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Give 400 IU to all infants – majority of Turkish pediatricians – Oct 2017

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

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

 Download the PDF from VitaminDWiki

We aimed to determine the knowledge and attitudes of Turkish pediatricians concerning vitamin D supplement.

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.

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%).

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

Created by admin. Last Modification: Thursday October 19, 2017 12:21:57 GMT-0000 by admin. (Version 2)

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8564 pediatricians’ knowledge in Turkey.pdf admin 19 Oct, 2017 12:21 364.67 Kb 57
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