How should we give vitamin D supplementation? evaluation of the pediatricians' knowledge in Turkey.
Ital J Pediatr. 2017 Oct 17;43(1):95. doi: 10.1186/s13052-017-0415-3.
Kara Elitok G1, Bulbul L2, Zubarioglu U3, Kıray Bas E3, Acar D3, Uslu S3, Bulbul A3.
- 1 Department of Pediatrics, Sisli Hamidiye Etfal Education and Research Hospital, University of Health Sciences, Istanbul, Turkey. drgizemkara at gmail.com.
- 2 Department of Pediatrics, Bakırköy Dr. Sadi Konuk Education and Research Hospital, University of Health Sciences, Istanbul, Turkey.
- 3 Department of Pediatrics, Sisli Hamidiye Etfal Education and Research Hospital, University of Health Sciences, Istanbul, Turkey.
Infant-Child category starts with
- No consensus on MINIMUM International Units (IU) for healthy infant of normal weight
- 400 IU Vitamin D is no longer enough
Was OK in the past century, but D levels have been dropping for a great many reasons.
FDA doubles the amount of vitamin D permitted in milk – July 2016 - No consensus: range is 600 to 1600 IU – based on many randomized controlled trials
- Review of 400 IU to 2000 IU daily and higher if non-daily
- Fewer pre-infants were vitamin D deficient when they got 800 IU – RCT Feb 2014
- 1600 IU was the conclusion of three JAMA studies
1000 IU recommended in France and Finland – 2013 - appears to be a good level - 5X less mite allergy after add vitamin D
- Child bone fractures with low vitamin D were 55X more likely to need surgery
- 75 % of SIDS had low vitamin D
- Children stayed in ICU 3.5 days longer if low vitamin D – Dec 2015
- 5 out of 6 children who died in pediatric critical care unit had low vitamin D – May 2014
- Infants have gotten free 400 IU of vitamin D in Turkey since 2005, More for longer would be even better – Feb 2022
- Preemies should have vitamin D supplements – reaching an agreement – April 2021
- Vitamin D loading dose was as effective as daily dosing (rickets in this case) – RCT July 2021
Having a good level of vitamin D cuts in half the amount of:
- Asthma, Chronic illness, Doctor visits, Allergies, infection
Respiratory Tract Infection, Growing pains, Bed wetting
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.
More than 100 IU/kg is probably better 854 items in the category Infant/Child See also - 34 pages in VitaminDWiki had BREASTFE*in title as of Jan 2022
- "BIRTH DEFECTS" 172 items as of July 2016
- Stunting OR “low birth weight” OR LBW OR preemie OR preemies OR preterm 1940 items as of Oct 2018
- 153 VitaminDWiki pages contained PRETERM or PREEMIE in title as of Nov 2024
- "SUDDEN INFANT DEATH" OR SIDS 214 items as of Dec 2020
- Overview of Rickets and Vitamin D
- Youth category listing has
175 items along with related searches - Down's syndrome and low vitamin D - several studies
- Rett syndrome associated with low vitamin D, treated by Omega-3
Download the PDF from VitaminDWikiBACKGROUND:
We aimed to determine the knowledge and attitudes of Turkish pediatricians concerning vitamin D supplement.METHODS:
The study was planned cross-sectional to be carried out between April-May 2015 in Turkey. A questionnaire form that determined the participants' opinions and practices concerning vitamin D supplement was completed via face-to-face interview.RESULTS:
A total of 107 pediatricians (49.3%) and 110 pediatric residents (50.7%) participated in the study. Of the physicians, 85.2% recommended vitamin D supplement for all infants and children regardless of diet, 13.4% recommended for the infants which are solely breastfed. Vitamin D supplement is recommended at a dose of 400 IU/day by 88.8% of pediatricians and by 90% of pediatric residents. Of the pediatricians and pediatric residents, 72% and 68.2%, respectively commence vitamin D supplement when the newborn is 15 days old.The rates of recommending vitamin D supplement until the age of one and two years were higher among pediatricians (48.6% and 41.1%, respectively) than pediatric residents (40.9% and 32.7%, respectively).
The rate of starting vitamin D supplement for fontanelle closure was significantly higher among pediatric residents (15.5%) than pediatricians (3.7%) (p = 0.002). It was determined that the rate of prescribing vitamin D supplement until fontanelle closure was higher among pediatric residents (18.2%) than pediatricians (0.9%).
CONCLUSIONS:
The present study suggest that the knowledge of pediatricians about recommendation of vitamin D needs to be enhanced by education programs in addition to free vitamin D supplement provided by the Ministry of Health.PMID: 29041957 DOI: 10.1186/s13052-017-0415-3
Give 400 IU to all infants – majority of Turkish pediatricians – Oct 2017Printer Friendly Follow this page for updates3511 visitors, last modified 19 Oct, 2017, This page is in the following categories (# of items in each category)