Vitamin D and health in pregnancy, infants, children and adolescents in Australia and New Zealand: a position statement.
Study Goal
The researchers aimed to evaluate the recommended levels of serum 25-hydroxyvitamin D (25(OH)D) in infants, children, adolescents, and during pregnancy and lactation, and to identify risk factors for low vitamin D levels.
Results Summary
The study found that the recommended serum 25(OH)D level is ≥ 50 nmol/L, with higher levels needed in summer to maintain adequate levels in winter. Exclusive breastfeeding combined with other risk factors increases the risk of low vitamin D in infants, and supplementation of 400 IU vitamin D₃ daily is recommended for at-risk infants.
Population
Infants, children, adolescents, pregnant and lactating women.
Effective Dosage
400 IU vitamin D₃ daily for infants at risk of low vitamin D.
Duration
At least the first year of life for infants.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
sunlight exposure | neutral | vitamin D | - | - | is the most important source | #1 |
vitamin D supplementation (600 IU daily) | neutral | vitamin D levels | children aged over 12 months and during pregnancy and lactation | 600 IU daily | recommended dietary allowance | #2 |
daily low-dose vitamin D supplements | neutral | vitamin D deficiency | - | - | can treat | #3 |
high-dose intermittent vitamin D | neutral | vitamin D deficiency | children and adolescents | - | can be used | #4 |
400 IU vitamin D₃ daily | neutral | vitamin D levels | infants at risk of low vitamin D | 400 IU daily | should be supplemented | #5 |
vitamin D supplementation | no change | non-bone health outcomes | - | lack of data | lack of data from robust randomised controlled trials | #6 |
• The recommended level for serum 25-hydroxyvitamin D (25(OH)D) in infants, children, adolescents and during pregnancy and lactation is ≥ 50 nmol/L. This level may need to be 10-20 nmol/L higher at the end of summer to maintain levels ≥ 50 nmol/L over winter and spring. • Sunlight is the most important source of vitamin D. The US recommended dietary allowance for vitamin D is 600 IU daily in children aged over 12 months and during pregnancy and lactation, assuming minimal sun exposure. • Risk factors for low vitamin D are: lack of skin exposure to sunlight, dark skin, southerly latitude, conditions affecting vitamin D metabolism and storage (including obesity) and, for infants, being born to a mother with low vitamin D and exclusive breastfeeding combined with at least one other risk factor. • Targeted measurement of 25(OH)D levels is recommended for infants, children and adolescents with at least one risk factor for low vitamin D and for pregnant women with at least one risk factor for low vitamin D at the first antenatal visit. • Vitamin D deficiency can be treated with daily low-dose vitamin D supplements, although barriers to adherence have been identified. High-dose intermittent vitamin D can be used in children and adolescents. Treatment should be paired with health education and advice about sensible sun exposure. Infants at risk of low vitamin D should be supplemented with 400 IU vitamin D₃ daily for at least the first year of life. • There is increasing evidence of an association between low vitamin D and a range of non-bone health outcomes, however there is a lack of data from robust randomised controlled trials of vitamin D supplementation.