Use of Supplemental Vitamin D Among Infants Breastfed for Prolonged Periods
Published online November 30, 2009
PEDIATRICS Vol. 125 No. 1 January 2010, pp. 105-111 (doi:10.1542/peds.2009-1195)
James A. Taylor, MDa, Leah J. Geyer, ABa, Kenneth W. Feldman, MDa,b
a Department of Pediatrics, University of Washington, Seattle, Washington
b Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington
OBJECTIVES: To determine the rate of vitamin D supplementation in predominantly breastfed children. To identify patient characteristics, parental beliefs, and practitioner policies associated with supplementation.
METHODS: A prospective observational study was conducted in a practice-based research network. Network pediatricians completed a survey regarding their policy on vitamin D supplementation for breastfed infants. Parents of children 6 to 24 months old completed a survey on the initial type of feeding given to the child, length of breastfeeding, formula supplementation, and use of multivitamins. Parents indicated their level of agreement with statements regarding vitamin D supplementation.
RESULTS: Among 44 responding pediatricians, 36.4% indicated that they recommended vitamin D supplementation for all breastfed infants. A total of 2364 surveys were completed on age-eligible children; 1140 infants were breastfed for at least 6 months with little or no formula supplementation. The rate of vitamin D use for these infants was 15.9%. Use of vitamin D was significantly associated with parental agreement that their child's pediatrician recommended supplementation (odds ratio OR: 7.8), and that vitamins are unnecessary because breast milk has all needed nutrition (OR: 0.12). Among parents of predominantly breastfed infants who indicated that their child's doctor recommended vitamin D, 44.6% gave the supplementation to their child. Conversely, 67% of parents agreed that breast milk has all needed nutrition, and only 3% of these parents gave vitamin D to their children.
CONCLUSIONS: A minority of breastfed infants received vitamin D supplementation. Educational efforts directed at both physicians and parents are needed to increase compliance with vitamin D supplementation guidelines.