before you decide what to do.

The first study looked at how taking vitamin D supplements while pregnant reduced the risk of a fetus being small for gestational age (SGA) by 28 percent. The researchers also found that during the first year of life, newborns whose mothers took vitamin D supplements weighed around 11 ounces more and were about a half an inch longer. They also concluded, “vitamin D supplementation with doses of 2000IU a day or lower during pregnancy may reduce the risk of fetal or neonatal mortality.”

The second study looked at the effect of vitamin D supplements on the bone strength and infection rate of two-year-olds. The researchers found supplementation with 400IU of vitamin D3 [more made no difference] was enough to help protect kids younger than two. So do discuss vitamin D with your doctor.

Q: My son recently sustained a concussion playing soccer when he banged heads with another player. I’m worried that although he seems fine he could have some lasting damage. They cleared him to play again on his high school team. How can we know it’s really okay? — Steven G., Rochester, NY

A: There’s a lot of new info on the repercussions of concussions and on how to treat them more responsibly. It focuses especially on kids and teens—they are most vulnerable—even though you hear a lot about players like Kevin Love, who was taken off the court in game six of the Cavs-Celtics NBA play-off game when he, like your son, suffered a concussion from banging heads with another player.

We don’t know how severe your son’s concussion was or the immediate symptoms, but we do know that under no circumstances should he be allowed to return to sports until a healthcare professional experienced in evaluating concussions says he’s symptom-free and it’s okay to return to play.

Ninety percent of adult concussions resolve in 7 to 10 days, but recovery time is often longer for children and adolescents. The decision to allow your son to return to team play should be based on his individual progress, not a set length of time. So, work with the doctor evaluating him and keep an eye out for cognitive, emotional, behavioral and sleep-related symptoms that appear over time or worsen. They include one pupil (the black part in the middle of the eye) being larger than the other; fatigue; difficulty waking up; persistent bad headache; decreased coordination; nausea or vomiting; slurred speech; convulsions; difficulty recognizing people or places; agitation and unusual behavior.

And follow up on his progress and evaluation. An alarming study in JAMA Open Network reveals 56 percent of patients who end up in the ER for a concussion fail to see a doctor for a follow up within three months of the accident!

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