Vitamin D Deficiency in Singapore: What You Need to Know

Vitamin D is often called the “sunshine vitamin”, yet despite Singapore’s year-round sunshine, many people here are deficient. This issue is particularly concerning among pregnant women and children, two groups for whom adequate vitamin D is critical for healthy growth and development.

This article breaks down what vitamin D deficiency looks like in pregnant women and in children, explores the risks and signs, and highlights practical solutions to prevent and address the problem.

Vitamin D Deficiency in Pregnant Women

Pregnancy is a time when vitamin D needs are higher than usual, and yet many women in Singapore begin their journey with insufficient levels. Research shows that deficiency is widespread and can affect both the mother’s health and the baby’s development.

Prevalence in Singapore

Recent research in Singapore shows that vitamin D deficiency during pregnancy is highly prevalent. A large study conducted at KK Women’s and Children’s Hospital (KKH) revealed that:

• Only 2.2% of women in their first trimester had sufficient vitamin D levels.

• About 49.5% had insufficient levels.

• 46.2% were moderately deficient.

• 2.2% were severely deficient.

Higher body mass index (BMI) was also linked to a greater risk, with every 5 kg increase in weight raising the odds of deficiency by 23%.

How does vitamin D deficiency affect mothers and babies?

Vitamin D deficiency can have significant consequences:

• For Mothers: Low vitamin D increases the risk of pregnancy complications such as pre-eclampsia, gestational diabetes, and poor sleep quality.

• For Babies: Babies rely on maternal vitamin D stores. Deficiency can contribute to low birth weight, impaired bone development, and even a higher risk of chronic conditions later in life.

Signs and symptoms of vitamin D deficiency in pregnancy

Although symptoms can be subtle, women may notice:

• Muscle weakness or bone pain

• Fatigue

• Sleep disturbances (noted in some Singapore cohort studies)

Who is most at risk?

Deficiency risk is highest among:

• Women with higher BMI

• Those who spend little time outdoors

• Women who wear clothing that covers most of their skin or use strong sun protection

• In the KKH study, all severely deficient women were Chinese, suggesting possible ethnic or lifestyle influences

Vitamin D Deficiency in Children

Vitamin D is just as critical for children, supporting their growth and immune system. Unfortunately, studies show that deficiency in Singaporean children is far more widespread than many parents realise.

Prevalence in Singapore

Children in Singapore also face surprisingly high rates of deficiency. In a study involving over 2,000 children, researchers found that:

• 63% were vitamin D deficient

• 33% were insufficient

• Only 3% had sufficient levels

This shows that most Singaporean children are not meeting their vitamin D needs, despite the sunny climate.

Health impacts of vitamin D deficiency in children

Without enough vitamin D, children face:

• Rickets in infants and toddlers (soft bones, bowed legs, skull deformities)

• Poor bone mineralisation and increased fracture risk

• Weakened immunity and possibly higher susceptibility to infections

Signs and symptoms of vitamin D deficiency in kids

Parents should watch for:

• Bowed legs or knock knees

• Delayed walking or crawling

• Slow closure of skull soft spots (fontanelles)

• Irritability, weakness, or bone pain

Risk factors for children

Children are more likely to be deficient if they:

• Exclusive breastfeeding without supplementation (breast milk alone has low vitamin D)

• Minimal outdoor play or consistent use of sunscreen

• Darker skin pigmentation, which reduces vitamin D synthesis

• Certain medical conditions or medications that affect absorption

What Can Be Done: Solutions for Pregnant Women and Children

The good news is that vitamin D deficiency can be managed and even prevented. Addressing the problem requires a combination of screening, diet, lifestyle, and supplementation.

1. Screening and Monitoring

• Pregnant women: Testing 25-hydroxyvitamin D levels in early pregnancy, especially if high-risk (overweight, limited sun exposure).

• Children: Pediatric check-ups and screening if symptoms or risk factors are present.

2. Recommended Daily Intakes

3. Dietary and Lifestyle Measures

• Safe Sun Exposure: 10–30 minutes of mid-morning or early afternoon sun on arms and legs, a few times per week. Darker-skinned individuals may need more.

• Food Sources: Fatty fish (salmon, sardines, mackerel), egg yolks, fortified milk or soy milk, mushrooms exposed to UV light.

• Supplements:

  • Pregnant women: Consider 800–1,000 IU daily, under medical advice.

  • Infants: Vitamin D drops (400 IU daily) recommended for exclusively breastfed babies.

  • Children: Supplements if diet and sun exposure are insufficient.

4. Safety Considerations

• Vitamin D toxicity is rare, but avoid overdosing — excessive supplementation can harm the kidneys and bones.

• Always seek medical advice before starting high-dose supplements, especially during pregnancy or for young children.

Conclusion

Vitamin D deficiency is a hidden but serious issue in Singapore, affecting both pregnant women and children. For mothers, deficiency can increase pregnancy risks and impact their babies’ development. For children, it can lead to bone deformities and long-term health issues.

The good news? It’s preventable. Through a balanced approach of safe sun exposure, dietary improvements, appropriate supplementation, and early screening, families in Singapore can protect both mothers and children from the effects of vitamin D deficiency.

A little sunshine and smart nutrition can make a big difference.