Prevention of Vitamin D deficiency in infancy: daily 400 IU vitamin D is sufficient (original) (raw)
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Vitamin D status in infancy: What is the solution?
Journal of Surgery and Medicine, 2019
Aim: Vitamin D deficiency and insufficiency are common public health problems throughout the world. Besides important multisystemic metabolic effects, vitamin D is necessary for a healthy skeletal system. Various reasons cause vitamin D deficiency in infancy, and supplementation is one of the treatment options. A nationwide supplementation program has been implemented in Turkey since 2005. In this study, we aimed to evaluate the efficacy of this program in our city. Methods: All infants aged between one and twelve months who were referred to the pediatric outpatient clinics of the hospital and tested for serum 25-(OH)-D levels between January 1, 2015 and December 31, 2016 were enrolled in the study. Patients with chronic illnesses were excluded. Data was obtained retrospectively from the hospital registry. In accordance with the criteria of American Academy of Pediatrics, patients were divided into three groups based on serum 25-(OH)-D levels as follows: 25-(OH)-D<15 ng/ml were considered deficient, 15.1<25-(OH)-D<20 ng/ml were considered insufficient and sufficiency was defined as 25-(OH)-D>20 ng/ml. Results: The study group consisted of 265 infants. The mean age of the group was 7.53 (2.75) months. Approximately 15% (n=39) of the study group had vitamin D deficiency, 10.5% (n=28) had insufficiency and Vitamin D levels of 74.4% (n=198) of the group were sufficient. Serum 25 (OH) D levels did not differ with gender, age or season (P=0.12, P=0.65 and P=0.09, respectively). Vitamin D levels were sufficient in 78.5% (n=150) of the urban area residents and 69.6% (n=32) of the rural area residents, between which there was no significant difference (P=0.32). Conclusion: Our results established that supplementation is one of the ways to avoid limitations affecting serum vitamin D levels. Supplementation with 400 IU/day Cholecalciferol is provided during the first year of life by the Turkish Ministry of Health, which we believe rendered gender, age, time of measurement and residential area insignificant in terms of 25(OH) D levels. This supplementation program may solve the problem of vitamin D insufficiency or deficiency among disadvantaged groups.
Vitamin D Deficiency in Children and Its Management: Review of Current Knowledge and Recommendations
Given the recent spate of reports of vitamin D deficiency, there is a need to reexamine our understanding of natural and other sources of vitamin D, as well as mechanisms whereby vitamin D synthesis and intake can be optimized. This stateof-the-art report from the Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society was aimed to perform this task and also reviews recommendations for sun exposure and vitamin D intake and possible caveats associated with these recommendations. Pediatrics 2008;122:398-417 V ITAMIN D IS a prohormone that is essential for normal absorption of calcium from the gut, and deficiency of vitamin D is associated with rickets in growing children and osteomalacia in adults. Rickets is the failure of mineralization of growing bone and cartilage. Initial descriptions of rickets were provided by Daniel Whistler and Francis Glisson in England as early as the 17th century. At the turn of the 20th century, with industrialization, this disease became endemic until it was discovered that exposure to sunlight and cod liver oil could both prevent and treat rickets. 1,2 Once vitamin D was identified and easy ways to supplement foods were developed, nutritional rickets almost disappeared from industrialized countries. 1-3 However, there has been a reappearance of rickets from vitamin D deficiency in recent decades as a result of multiple factors, which we will discuss in the course of this review. Dark-skinned infants who are exclusively breastfed and infants born to mothers who were vitamin D deficient through pregnancy seem to be at particularly high risk. However, rickets is also being reported in older children.
Vitamin-D Levels in Infants and Young Children in the Era of Routine Supplementation
Journal of evolution of medical and dental sciences, 2021
BACKGROUND Vitamin D deficiency has been found to be very prevalent in India with a prevalence of 50-90 % in many parts of India. The Indian Academy of Paediatrics (IAP) has hence recommended routine administration of vitamin D in infants. In this study, we aim to find the prevalence of vitamin D deficiency in a random population and the efficacy of routine vitamin D administration in preventing vitamin D deficiency. METHODS 48 children ranging from 2 months to 5 years who attended a medical camp were selected and their 25-OH vitamin D levels were determined. A detailed history regarding their diet and routine vitamin D supplementation was taken. RESULTS In the sample studied, only 8.3 % of children were vitamin D deficient and 10.4 % of children were vitamin D insufficient. Of the 9 children who were on supplements for more than 6 months, none developed vitamin D deficiency or insufficiency. Children born to multipara were more prone to develop vitamin D insufficiency (p value of 0.046). CONCLUSIONS The prevalence of vitamin D deficiency was found to be 8.3 % only, very low when compared with other studies in the infants and preschool children age group and there was no significant difference with supplementation of vitamin D. A follow up of these children to find out if the incidence increases with increasing age will be ideal.
Vitamin D Supplementation and Status in Infants: A Prospective Cohort Observational Study
Journal of Pediatric Gastroenterology and Nutrition, 2011
Objective: Vitamin D status in infants depends on supplementation. We examined the vitamin D status in relation to supplementation dose and scheme in infants. Patients and Methods: One hundred thirty-four infants age 6 months and 98 infants age 12 months (drop out 27%) were investigated. Vitamin D intake (diet, supplements), anthropometry, and 25-hydroxyvitamin D (25-OHD) serum concentration at the 6th and 12th months were assessed. Results: Vitamin D intake of 1062 AE 694 IU at the 6th month was not different from that at the 12th month (937 AE 618 IU). Vitamin D intake expressed in international units per kilogram of body weight decreased from 141 AE 80 IU/ kg at the 6th month to 93 AE 62 IU/kg at the 12th month (P < 0.0001), which was associated with a reduction in 25-OHD from 43 AE 20 ng/mL to 29 AE 12 ng/ mL, respectively (P < 0.0001). In the subgroup of everyday supplemented infants (n ¼ 43), vitamin D intake decreased from 143 AE 88 IU/kg at the 6th month to 118 AE 60 IU/kg at the 12th month (P < 0.05), which coincided with a reduction of 25-OHD from 40 AE 19 ng/mL to 32 AE 13 ng/mL (P < 0.01). In the subgroup with variable supplementation habits (n ¼ 32), vitamin D intake decreased from 146 AE 79 IU/kg to 77 AE 56 IU/kg (P < 0.001), which was associated with a reduction of 25-OHD from 42 AE 21 ng/mL to 25 AE 8 ng/mL (P < 0.0001). 25-OHD concentration change between the 6th and the 12th months negatively correlated with the 25-OHD level assessed at the 6th month (r ¼ À0.82; P < 0.0001). Conclusions: Vitamin D supplementation of infants should consider their rapid body weight increment. We postulate vitamin D daily dose close to 100 IU/kg body weight as favorable for infants up to age 12 months.
Prophylactic vitamin D in healthy infants: assessing the need
Metabolism-clinical and Experimental
The objective was to evaluate the need for vitamin D prophylaxis in healthy infants. This was a prospective and randomized study performed at primary care clinics. Eighty-eight full-term 1-month-old healthy infants were randomly assigned to receive (n = 41) or not (n = 47) 402 IU/d of vitamin D for 1 year. Primary outcome measures were serum 25-hydroxyvitamin D (25OHD) and parathyroid hormone (PTH) concentrations at 3, 6, and 12 months of age; secondary measures included data on feeding, habitat, season of birth, sun exposure, and physical examination. At 3 and 6 months of age, serum 25OHD levels (±SD) were significantly higher (P < .001) in the prophylaxis group. In the group without prophylaxis, serum 25OHD increased with age; and breast-fed infants aged 3 months had the lowest value (20.2 ± 9.4 ng/mL), which was significantly (P = .001) lower than that of formula-fed infants (35.0 ± 9.7 ng/mL). The PTH levels were not influenced by the prophylaxis or feeding. No influence of either the habitat or season of birth on serum 25OHD concentrations was demonstrated. No infant had clinical signs of vitamin D deficiency. Serum 25OHD and PTH concentrations were weakly but significantly correlated (r = −0.29, P = .009) at 3 months of age. Healthy infants without vitamin D prophylaxis had lower circulating concentrations of 25OHD at 3 and 6 months of age, the lowest value being found in 3-month breast-fed infants. The clinical relevance of these findings is probably negligible because serum 25OHD levels spontaneously increased with age and were not associated with high serum PTH. Clinical manifestations of rickets were not observed.
Characteristics of vitamin D deficiency in early infancy, 2022
Purpose: Vitamin D deficiency is a health problem in developing countries. This study aims to investigate the characteristics of children with vitamin D deficiency in early infancy. Materials and Methods: Hundred and forty infants with vitamin D deficiency (mean age:3.5 ± 1.7 [0-6] months) and a control group of 200 healthy infants (mean age: 3.4 ± 1.7 [0-6] months) were included in the study. Serum calcium, phosphorus, alkaline phosphatase, parathyroid hormone (PTH), and 25-hydroxyvitamin D (25(OH)D) levels were measured in the patient, control groups, and the mothers of the patients. In 38 patients, radiological findings were evaluated with knee and wrist radiographs. Thacher Rickets Severity Scoring (RSS) system was used for radiological evaluation of rickets severity. Results: The most common (42%) complaints were respiratory symptoms, including cough, respiratory distress, and wheezing. The most common finding of physical examination was the rachitic rosary. Serum calcium (Ca++), alkaline phosphatase (ALP), 25(OH) vitamin D, and parathormone (PTH) levels were significantly different in the patient and the control groups. The mean Thacher radiological score of 38 patients was 3.1 ± 2.1 (0-8) points. The mother's dressing style of covering up the whole body, i.e., veiling, increased the infant's risk of vitamin D deficiency by 17.5 times. Conclusion: Subtle clinical, laboratory, and radiological findings of vitamin D deficiency are detected in early infancy. Vitamin D deficiency should be considered primarily in infants with hypocalcemia whose mothers are less frequently exposed to sunlight due to geographical conditions and their preferred or imposed lifestyle.
Vitamin D deficiency and prevention: Turkish experience
Acta Paediatrica, 2011
A nationwide 'vitamin D prophylaxis augmentation programme' initiated in 2005 in Turkey reduced the prevalence of rickets from 6% in 1998 to 0.1% in 2008 in children under 3 years of age. The programme included free distribution of vitamin D drops to all newborns and infants (0-12 months) visiting primary health stations throughout the country. Free disposal of vitamin D to infants is an effective strategy for preventing vitamin D-deficient rickets.
Vitamin D deficiency and prevention
A nationwide 'vitamin D prophylaxis augmentation programme' initiated in 2005 in Turkey reduced the prevalence of rickets from 6% in 1998 to 0.1% in 2008 in children under 3 years of age. The programme included free distribution of vitamin D drops to all newborns and infants (0-12 months) visiting primary health stations throughout the country. Free disposal of vitamin D to infants is an effective strategy for preventing vitamin D-deficient rickets.
Management of Vitamin D Deficiency in Children: An Update
Bangladesh Journal of Child Health, 2020
Vitamin D is a steroid hormone that plays a major role in maintaining skeletal health and it also has a role in disorders other than bone metabolism. In the paediatric population, vitamin D deficiency has emerged as a significant public health problem throughout the world and majority of children has vitamin D deficiency in spite of wide availability of sunlight. Vitamin D deficiency status is defined as deficiency when 25(OH)D level is less than 30 ng/mL (75 nmol/L) The manifestations of deficiency may vary from hypocalcemic seizures and tetany in infancy, florid rickets in toddlers, and pain in adolescent. Vitamin D deficiency is associated with other different clinical diseases, such as, insulin resistance, metabolic syndrome, respiratory tract infections, asthma, and autoimmune diseases. It is also associated with prematurity, obesity, malabsorption, extreme latitudes and little sunlight exposure. Routine supplementation of vitamin D starting from newborn period is endorsed by v...