US babies get too little Vitamin D –

A study by Cria Perrine, PhD and colleagues of the Centers for Disease Control and Prevention, to determine the proportion of US infants who meet either the 2003 or 2008 recommendation for vitamin D consumption analysed data collected as part of the Feeding Practices Study II, a survey of U.S. mothers conducted from 2005 to 2007.
The survey included nine groups of mothers of children between 1 and 10.5 months old, with between 1,633 and 1,952 mothers surveyed for each age group.

The study found that among infants fed both breast milk or formula, 28% to 35% met the 2003 recommendation, but only 9% to 14% met the 2008 guideline, which recommended nearly twice the vitamin D intake. Among infants who consumed only formula, 81% to 98% met the 2003 recommendation, but only 20% to 37% met the 2008 recommendation.

So, to meet the 2008 AAP recommendation that infants consume at least 400 IU/day of vitamin D, most infants, not just those who are breast-fed, may require an oral vitamin D supplement daily, beginning within their first few days of life.

Vitamin D deficiency is associated with respiratory infections, type 1 diabetes, cardiovascular disease, and cancer later in life, and with nutritional rickets in children.
The vitamin is synthesized in the skin with exposure to sunlight and can be obtained through diet, but other AAP guidelines recommend that children under 6 months be kept out of the sun and that those over 6 months wear sunscreen and clothing to prevent later skin cancer.

In 2003, the AAP recommended that all children consume 200 IU per day of vitamin D during their first two months of life. Despite this, vitamin D deficiency has been reported in 10% to 65% of neonates, infants, and toddlers in the US, depending on the criteria used to define optimal vitamin D levels.
Vitamin D insufficiency, a lesser degree of low vitamin D consumption, has been reported in 40% to 56% of children.
Responding to growing evidence that U.S. children aren't getting enough of the vitamin, the AAP in 2008 doubled the daily recommended dose to 400 IU per day from a child's first few days of life until adolescence.

In addition to finding that few US infants met either the 2003 or 2008 AAP recommendations for vitamin D, the researchers found that use of oral vitamin D supplements was low.

The researchers cautioned that the women in the study had higher levels of education, fewer children, and breast-fed longer than would be expected of a nationally representative sample.

They also noted that the study relied on the mothers' ability to recall information about their children's feedings, which could be unreliable. However, the estimates of daily formula intake by infants seems to match those found in previous studies.

Perrine C, et al "Adherence to vitamin D recommendations among US infants" Pediatrics 2010; 125: 627–32.


First Published in March 2010


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