Effect of Sunlight Exposure on Vitamin D Levels in Children With Cerebral Palsy

This study evaluates the effect of sunlight exposure for 8 weeks in increasing serum vitamin D levels among children with cerebral palsy. Children with cerebral palsy have a high risk of vitamin D deficiency due to limited mobility, inadequate nutritional intake, and the use of antiepileptic medications that may interfere with vitamin D metabolism. Sunlight exposure is a natural and accessible source of vitamin D.

Eligible participants are children with clinically confirmed cerebral palsy. Children with cerebral palsy who meet the eligibility criteria will be recruited from the Pediatric Clinic and Pediatric Inpatient Unit of Dr. Cipto Mangunkusumo National General Hospital, Jakarta. Children with chronic liver or kidney disease, contraindications to direct sunlight exposure, inability to follow the intervention schedule, severe malnutrition, or baseline vitamin D deficiency (<20 ng/mL) will not be included in the study.

Vitamin D status will be assessed by measuring serum vitamin D concentration using the ARCHITECT 25-OH Vitamin D assay. The assessment will be performed through blood sampling conducted by trained healthcare personnel according to standard medical procedures.

During the study, parents or caregivers will be instructed to monitor the child's condition, including signs of discomfort during sunlight exposure such as overheating, skin redness, persistent crying, or other complaints. If participants are unable to complete the exposure in one session due to discomfort, the exposure may be performed gradually within the same day while maintaining the required total duration.

Researchers will monitor adherence to the intervention through scheduled video calls to ensure that the sunlight exposure procedure is performed according to the study protocol. Dietary intake assessment will be performed using food recall and analyzed by the research team.

Inclusion criteria

• Children aged 1-5 years.
• Diagnosed with cerebral palsy, with the diagnosis clinically confirmed by a pediatrician.
• Parents or legal guardians provide written informed consent to participate in the study.
• Covered by the Indonesian National Health Insurance or other insurance.

Exclusion criteria

• Children with chronic liver disease or chronic kidney disease.
• Children with contraindications to direct sunlight exposure, such as allergies, hypersensitivity, or skin disorders.
• Children with severe malnutrition.
• Children with vitamin D deficiency (baseline serum vitamin D level < 20 ng/mL).