Journal of Pediatric Nursing, Volume 45, March–April 2019, Pages 57-61, https://doi.org/10.1016/j.pedn.2019.02.002
Renée L. Davis DNP, RN, CPNP-PCaAlongkorn Aksornsri MNS, Rnb Michelle M.Papachrisanthou DNP, RN, CPNP-PCc
Most of the crteria concern detecting health problems, rather than preventing the problems
None of the groups include the followinfg problems often associated with low vitamin D
- pre-term births
- breathing problems
- live from from equator
- poor sleep
- low strength
- rarely get outdoors due to a medical problem
- Romania joins Turkey in giving free Vitamin D to all infants – 2018
- Infants need 400 IU of vitamin D to prevent rickets – meta-analysis Feb 2019
- Vitamin D consensus for Italian children, 30 ng needed, up to 4,000 IU if over age 10 – May 2018
- Vitamin D levels have been crashing since 1995 (Polish Children, Elite Military, etc)
- Unfortunately. most organizations are unaware how quickly the situation is getting worse
- 10 Reasons why children no longer have healthy levels of Vitamin D
- Reasons for children having low vitamin D (proposed by 10 societies) - May 2018
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 doubled the vitamin D level in milk in July 2016
- No consensus: range is 600 to 1600 IU – based on many randomized controlled trials
- Fewer 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
A recommended level may be agreed upon around the world by 2020
- 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
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
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
588 items in the category Infant/Child See also
- breastfed 962 items as of Sept 2017
- "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
- "SUDDEN INFANT DEATH" OR SIDS 177 items as of Nov 2018
- Overview of Rickets and Vitamin D
- Youth category listing has
145 items along with related searches
- Early vitamin D deficiency detection can improve the health of children.
- Vitamin D screening recommendations are based on risk factors.
- No consensus on vitamin D deficiency screening in children and adolescents exists.
Problem: No consensus on vitamin D deficiency (VDD) screening in children and adolescents exists. Early VDD detection can improve the health of children. VDD can cause bone mineralization diseases, such as rickets in children. The purpose of this review is to determine existing VDD screening recommendations or clinical practice guidelines in children and adolescents.
Eligibility criteria: Inclusion criteria were VDD screening ‘guideline’, ‘clinical practice guideline’, and ‘recommendations’ for children and adolescents in English, published 2001–2018.
Results: Eight current guidelines addressed VDD screening recommendations with the common recommendation results endorsing screening only for VDD in at-risk children and adolescents.
Conclusions: There is insufficient evidence for pediatric healthcare providers to recommend which VDD risk factors should be utilized for screening in children and adolescents.
Implications: Further studies should focus on developing a validated VDD screening tool for children and adolescents based on risk factors.