Vitamin D supplementation of Canadian infants: practices of Montreal mothers.
ABSTRACT Health policy in North America advocates that all breastfed infants receive a vitamin D supplement of 400 IU per day for the primary prevention of rickets. Despite this recommendation, rickets still occurs in Canada. It is not known whether vitamin D deficiency in the Canadian population is solely attributable to inadequacies in vitamin supplementation. Thus, the evaluation of current practices, including awareness and compliance with recommendations, is clearly needed. The objective of this study was to describe the vitamin D supplementation practices of mothers of newborns living in the Montreal area. This was a cross-sectional telephone survey of 343 mothers delivering a healthy term infant from December 2007 to May 2008 at the Royal Victoria Hospital (Montreal, Que.). Ninety percent of all mothers breastfed their infants during the first 6 months; 53% did so exclusively. Of mothers exclusively breastfeeding, 74% reported meeting the Health Canada recommendation. The main reason for not adhering to the recommendation was the assumption by mothers who began to feed fortified formula (400 IU.L-1) that supplementation was no longer necessary. Fifty percent of infants receiving mixed feedings without supplementation prior to 6 months did not achieve the recommended intake. Receiving advice about supplementation and the higher education of mothers were significant positive determinants of supplementation practices. This work identified infants consuming mixed feedings and those consuming only formula in the first 6 months as groups at high risk for not meeting the recommended 400 IU.day-1 of vitamin D. Therefore there may still be gaps in knowledge regarding vitamin D supplementation.
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ABSTRACT: Rickets was first described in the 17th century and vitamin D deficiency was recognized as the underlying cause in the early 1900s. Despite this long history, vitamin D deficiency remains a significant health concern. Currently, vitamin D supplementation is recommended in Canada for breast fed infants. There are no recommendations for supplementation in formula-fed infants. The objective of this report is to bring attention to the risk of severe vitamin D deficiency in high risk, formula fed infants. A retrospective chart review was used to create this clinical case series. Severe vitamin D deficiency was diagnosed in six formula-fed infants over a two-and-a-half year period. All six infants presented with seizures and they resided in First Nation communities located at latitude 54 in the province of Manitoba. While these infants had several risk factors for vitamin D deficiency, they were all receiving cow's milk based formula supplemented with 400 IU/L of vitamin D. This report suggests that current practice with regards to vitamin D supplementation may be inadequate, especially for high-risk infants. Health care professionals providing service to infants in a similar situation should be aware of this preventable condition. Hopefully this would contribute to its prevention, diagnosis and management.International journal of circumpolar health. 01/2013; 72.
- Canadian family physician Medecin de famille canadien 06/2013; 59(6):607-8. · 1.19 Impact Factor
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ABSTRACT: To examine the use of vitamin D supplements during infancy among the participants in an international infant feeding trial. Longitudinal study. Information about vitamin D supplementation was collected through a validated FFQ at the age of 2 weeks and monthly between the ages of 1 month and 6 months. Infants (n 2159) with a biological family member affected by type 1 diabetes and with increased human leucocyte antigen-conferred susceptibility to type 1 diabetes from twelve European countries, the USA, Canada and Australia. Daily use of vitamin D supplements was common during the first 6 months of life in Northern and Central Europe (>80 % of the infants), with somewhat lower rates observed in Southern Europe (>60 %). In Canada, vitamin D supplementation was more common among exclusively breast-fed than other infants (e.g. 71 % v. 44 % at 6 months of age). Less than 2 % of infants in the USA and Australia received any vitamin D supplementation. Higher gestational age, older maternal age and longer maternal education were study-wide associated with greater use of vitamin D supplements. Most of the infants received vitamin D supplements during the first 6 months of life in the European countries, whereas in Canada only half and in the USA and Australia very few were given supplementation.Public Health Nutrition 06/2013; · 2.25 Impact Factor