By EILISH O’REGAN, Monday August 06 2012
A growing number of parents are contacting the National Poisons Unit with fears that they have harmed their baby by giving them too much vitamin D supplement.
The unit, based in Beaumont Hospital in Dublin, pointed out that since May 2010 it has been the policy of the Department of Health that all infants, from birth to 12 months, be given a daily supplement of 5 micrograms (200IU) of vitamin D3, to help development of bones and teeth.
However, doctors at the centre say that the advice to give the babies the correct dose into their mouths should be changed.
A mother should instead apply the drops to the bottle teat or breast before feeding their baby to prevent accidents.
The advice follows eight enquiries made by parents over five months to the centre about possible vitamin D overdose from June to October 2010.
This compared to five enquiries in the preceding 17 months.
"Nine of these 13 cases were due to therapeutic error, where a parent had administered an excessive dose on a single occasion (five cases), repeatedly, over periods of two to 10 days (three cases), or chronically (for six weeks in one case)," they wrote in the 'Irish Medical Journal'.
"Two infants were inadvertently given an acute overdose; in one case the solution came out of the dropper faster than the parent expected while giving the drops directly into a 17-day-old baby's mouth. In the other case, an unsecure dropper top resulted in five ml being given to a six-week-old infant.
"In other cases, recommended daily doses were exceeded, and four who were overdosed repeatedly were referred to hospital to check for hypercalcaemia, with symptoms like nausea and abdominal pain.
"These cases of accidental vitamin D3 overdose in infants indicate that parents may have difficulty reading or understanding the dosing instructions that accompany these over-the-counter food supplements.
"Dosing errors might be prevented by pictograms accompanying the written instructions, as well as instruction by healthcare professionals."
They pointed out that while vitamin D3 has negligible acute toxicity, parents will be unaware of this fact and will seek medical advice if their young baby receives an excessive dose.
"These cases of accidental vitamin D overdose in infants signal problems with the dosing instructions and the method of administration of vitamin D3 supplements. These should be revised to prevent further accidents occurring."
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Extremely unlikely that there would be any problem with giving a months worth of vitamin D accidentally.
The body averages out the amount of vitamin D over a period of a month or so.
The Germans gave 600,000 IU of vitamin D2 quarterly to children (which is too long and and the wrong type)
Which averages out to 33X what is given in Dublin
Note: The US recommend 3X that of Dublin for a daily MINIMUM for infants
- 600,000 IU of vitamin D2 every 4 months for decades in East Germany – 1987
- Dosing error gave 12000 IU vitamin D to infant, but no indication of any problem – April 2012
- Day care vitamin D grant being offered in the UK – July 2012
- UK pediatricians have a lot to learn about vitamin D – May 2012 which has the following
Identify additional groups of children who are also at high risk, not just dark skin (e.g. excess fat)
Test for a rare allergic reaction to vitamin D before giving high doses.
Dose size should increase with the number of high risk categories a child is in
Also provide some cofactors, not just vitamin D
Followup with maintenance doses after the loading dose
- 100 IU per kg of infant July 2011, Poland etc.
Items in both categories Infant/Child and Toxicity are listed here:
- Vitamin D Toxicity with no long term problems starts at 300 ng (infant with 222 ng had no symptoms) – March 2022
- Vitamin D toxicity is extremely rare, accidental, and very mild in Iranian children – July 2020
- Infant hospitalized after Vitamin D overdose (8,000 X too much) Feb 2016
- Rare infant vitamin D toxicity – due to errors which resulted in more that 240,000 IU – Jan 2014
- Concern about accidentally giving infant too much liquid vitamin D – Aug 2012
- Dosing error gave 12000 IU daily vitamin D to infant, but no indication of any problem – April 2012
- CYP24A1 gene mutation is a cause of rare infant vitamin D toxicity – Aug 2011