Randomised controlled trial analysing supplementation with 250 versus 500 units of vitamin D3, sun exposure and surrounding factors in breastfed infants.
Arch Dis Child. 2011 Jan;96(1):91-5. Epub 2010 Sep 22.
Siafarikas A, Piazena H, Feister U, Bulsara MK, Meffert H, Hesse V.
Sana-Hospital Lichtenberg, Humboldt University, Berlin, Germany. aris.siafarikas at health.wa.gov.au
BACKGROUND: The rate of non-compliance with vitamin D supplementation is as high as 45%. This is why randomised controlled trials are needed to analyse the response to low doses of vitamin D3.
OBJECTIVE: (1) To compare supplementation with 250 versus 500 units of vitamin D3 and (2) to analyse sun exposure time/ultraviolet B (UVB) exposure during the first 6 weeks of life.
DESIGN: 40 breastfed infants (skin photo-types I, II) were recruited in Berlin, Germany (52.5°N), during summer (n=20) and winter (n=20) and randomised into equal groups on either 250 or 500 units of vitamin D3 per day. Outcome measures were: parameters of vitamin D and bone metabolism at delivery and 6 weeks later, sun exposure time, UVB dosimetry and surrounding factors including maternal diet.
RESULTS: At delivery 25-hydroxy vitamin D levels were insufficient: 68 (53-83) nmol/l in each group. 6 weeks later levels were sufficient: 139 (114-164) nmol/l on 250 units of vitamin D3 per day and 151 (126-176) nmol/l on 500 units/day. There was no seasonal variation. Daily sun exposure time was 0.4-3.5 h and higher in summer. UVB exposure was 0.01-0.08 minimal erythema dose/day. Calcium levels were within normal.
CONCLUSIONS: In Berlin, Germany, supplementation with 250 units of vitamin D3 is sufficient for breastfed infants during their first 6 weeks of life in summer and winter. UVB exposure is very low throughout the year. PMID: 20861405
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