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Polish pediatric center: 40 percent took vitamin D – March 2019

Vitamin D supplementation in theory and daily practice – implementation of new updated Polish recommendations on the example of one pediatric centre

Barbara Wasyl-Nawrot, Małgorzata Wójcik, Krzysztof Kasperczyk, Jerzy B. Starzyk
Pediatr Endocrinol Diabetes Metab 2018; 24 (4): 174-178
DOI: https://doi.org/10.5114/pedm.2018.83363

VitaminDWiki

Note: 40 ng in the summer for those children taking vitamin D
Infant-Child category has

Having a good level of vitamin D cuts in half the amount of:

Need even more IUs of vitamin D to get a good level if;

  • Have little vitamin D: premie, twin, mother did not get much sun access
  • Get little vitamin D: dark skin, little access to sun
  • Vitamin D is consumed faster than normal due to sickness
  • Older (need at least 100 IU/kilogram, far more if obese)
  • Not get any vitamin D from formula (breast fed) or (fortified) milk
    Note – formula does not even provide 400 IU of vitamin D daily

Infants-Children need Vitamin D

  • Sun is great – well known for 1,000’s of years.
    US govt (1934) even said infants should be out in the sun
  • One country recommended 2,000 IU daily for decades – with no known problems
  • As with adults, infants and children can have loading doses and rarely need tests
  • Daily dose appears to be best, but monthly seems OK
  • Vitamin D is typically given to infants in the form of drops
       big difference in taste between brands
       can also use water-soluable form of vitamin D in milk, food, juice,
  • Infants have evolved to get a big boost of vitamin D immediately after birth
    Colostrum has 3X more vitamin D than breast milk - provided the mother has any vitamin D to spare
  • 100 IU per kg of infant July 2011, Poland etc.
    1000 IU per 25 lbs.jpg
    More than 100 IU/kg is probably better

Getting Vitamin D into infants

Many infants reject vitamin D drops, even when put on nipple
I speculate that the rejection is due to one or more of: additives, taste, and oils.
Infants have a hard time digesting oils, 1999  1997   and palm oils W.A. Price 1 2 3
Coconut oil, such as in D-Drops, is digested by infants. 1,   2   3
Bio-Tech Pharmacal Vitamin D has NO additves, taste, oil
One capsule of 50,000 Bio-Tech Pharmacal Vitamin D could be stirred into monthly formula
   this would result in ~1,600 IUs per day for infant, and higher dose with weight/age/formula consumption


Infant-Child Intervention trials using Vitamin D:


Vitamin D in Europe category listing has 189 items has the following

% of Europeans with < 30 nanograms – after adjustment of readings

StudyCountries< 30 ng
HELENA 9 EU 97%
OPUS Denmark87%
Tromsø Study: Fit Futures Norway 96%
HGS Greece 97%
INNS Greece 90%
Cork BASELINE Birth Ireland 84%
NDNS 1–18 y United Kingdom 90%
NDNS >18 y United Kingdom 91%
DEG4 Germany 91%
Tromsø Study–6th Survey Norway 75%
NHS Netherlands 78%
LASA Netherlands 68%
AGES–Reykjavik Iceland 86%
Finnish Migrant Health . . Finland89%
NANS Ireland 81%
Health 2011 Finland 76%
HUBRO Norway 66%
Health 2006 Denmark 68%

 Download the PDF from VitaminDWiki
Image

Note: 60% (not shown in pie chart) did not get ANY vitamin D supplementation


Introduction: According to updated evidence-based national recommendations which have been published recently vitamin D deficiency remains still highly prevalent in Poland and requires supplementation.

Aim of the study: was to evaluate the effectiveness of implementation of the new national recommendations into daily practice.

Material and methods: An analysis of medical records of 100 children aged from 6 months to 14 years admitted to the Department of Pediatrics, Hospital in Brzesko, Lesser Poland, from 1st July 2018 to 31st August 2018.

Results
41% patients declared vitamin D supplementation.

  • Among patients under 1 year of age 3 (60%) received recommended supplementation of 400-600 IU daily,
  • in the group of 1-11 years old 15 (19.5%) used a 600-1000 IU dose daily, 13 (17%) < 600 IU/daily, and 2 (2.5%) > 1000 IU daily, 1 patient did not remember the dose.
  • In the group >11 years of age 6 (37.5%) supplemented 800-2000 IU/day, 1 (6.3%) less than 800 IU, no one overdosed supplementation. In the group without supplementation, there were 3 patients with a de-creased 25(OH)D blood serum level (< 20 ng/ml).
  • Mean 25(OH)D serum level was significantly higher in the group with vitamin D supplementation (42 vs. 33.9 ng/ml; p = 0.0006).
  • There was no significant difference between mean 25(OH)D level in patients receiving adequate (40.5 ng/ml), to low (43 ng/ml), or to high vitamin D doses (49 ng/ml).
  • There was no significant correlation between vitamin D dose and the 25(OH)D serum level [R = (–) 0.24, p > 0.05)].

Conclusions
There is an urgent need for physicians to provide an education concerning general rules of vitamin D supplementation, because the pre-sent guidelines of the vitamin D supplementation are not implemented well enough.

Created by admin. Last Modification: Thursday April 11, 2019 15:40:16 GMT-0000 by admin. (Version 6)

Attached files

ID Name Comment Uploaded Size Downloads
11746 Polish.jpg admin 11 Apr, 2019 15:06 17.20 Kb 15
11745 PEDM_Art_35979-10.pdf PDF 2019 admin 11 Apr, 2019 14:57 348.69 Kb 1
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