Prevention and treatment of hypervitaminosis D in children

Prevention of hypervitaminosis D in children is closely related with the rational prevention of rickets, which includes a number of General and specific measures. Among them rational nutrition of the child, sufficient stay in the fresh air, observance of sanitary-and-hygienic mode, hardening and proper upbringing. Specific prevention of rickets include ultraviolet irradiation, the use of fish oil and vitamin D.
In recent years, thanks to the substantial improvement of living conditions of the population, and nutrition of children have changed the features of clinical course of rickets. Currently there are hardly any severe disease (Tabolin and others, 1974).
Crucial in the prevention of rickets are non-specific activities of a General nature aimed at creating optimal physiological conditions as the pregnant woman and the child's first year of life. In this regard, antenatal care of the fetus should be conducted before the birth of the child in the following directions:
1. Strengthening the health of future young parents. The widespread use of physical education and sports, the maximum exposure to fresh air, the fight against Smoking and alcoholism.
2. Rickets is easily and heavier occurs in premature infantsborn with low weight. In this regard, prevention of prematurely born is an important factor in the prevention of rickets. Careful observation in the antenatal clinic of pregnant women with threatened nedvishimosti.
3. Pregnant women should regularly attend antenatal clinic during the whole pregnancy, to observe the regime of work and rest, especially diet, rational use of prenatal leave; also important psycho prepare for childbirth and so on
Nutrition of pregnant women should be varied and nutritious. It is necessary to observe moderation in eating, as overeating is harmful and can lead to obesity, adverse effects on fetal development.
In the first half of pregnancy should eat 4 and the second 5-6 times a day, with a mandatory daily included in the diet products that contain complete proteins (cheese, cheese, milk, meat, fish, eggs). It is very important enough consumption of vegetables, fruits, berries, as these products are rich in vitamins a, b, C, mineral salts and microelements. Food should be prepared from fresh benign products. Protein in the daily diet should be up to 100 g in the first half of pregnancy and 110-120 g - in the second half, fat - 100 g, liquid - up to 1,5 l throughout pregnancy no Smoking, drinking alcoholic beverages, including beer and spices and spices (horseradish, mustard, pepper).
In addition, to strengthen the health of the pregnant woman needed moderate exercise, wet wiping, longer sleep (8-9 hours): in the summer with the Windows open, in the winter - with an open window. You cannot do the heavy work (tray of food on the farm, weeding and hoeing, stacking straw, big Laundry, transfer of gravity, working in hot shops, and so on).
But contraindications and immobile, sedentary lifestyles that are harmful effect on the organism of a pregnant woman and fetus. Should more fresh air, hygiene accommodation, bed and workshop.
Along with these activities to strengthen health of the pregnant woman at the same time, a number of specific measures for the prevention of rickets with respect to the health of the mother, the characteristics of the course of pregnancy, lifestyle, nutrition, age, time of year and climatic factors.
Specific antenatal prevention is carried out mainly pregnant women living in inadequate housing and physical living conditions, insufficient being in the fresh air and the sun, leading a sedentary lifestyle.
In addition, specific prevention should be women with frequent pregnancies, and with symptoms of hypovitaminosis D (caries, osteoporosis bone, hypophosphatemia, hypocalcemia, increased alkaline phosphatase activity, negative or slabopolozhitelnym trial of Sulkowice).
When specific antenatal prophylaxis to pregnant women, the following methods:
1. A daily intake of vitamin D (a continuous fractional method) during the last two months of pregnancy. Daily dose of the vitamin in the South is 750-1500 ME (one drop of oil solution every day or every other day); in the Northern, Central and Eastern Kazakhstan, where the need for vitamin D is higher because of less sun exposure, should be encouraged 1500-3000 ME (1 to 2 drops of oil solution to the reception). In some cases, the dosage may be increased to 3,000 - 5,000 IU per day.
2. One or two courses UV exposure during pregnancy in increasing dosage - from 0.25 to 2.5-3 biodoses at a distance from the burner to 100 cm, only 18 to 20 sessions.
3. Regular intake of fish oil 1-2 tablespoons a day after meals, if a woman well it takes, in the last stages of pregnancy. It should be emphasized that it is impossible to combine these methods antenatal specific prevention of rickets in order to avoid the development of E-vitamin intoxication. At the same time it should be noted that there is no need for specific antenatal prevention of rickets all women with good material and living conditions, with a balanced diet and sufficient exposure to fresh air, pregnant without signs of hypovitaminosis D, as well as over the age of 35 years. Correct the activities of antenatal specific and nonspecific prevention of rickets is carried out by the medical staff of women's consultations with the active participation of pediatricians.