Arch Dis Child 2015;100:A123-A124 doi:10.1136/archdischild-2015-308599.271
British Association of General Paediatrics and the Paediatricians in Medical Management Group
D Denaxa, A Colthorpe, G Bradley, A Mukherjee
General Paediatrics, Royal Oldham Hospital, Manchester, UK
Aim It has been over a year since the RCPCH circulated interim guidance regarding vitamin D supplements in childhood recommending that breastfed babies from birth and formula fed infants from 6 months should receive vitamin D until 5 years old. Our aim was to assess the percentage of eligible children that take supplements and secondarily vitamin D intake in pregnant and breastfeeding women.
Methods We performed a prospective audit in children presenting to the paediatric assessment unit aged from birth up to 5 years from 20/09/14 for 2 months. We recorded: age, ethnic group, gestational age at birth, breastfeeding history, whether patients have taken or taking vitamin D and the indication for that. We also recorded whether the child belonged to a risk group due to prematurity, neurodisability or gastrointestinal problem and whether the child ever presented with seizures due to vitamin D deficiency.
Secondary outcomes were percentage of women taking vitamin D supplements during pregnancy and breastfeeding.
Results We recruited 158 patients with a mean age of 18 months, 57% were males and 33% were either Afrocarribean or Asian.
- 15% of the children were at high risk:
13% due to prematurity and
2% due to neurodisability.
At the time of the audit only 17% of children were taking vitamin D (image 1) and only 25% had ever taken vitamin D. Of those that were breastfed and less than 6 months 29% were on supplements (image 2); of those older than 6 months only 21% (image 3). Vitamin D was started by parents in 29% and the remaining majority by health professionals. Half of the mothers took vitamin D in pregnancy and only 20% during breastfeeding.
Conclusions Despite the circulation of the RCPCH guidelines to paediatricians only a quarter of children under five have ever been on vitamin D. All health care professionals in primary and secondary care should work together towards creating clear and updated policies regarding vitamin D supplements in childhood, pregnancy and lactation, and more work on implementing these policies is needed.
- Third study found that Infants needed 1600 IU of vitamin D – JAMA RCT May 2013
- Unsupplemented infants were 19X more likely to be vitamin D deficient - May 2012
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- 26 X increase in Vitamin D prescriptions for youths in England in 8 years – Dec 2019
- European Food Safety Authority (EFSA) found “paucity” of Vitamin D data for infants – Nov 2019
- Polish pediatric center: 40 percent took vitamin D – March 2019
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- Romania joins Turkey in giving free Vitamin D to all infants – 2018
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- UK infants are the least likely to get Vitamin D in Europe – political action overdue – April 2018
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- 10X increase in cost of vitamin D per child-year in UK in 6 years - Aug 2017
- Vitamin D in European children – no consensus on “adequate” levels – April 2017
- High vitamin D levels in Romanian children – wonder why – May 2015
- 3X increase in UK children who are vitamin D deficient in just 5 years – Nov 2015
- Only 1 in 10 UK parents had been told about vitamin D by their child’s doctor – April 2015
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- UK program to increase Vitamin D (Healthy Start) continues to be a farce - Nov 2014
- UK people and doctors still clueless about vitamin D – Survey Oct 2014
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- Post-mortem analysis of children in London Hospital – only 1 child had adequate level of vitamin D – July 2014
- Danish study of childhood diseases vs vitamin D fortification – May 2013
- Presentation: pre and post natal vitamin D, with audience comments – Manchester UK Sept 2013
- Most European infants get vitamin D supplements, vs only 1 in 50 in US – June 2013
- UK Milk producer sets vitamin D day, yet UK milk rarely has vitamin D – March 31 2013
- Fewer than 15 percent of 5 year-olds getting vitamin D prescriptions in France – Nov 2012
- UK Day-Cares being offered grants to develop vitamin D methods – July 2012
- UK pediatricians have a lot to learn about vitamin D – May 2012
- Death of Babies in UK due to vitamin D deficiency – Jan 2012
- Nutritional Rickets in Denmark especially among immigrant children- Feb 2012
- Recommend 100 IU of vitamin D per kg of infant - Poland July 2011
- Infants in Finland who got 2000 IU vitamin D daily grew to normal height – March 2011
- All babies in Ireland should have 200 IU of vitamin D - Feb 2011
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