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Letters Child abuse controversy

Don’t ignore preventive message of baby Jayden’s case

BMJ 2012; 344 doi: (Published 15 May 2012) Cite this as: BMJ 2012;344:e3386
  1. Patricia J Lucas, senior lecturer1,
  2. Tricia Jessiman, research associate1,
  3. Ailsa Cameron, senior lecturer1
  1. 1Centre for Research in Health and Social Care, School for Policy Studies, University of Bristol, Bristol BS7 8LJ, UK
  1. patricia.lucas{at}

We read the judgement of the prosecution of the parents of baby Jayden with sadness and interest.1 It is accepted that Jayden had congenital rickets—he was born with it, probably because his mother was vitamin D deficient during pregnancy. He was entirely breast fed; one of the sad facts is that, unbeknown to his mother or those advising her, this contributed to his vitamin D deficiency.2

His mother attended all antenatal and postnatal appointments and engaged fully with all health services, including immunising and exclusively breast feeding her son. Because she was in a high risk group when pregnant (being under 18), the government’s Healthy Start scheme should have guaranteed that she received free Healthy Start vitamins, which contain folic acid, vitamin C, and vitamin D.

The main source of vitamin D is skin synthesis during exposure to sunlight, a rare commodity in northern Europe for at least half of the year. Half of adults have insufficient vitamin D levels, and one in six is severely deficient during winter and spring.3 Advice to eat well and breast feed exclusively for six months will not stop this deficiency passing from mothers to babies, particularly in those with pigmented skin. On many occasions this family should have been encouraged to take vitamin supplements, including vitamin D, which would have helped prevent rickets.

The National Institute for Health and Clinical Excellence recommends that all pregnant women who are eligible or likely to be eligible for Healthy Start should be offered the vitamin supplement,4 but awareness of this is probably low. Rapid responses from BMJ readers to a review on vitamin D report poor awareness among mothers and poor access to the vitamins.3

Jayden’s case illustrates the need for all health professionals delivering care to pregnant women and young children to be aware of the simple preventive action of ensuring Healthy Start vitamins are reaching families.


Cite this as: BMJ 2012;344:e3386


  • Competing interests: None declared.


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