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Call for BME babies to have vitamin D from birth

HEARTBROKEN: Beverley Thahane had brought her concerns for her son to a series of medics

A BEREAVED mother who was told the death of her six month-old son last year was “entirely preventable” is backing calls from health experts for babies, especially those of African Caribbean origin, to be given vitamin D supplements.

South African-born Beverley Thahane, 38, had brought her concerns for her second child, Noah, to a series of medics, since he was just three months old. Despite Noah displaying a range of symptoms including rapid breathing and suffering seizures, his mother was told he would be alright.


RICKETS: Beverley Thahane authentic

Other explanations offered to Beverley included that Noah had bronchitis and asthma, and later that his optimum birth weight and length and early growth were indicators that there was no major need for concern.

“Noah would suddenly start breathing rapidly as though he had been running,” Beverley told The Voice from her home in Telford, Shropshire. “He passed out more than once. I knew something was wrong. I told my older son, who was nine at the time, to keep an eye out and be prepared for us to take Noah back to hospital.” In January 2017, having just been breastfed and changed, Noah exhibited restless behaviour. Moments later Beverley found him unresponsive and despite administering CPR until the first responders arrived, he could not be revived. Noah had suffered a cardiac arrest.

PREVENTABLE
It was on the way back home from hospital, two days after Noah’s passing that Beverley, a hospital clerical officer, received a call from a University of Birmingham (UoB) researcher, Dr Wolfgang Högler, to explain that Noah’s death was entirely preventable. Dr Högler’s team identified that Noah had undiagnosed severe nutritional rickets and all complications were ultimately caused by severe vitamin D deficiency.

Beverley added: “I could not believe what I was hearing. How could this be? I had said to so many doctors that something was wrong, but it seemed like no-one was listening. I was utterly heartbroken and horrified to learn that Noah’s death could have been prevented.” Vitamin D is essential for skeletal growth and bone health, and deficiency can result in rickets, soft bones and seizures or heart failure as a result of a lack of calcium. BME people are at particular risk as dark skin produces far less vitamin D than white skin, and, from October to April, there is not enough appropriate sunlight in the UK for dark skinned people.

Surveys suggest that around a fifth of adults and up to 24 per cent of children may have low vitamin D status. Deficiency rates are even higher in BME communities, who are under-represented in current diet/nutritional surveys.

Beverley said: “After Noah died, I asked myself, was it down to race, there not being enough black doctors, should I have been more demanding? I had not been informed of the need for infant vitamin D supplementation, or that we were at greater risk due to having dark skin, and I had no idea how catastrophic the effects of a vitamin deficiency can be.”

Beverley is supporting the recommendations from Dr Högler, and fellow UoB researcher, Dr Suma Uday, that vitamin D supplementation policy is changed to protect the vulnerable. In new research published in the BMC Pediatrics journal, the medics call for updates and simplification of “overly complex and outdated” guidance to include supplementation of all babies. They are also calling on the Government to introduce mandatory monitoring of babies and pregnant women to ensure they are taking vitamin D supplements.

PROGRAMME

The authors suggest that studies should explore the feasibility of introducing a rickets prevention programme, which would see children receiving oral bolus vitamin D supplements alongside routine immunisations at GP surgeries, with a similar strategy for pregnant women at antenatal visits. The medics’ research is based on the cases of three five- to six-month-old babies, including Noah, that were all born in England to mothers of BME origin who developed low-calcium heart failure and rickets as a direct consequence of vitamin D deficiency.

Dr Högler, a Reader in Paediatric Endocrinology at the UoB and a consultant endocrinologist at Birmingham Children’s Hospital (BCH), said: “These cases have in common that their risk and need for supplementation went unrecognised, adherence to supplementation was not monitored, and that clinical symptoms were relatively silent until severe complications manifested.”

Dr Uday, also of BCH, said that vitamin D deficiency is also common in other ‘risk groups’ – including babies, pregnant women, people who practice whole body clothing, people whose diets lack calcium and elderly people who spend more time indoors.

Recently, a friend of Beverley’s, whose son was also exhibiting rapid breathing, insisted that the hospital send its refusal to test him for vitamin D deficiency in writing. The test which followed resulted in a positive diagnosis for which the three-month old received treatment. Beverley concluded: “If anything, my friend’s son is still alive because of Noah.”

To find out more please visit birmingham.ac.uk/research/ perspective/vitamin-dsupplementation.aspx

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