Vitamin D: Still a topical matter in children and adolescents.

A position paper by the Committee on Nutrition of the French Society of Paediatrics.

Arch Pediatr. 2012 Jan 25.
Vidailhet M, Mallet E michel.vidailhet at wanadoo.fr, Bocquet A, Bresson JL, Briend A, Chouraqui JP, Darmaun D, Dupont C, Frelut ML, Ghisolfi J, Girardet JP, Goulet O, Hankard R, Rieu D, Simeoni U, Turck D; Comité de nutrition de la Société française de pédiatrie.
Service de pédiatrie et génétique clinique, hôpital d'enfants, université Henri-Poincaré, allée du Morvan, 54511 Vandœuvre-les-Nancy, France.

The aims of the present position paper by the Committee on Nutrition of the French Society of Paediatrics were to summarize the recently published data on vitamin D in infants, children and adolescents, i.e., on metabolism, physiological effects, and requirements and to make recommendations on supplementation after careful review of the evidence. Scientific evidence indicates that calcium and vitamin D play key roles in bone health.

The current evidence, limited to observational studies, however, does not support other benefits for vitamin D.
More targeted research should continue, especially interventional studies.

In the absence of any underlying risk of vitamin D deficiency, the recommendations are as follows:

• pregnant women: a single dose of 80,000 to 100,000IU at the beginning of the 7th month of pregnancy;
• breastfed infants: 1000 to 1200IU/day;
• children less than 18 months of age, receiving milk supplemented with vitamin D: an additional
  daily dose of 600 to 800 IU;
• children less than 18 months of age receiving milk not supplemented with vitamin D:
  daily dose of 1000 to 1200 IU;
• children from 18 months to 5 years of age: 2 doses of 80,000 to 100,000 IU every winter (November and February).

In the presence of an underlying risk of vitamin D deficiency (

• dark skin;
• lack of exposure of the skin to ultraviolet B [UVB] radiation from sunshine in summer;
• skin disease responsible for decreased exposure of the skin to UVB radiation from sunshine in summer;
• wearing skin-covering clothes in summer;
• intestinal malabsorption or maldigestion;
• cholestasis; (bile cannot flow from liver)
• renal insufficiency;
• nephrotic syndrome;
• drugs [rifampicin; antiepileptic treatment: phenobarbital, phenytoin];
• obesity;
• vegan diet),

it may be justified to start vitamin D supplementation in winter in children 5 to 10 years of age as well as to maintain supplementation of vitamin D every 3 months all year long in children 1 to 10 years of age and in adolescents.

In some pathological conditions, doses of vitamin D can be increased.
If necessary, the determination of 25(OH) vitamin D serum concentration will help determine the level of vitamin D supplementation.

Copyright © 2012. Published by Elsevier SAS.

PMID: 22284232
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See also VitaminDWiki

• Fewer than 15 percent of 5 year-olds getting vitamin D prescriptions in France – Nov 2012
• Overview Pregnancy and Vitamin D
• Published Vitamin D Recommendations
• Reasons for Vitamin D Deficiency
• Overview Deficiency of vitamin D includes a list of high-risk groups
  which is much longer than the list in the above abstract
• All items in category Infants and Children and Vitamin D 853 items
• All items in category High Risk of Vitamin D deficiency 67 items