Breastfeeding atSo, Nutrition Co. Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents

American College of Obstetrics and Gynecology.
PEDIATRICS (Impact Factor: 5.47). 12/2008; 122(5):1142-52. DOI: 10.1542/peds.2008-1862
Source: PubMed


Rickets in infants attributable to inadequate vitamin D intake and decreased exposure to sunlight continues to be reported in the United States. There are also concerns for vitamin D deficiency in older children and adolescents. Because there are limited natural dietary sources of vitamin D and adequate sunshine exposure for the cutaneous synthesis of vitamin D is not easily determined for a given individual and may increase the risk of skin cancer, the recommendations to ensure adequate vitamin D status have been revised to include all infants, including those who are exclusively breastfed and older children and adolescents. It is now recommended that all infants and children, including adolescents, have a minimum daily intake of 400 IU of vitamin D beginning soon after birth. The current recommendation replaces the previous recommendation of a minimum daily intake of 200 IU/day of vitamin D supplementation beginning in the first 2 months after birth and continuing through adolescence. These revised guidelines for vitamin D intake for healthy infants, children, and adolescents are based on evidence from new clinical trials and the historical precedence of safely giving 400 IU of vitamin D per day in the pediatric and adolescent population. New evidence supports a potential role for vitamin D in maintaining innate immunity and preventing diseases such as diabetes and cancer. The new data may eventually refine what constitutes vitamin D sufficiency or deficiency.

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    • "Although human milk is the ideal nutrition source for infants in the first year of life, it does not provide adequate levels of vitamin D (Jain, Raychaudhuri, & Barry, 2011). Human milk contains relatively low levels of vitamin D (25–78 IU/L) compared to fortified milk or formula (352– 400 IU/L) (Wagner & Greer, 2008), and is greatly affected by maternal vitamin D intake and UVB exposure (Gordon et al., 2008). Therefore, vitamin D concentrations are especially low in breast milk from mothers who are vitamin D deficient (Gordon et al., 2008). "
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    ABSTRACT: Design and methods: A total of 171 infants receiving a routine health check at a Maternal and Child Health Care Center were recruited. Plasma vitamin D 25-OHD level was assessed using a standard analysis of a blood sample. Other data collected included age, gender, birth order, season of birth, and mode of feeding. Results: Prevalence of vitamin D deficiency (≤15ng/mL) was 77% (132 out of 171 infants). Infants at risk of vitamin D deficiency were those between 1 to 6months of age, male, third born or later, born in winter, and exclusively breastfed. The multivariate model showed birth order to be the largest contributor of vitamin D deficiency (R(2)=0.196), followed by breastfed infants (R(2)=0.071), infants born in winter (R(2)=0.037), male gender (R(2)=0.028), and infants aged between 1 and 6months (R(2)=0.027). Conclusion: Hypovitaminosis D appears to be more common among healthy infants in Jordan. Hypovitaminosis D was found to be common among third or later exclusively breastfeed male infants aged 1 to 6months who were born during winter. Practice implication: Maternal and child health nurses have a critical role to play in educating mothers about the importance of preventing hypovitaminosis D through adequate sun exposure and ensuring adequate supplementation. A higher dose of vitamin D supplementation for high-risk infants beyond the age of 1year from developing countries should be administered.
    Full-text · Article · Nov 2015 · Journal of pediatric nursing
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    • "Both children and pregnant/lactating women are identified as groups particularly vulnerable to vitamin D deficiency [15]. The American Academy of Pediatrics recommends a daily intake of 400 IU of vitamin D for infants and children, whereas the Institute of Medicine and The Endocrine Society recommend 400 IU daily for infants and 600 IU daily for children of 1 to 18 years old [16] "
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    ABSTRACT: Vitamin D features immunomodulatory effects on both the innate and adaptive immune systems, which may explain the growing evidence connecting vitamin D to allergic diseases. A wealth of studies describing a beneficial effect of vitamin D on atopic dermatitis (AD) prevalence and severity are known. However, observations linking high vitamin D levels to an increased risk of developing AD have also been published, effectively creating a controversy. In this paper, we review the existing literature on the association between AD and vitamin D levels, focusing on childhood. As of today, the role of vitamin D in AD is far from clear; additional studies are particularly needed in order to confirm the promising therapeutic role of vitamin D supplementation in childhood AD.
    Full-text · Article · May 2015 · Journal of Immunology Research
    • "It concluded that substantially more research is required before a consensus can be reached. An alternative view is that vitamin D supplements should be given to those at risk of deficiency (Wagner & Greer, 2008). The UK Department of Health recommends that all children up to the age of 5 years should receive vitamin D supplements (Department for Health, 2009), although the supplements themselves are not always available and the advice may not be followed through by health professionals; consequently, uptake is poor. "
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    ABSTRACT: Background Dietary intakes of vitamin D are very low in the UK. Dietary calcium is also necessary to promote bone health. The fortification of foods with vitamin D could be a safe and effective way of increasing intake.Methods Diets of preschool children, 755 at 18 months and 3.5 years, from the Avon Longitudinal Study of Parents and Children were assessed using dietary records completed by parents. Energy, vitamin D and calcium intakes were calculated. Multinomial logistic regression was used to estimate the odds ratio for being in the highest/lowest quartile of intake. Intakes were recalculated to test different fortification regimes.ResultsVitamin D intakes were low; all children were below the UK and US dietary recommendations. Calcium intakes decreased between the two ages as a result of reduced milk consumption. Children in the lowest quartile for vitamin D intake at 18 months were twice as likely to remain in that quartile at 3.5 years (odds ratio = 2.35; 95% confidence interval = 1.56–3.55). The majority of foods provide no vitamin D with fat spreads and milk as the main sources. The contribution from breakfast cereals increased, from 6% to 12%, as a result of the increased consumption of fortified cereals. Dairy foods provided the highest contribution to calcium at 18 months but were less important at 3.5 years. Theoretical intakes from different fortification regimens suggest that milk fortified at 2 μg 100 g–1 vitamin D would provide most children with adequate but not excessive intakes.Conclusions Dietary vitamin D intakes were very low and calcium intakes were mostly adequate. Fortification of milk with vitamin D could be a good way to boost intakes.
    No preview · Article · Sep 2014 · Journal of Human Nutrition and Dietetics
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