Let doc decide how to handle vitamin D, concussion

Q: Should I take vitamin D while I’m pregnant? Should I give a supplement to my 2-year-old? I hear conflicting reports on how necessary it is. — Claudia H., Mill Valley, California

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 that 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 Ddeficiency.

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 by 28 percent. The researchers also found that during the first year of life, newborns whose mothers took vitamin D supplements weighed about 11 ounces more and were about half an inch longer. They also concluded, “vitamin D supplementation with doses of 2,000 IU 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 2-year-olds. The researchers found that supplementation with 400 IU of vitamin D-3 (more made no difference) was enough to help protect kids younger than 2.

So, do discuss D with your doc.

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 OK? — Steven G., Rochester, New York

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 playoff 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 doing sports until a health care professional experienced in evaluating concussions says he’s symptom-free and it’s OK to return to play. That means no PE, no recreational activities and no team practices or games.

Ninety percent of adult concussions resolve in seven to 10 days, but recovery time often is 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 sleeprelated 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 that 56 percent of patients who end up in the emergency room for a concussion fail to see a doctor for a follow up within three months of the accident! So make sure you have your son follow up with his doctor.

Mehmet Oz, M.D., is host of “The Dr. Oz Show,” and Mike Roizen, M.D., is Chief Wellness Officer and Chair of Wellness Institute at Cleveland Clinic. Email your health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdaily@sharecare.com