Vitamin D supplementation of Canadian infants: practices of Montreal mothers

School of Dietetics and Human Nutrition, McGill University, Ste-Anne-de-Bellevue, QC H9X 3V9, Canada.
Applied Physiology Nutrition and Metabolism (Impact Factor: 2.34). 06/2010; 35(3):303-9. DOI: 10.1139/H10-021
Source: PubMed

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 of vitamin D. Therefore there may still be gaps in knowledge regarding vitamin D supplementation.

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    • "Parental difficulties with supplementation suggest need for more " hands-on " instruction. Maternal knowledge of food sources of vitamin D and synthesis from UVR was low for many mothers, despite knowledge of the importance of vitamin D infant supplementation , again similar to findings in the Montreal study (Gallo et al., 2010). Some mothers wanted information about supplementing children more than 1 year of age. "
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    ABSTRACT: This study compares knowledge and practice of infant vitamin D supplementation among immigrant, refugee, and Canadian-born mothers. Focus group discussions with 94 mothers of children aged 0 to 3 years recruited from early childhood centers and a refugee health clinic. Both immigrant and Canadian-born mothers indicated good knowledge and use of infant vitamin D supplementation. In contrast, Canadian government-assisted refugees were less likely to supplement with vitamin D. The main source of information about vitamin D was public health prenatal classes. Many mothers reported inconsistent guidance from health care providers. Exclusively breastfed infants of refugees may be more at risk of vitamin D deficiency. All mothers require clear recommendations, both in clinical and public health settings. Mothers, both new Canadian and Canadian-born, require clear and consistent messaging from health professionals. Refugee mothers, however, require more educational support to promote infant vitamin D supplementation.
    Journal of Transcultural Nursing 05/2014; 26(3). DOI:10.1177/1043659614531793 · 0.66 Impact Factor
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    • "However, this survey did not consider the frequency, dose, or form of supplement, nor were supplementation practices assessed among women who fed their infants a combination of breast milk and formula. Further, this survey included women who gave birth as early as 2002 and there may now be greater awareness about the importance of vitamin D. Indeed, Gallo et al. [18] reported that in one Montreal hospital 98% of exclusively breastfeeding mothers who gave birth in 2007-2008 supplemented their infants at some point prior to 6 months of age. "
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    ABSTRACT: Vitamin D deficiency during infancy may lead to rickets and possibly other poor health outcomes. The World Health Organization recommends exclusive breastfeeding for the first 6 months. Breast milk is the best food for infants but does not contain adequate vitamin D. Health Canada recommends all breastfed infants receive a daily vitamin D supplement of 400 IU; however, there appears to be limited current Canadian data as to whether parents or caregivers are following this advice. The aim of this study was to determine the rates of vitamin D supplementation among 2-month old infants in Vancouver and Richmond, British Columbia, Canada. Mothers of all healthy infants born between April and May 2010 were approached to participate. Telephone surveys were conducted with 577 mothers (response rate 56%) when their infants turned 2 months. Over half of the infants received only breast milk in the week prior to the survey. One third received a mixture of breast milk and infant formula and 10% received only formula. About 80% of the infants were supplemented with vitamin D at 2 months. Infants who received only breast milk were most likely to be supplemented with vitamin D (91%). Over 60% of the infants had a total vitamin D intake of 300- < 500 IU/d from supplements and formula and only 5% did not receive any vitamin D. Most parents were advised to give vitamin D supplement by health professionals, such as public health nurses, midwives, and doctors. About 90% of the infants received breast milk at 2 months of age. The vitamin D supplementation rate was 80%. Future studies are needed to monitor breastfeeding duration and vitamin D supplementation rates as infants get older.
    BMC Public Health 12/2011; 11(1):905. DOI:10.1186/1471-2458-11-905 · 2.26 Impact Factor
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    • ". CONSORT diagram depicting the recruitment and follow-up of infants during the randomized, cross-over study. administered in a 1 mL volume by dropper and was the most common formulation mode at the time in Quebec (Gallo et al. 2010). Both were given at any time of day and provided 400 IU of vitamin D 3 . "
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    ABSTRACT: Lack of adherence with vitamin D supplementation is still a risk factor for rickets. In a randomized cross-over design, infants received 400 IU cholecalciferol by dropper (1 mL syrup) or filmstrip. Infant and parent preference scores and adherence were then compared. Forty-three parents of healthy infants preferred the filmstrip (85.4% of parents; 95% confidence interval of 70.1%-93.9%; p < 0.001), a result that was corroborated by higher infant and parental scores and compliance. Ease of administration of supplements with improved acceptance may improve adherence.
    Applied Physiology Nutrition and Metabolism 06/2011; 36(3):414-8. DOI:10.1139/h11-018 · 2.34 Impact Factor
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