your child has trouble going to sleep at night and complains that his legs hurt. Is it simply another stall tactic, or could it be growing pains?

“Growing pains are intermittent aches or pains experienced by 25 percent to 40 percent of children between the ages of 3 and 12,” says Lesa Werner, ND, a Los Angeles-based member of the Holistic Pediatric Association. Children with this common condition often complain of throbbing or aching in their thighs, shins, or calf muscles. No one knows the exact origin of these mysterious aches, but some experts feel they're simply caused by overuse of muscles, tendons, and joints because pains often occur after a day of active play. Others feel that rapid bone formation during intense growth spurts can put undue strain on a child's developing muscles.

In addition to growth forces, other factors could be at play. “I think most growing pains are nutritional issues,” specifically a mismatch between the rate of bone growth and the nutrients required to fuel that growth, says James E. Dowd, MD, a pediatric and adult rheumatologist in Brighton, Michigan, and coauthor of The Vitamin D Cure (Wiley, 2008). Consider the following to help your child find relief.

Ensure adequate D

Because vitamin D is essential for calcium absorption and fuels bone growth, a deficiency may compromise the body's ability to build both muscle and bone mass, particularly during childhood, says Dowd. He adds that as many as 65 percent of his pediatric patients are vitamin D deficient. Recent studies back him up: The Archives of Pediatrics and Adolescent Medicine reports that vitamin D deficiencies are widespread among American children.

To boost D, have kids get at least 15 minutes of sunshine daily, sans sunscreen. Lacking that, for newborns and children up to 5 years old, Dowd recommends ½ to 1 teaspoon daily of cod-liver oil, which supplies more vitamin D per tablespoon than any other food source. Milk is good but not as efficient: 1 cup of fortified milk offers 98 IU vitamin D, while a fraction of that — 1 teaspoon — of cod-liver oil provides 453 IU. He suggests flavored varieties of the oil, which most kids find easier to swallow, or capsules. (But don't overdo it; more than 1 teaspoon cod-liver oil per day will provide too much vitamin A.) For older children, Dowd advises a daily vitamin D supplement with a dose of 20 IU per pound.

Try homeopathy and massage

Prescribed for years by herbalists for achy limbs, arnica is gaining credence in conventional medicine as an effective, safe treatment for muscle pain. Even though studies are scientifically inconclusive, in 2005, the Emergency Medical Clinics of North America published an article supporting arnica's use and cited years of anecdotal evidence describing its merits. “If growing pains are acute, I often prescribe a brief course of a homeopathic arnica blend, called Traumeel,” Werner says. Look for arnica ointments or in 30c homeopathic tablet form (take your child to a holistic doctor for the correct dose). Homeopathic remedies are safe for short-term use, but if symptoms don't improve, or if they worsen, contact your child's doctor for a thorough examination.

And don't overlook hands-on therapies to soothe pains. Relaxation techniques, such as a warm bath followed by a leg massage and application of a heating pad, can help calm tired, sore muscles, says Cathie-Ann Lippman, MD, in Beverly Hills, California. As a bonus, warm baths help induce sleep, and a good night's rest goes a long way toward giving muscles the chance to recover from the hard work of growing up.

More than a growth spurt?

Call your child's doctor if:

  • pain is accompanied by a rash, swelling, or redness in the joints
  • your child also has a fever
  • pain is severe and persistent
  • pain accompanies a loss of appetite, fatigue, or uncharacteristic behavior

Preventive care

During pregnancy and breastfeeding, mom's diet can influence the quality of her baby's bones. Supplementing with vitamin D and calcium and eating adequate protein (5 ounces per day) and vegetables (2-3 cups per day) will help support a child's bone and muscle growth for years after weaning.

Source: James E. Dowd, MD.

For more about kids' vitamin needs, go to deliciouslivingmag.com and type kids vitamin guide into the search box.