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I Have Been Asking You All Medical Queries Related To

Posted on Thu, 3 Jan 2019

Question: I have been asking you all medical queries related to my daughter who is now 2.6 year old and thanks for all your right answers and suggestions so far.

Recently we moved to USA and before moving we consulted a paediatrician for all the basic medicines for my daughter. Prescription is also attached for your reference.

I have a questions on Vitamin D3 prescribed here. Doctor suggested to take Nutri-D daily 5ml for 6 months. Since the Nutri D was not available, I took Ultra-D3 syrup(Image attached). But later I realised that Nutri-D is 600 IU for 5ml but Ultra-D3 is 1000 IU for 5ml. We have not yet started her with this syrup.

1. Kindly suggest how much ml of Ultra-D3 we can give her daily.
2. Since we are in a cold place(Baltimore, Maryland), do you suggest taking Vitamin D3 for longer?
3. We just got one bottle of 100ml Ultra-D3 from XXXXXXX and I have seen here that Vitamin D3 tablets are widely available in most of the shops. Can we pick any Vitamin D3 with right IU/ml and give her?
4. Also, I will be going back to XXXXXXX in next 2 months time and again come back after 2 months. Do you suggest any other medication to keep handy which is not in the prescribed list attached?

Thanks for your suggestion.

Answered by Dr. Diptanshu Das (11 hours later)

Brief Answer:
Any brand of Vitamin D3 can be used

Detailed Answer:
Thanks for using the Ask a Doctor service. Pardon me for the inadvertent delay in responding.

Let me try to address the issues one by one:
1. Ultra D3 (1000IU/5 ml) 2.5 ml once daily needs to be given.
2. The cold temperatures are not related to Vitamin D3. So that does not make a difference.
3. You can pick any brand of Vitamin D3. Just give around 400 to 500 IU per day. Adjust the dose as per the strength of the solution.
4. No specific medication. Just keep paracetamol or acetaminophen handy and give it in case of fever or pain.

Feel free to write back.

Regards

Above answer was peer-reviewed by : Dr. Kampana

Follow up: Dr. Diptanshu Das (8 hours later)

Thanks for your response.

Is it absolutely necessary to give her Vitamin D supplements if the cold area is not related to deficiency of it?

Her paediatrician gave her vitamin d and other supplements only for an year. After that he suggested some tonic(I don’t remember the name now) and told it is good for brain development. We tried giving her that but she was not liking its smell and taste so we had to discontinue it.

Now it is almost one and half year since we are not giving any supplements to her. We are giving her all kind of food and she eats everything we eat and we don’t prepare a separate food for her. Should we give her any supplement? She is otherwise healthy and her growth is good for her age.

Answered by Dr. Diptanshu Das (2 minutes later)

Brief Answer:
Supplements not needed

Detailed Answer:
Vitamin D deficiency is very common now-a-days and I think that to be the reason that the supplement has been advised. I doubt if there is any connection to the cold climate.

The paediatrician probably gave a omega 3 fish oil supplement to facilitate brain development. Often such syrups have a bad taste or smell. However, brain development requires the brain to be exercised and I would stress on this rather than omega 3 supplements.

I do not think that you need to give your child any supplement unless there is any specific deficiency symptom.

Regards

Above answer was peer-reviewed by : Dr. Yogesh D

Follow up: Dr. Diptanshu Das (25 minutes later)

Thank you for the advise.

How do I know she has Vitamin D deficiency? Condition here is very cold and we don’t go out quit often to get sunlight.

Are you advising not to start her with the Vitamin D supplement now?

Answered by Dr. Diptanshu Das (10 minutes later)

Brief Answer:
testing for the levels will help in confirmation

Detailed Answer:
You just need to test her blood for 25-OH-Vitamin D level and you would know if there is a deficiency.

I am advising to give the Vitamin D supplement but not any other supplement like omega 3 supplements.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Diptanshu Das (5 hours later)

Ok. I will start giving her Vitamin D supplement. How long do you recommend us to give it?

We are not giving her any Omega 3 and other supplements anyways. Thanks for your advise on this.

Answered by Dr. Diptanshu Das (3 hours later)

Brief Answer:
For a month or two each year

Detailed Answer:
Since the child is already 2.6 months old, I would insist it to be given for a month or two each year. I assume that vitamin D has been continuously supplemented in the past.

Regards

Above answer was peer-reviewed by : Dr. Prasad

Follow up: Dr. Diptanshu Das (1 hour later)

Vitamin D is supplemented continuously for first year only. After that no supplements given till now. She is out of any supplements from past 1.5 years. Kindly suggest.

Answered by Dr. Diptanshu Das (16 hours later)

Brief Answer:
Get blood tested

Detailed Answer:
It would make sense to get the blood tested for 25-OH-Vitamin D level tested. It would not hurt if supplementation is done without testing.

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Above answer was peer-reviewed by : Dr. Prasad