The healthiest 10% of children never need to see a doctor. Why aren’t all children so healthy? I believe that genes and bad luck play only a small role and that closer to 80% of children could grow to adulthood without ever seeing a doctor except to repair wounds, broken bones, and other physical trauma. If I’m correct, we are living in a time of epidemic poor health amongst children. I’ve chosen to focus on just two conditions: pale faces and cavities.

To me, the cause of pale faces and cavities is deficiency of just four special vitamins – vitamins C, D, B1 (thiamine) and B3 (niacin). These four vitamins are special because they are the only four associated with named, formerly epidemic, deficiency diseases. The four diseases are scurvy, rickets, beriberi, and pellegra respectively. Wise use of just these four vitamins will prevent untold suffering.

When is the best time to start working to use these four vitamins to prevent deficiency in children? Far and away the best time to start is long before pregnancy. I don’t believe anyone will argue with me when I say that the healthier the mother, the better the odds of a healthy baby. That said, there is shockingly little good data to draw upon. How can modern medicine devote so few resources to working out tests that predict the risk of a poor birth outcome before a women becomes pregnant? The truth is, young people who want to become parents (that’s almost everyone) don’t want to ask such questions. The reason I’m writing is that modern science (not modern medicine) has indirectly gathered alot of information. When admittedly abstract reasoning is applied using solid first principles of science, the importance of vitamins C, D, B1, and B3 is clear.

Many women of child bearing age are unhealthy. Numerous articles point out that taking pregnancy vitamins does not significantly improve the health of babies. From this, the authors typically conclude that vitamin deficiency is not a cause of unhealthy babies. Although logical, this conclusion is incorrect. Vitamin deficiency is the dominant cause of poor health amongst women of child bearing age. I don’t want to argue this point. I want to test it. Getting the doses I recommend of just four vitamins – vitamins C, D, thiamine, and niacin involves little in the way of cost and effort and has negligible risk.

Poor health caused by chronic, marginal vitamin deficiency of vitamins C, D, thiamine, and niacin can not be corrected by taking prenatal vitamins during pregnancy. Preganancy places many unique demands upon a woman’s body. It is unrealistic to expect a woman’s body to become healthier during pregnancy.

The way to prevent pale faces and cavities in children is to get expectant mothers into excellent health. The place to start is with girls. The R.D.A.’s for children are too low. Children need a multivitamin, extra vitamin C, niacin, thiamine, and sunshine (vitamin D). Read more here. They need to learn to master the use of vitamins for themselves as young adults. They need to study and experience vitamin side effects.

Young adulthood is the best time to experiment with high doses of vitamins. The risk of permanent harm is negligible and young adults bounce back quickly from any side effects. It is particularly important to master vitamin C, sun exposure (vitamin D), niacin, and thiamine because they are the four special vitamins associated with the four named vitamin deficiency diseases: scurvy, rickets, pellagra, and beriberi. Mastery of these vitamins will result in excellent health for a majority of young women. When and if a young woman in excellent health decides to get pregnant, the conservative course of action is to reduce vitamin consumption to the tried and true levels in prenatal vitamins. The only exception is vitamin C. If a young woman has mastered vitamin C and settled on a daily dose above 2000 mg/day, she should consider continuing to take extra vitamin C at a dose of 1000 to 2000 mg/day, just below the UL of 2000 mg/day set by the Food and Nutrition Board.

Reliable reports from independent physicians working in several countries claim that vitamin supplements at doses significantly higher than contained in prenatal vitamins can prevent poor birth outcomes. These include birth defects, premature births, colicky babies, and difficult labor. The physicians making these reports typically had long term relationships with patients. The mothers they worked with were taking vitamins before becoming pregnant and were, as a result, in better than average health.

I want to emphasize that I am not recommending taking high doses of vitamins during pregnancy. Even doses of vitamins at the UL (the upper safe limit) are known to cause side effects for a small minority. The Food and Nutrition Board developed the R.D.A.’s by studying young adults in excellent health. This includes the R.D.A.’s contained in prenatal vitamins. To me, this means that if an expecting mother is in excellent health, prenatal vitamins will maintain her excellent health throughout the pregnancy and birth. Pregnancy is a time for conservative behavior. It is not a time to be experimenting with vitamin doses.

What I’m recommending is extra sunshine and vitamins for children and young adults. If you are a young adult reading this column and you are looking for a place to start, here is one:

Vitamin C – 4000 mg/day first thing in the morning
Vitamin D – ample sunshine in the spring, summer, and fall including full body exposure at least once/month. 1000 IU/day during the winter months.
Thiamine – 5 to 10 mg/day as TTFD in an enteric-coated tablet. It has to be TTFD and the tablet has to be enteric coated. Alternatively, purchase TTFD cream and apply 5 to 10 mg topically.
Niacin – take 250 mg time release niacin once per week

If you are a parent and are looking for vitamin doses for your children, read more here.

It’s time to work to prevent pale faces and cavities in children by building bodies in robust health. It’s time to start closing neo-natal care units, and winding down the production of the many medications used to treat children born pre-term. It’s time to take control of our health by taking full advantage of the wealth of knowledge about the nutrients that make us and keep us healthy. I can think of no better investment in the future than improving the health of the young women about to produce the next generation. If there are young women in your family who are not in excellent health, they have much to gain and nothing to lose by mastering vitamin C, sunshine (vitamin D), niacin and thiamine.