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A Simple Policy for Prevention of Vitamin D Deficiency & Rickets in Childhood
- Justin Davies, S. Faisal Ahmed, Jeremy Allgrove, Nicholas J. Bishop, Christine Burren, Timothy D. Cheetham, Justin H. Davies, John W. Gregory, Sharon Lim, M. Zulf Mughal, Lucy Reynolds, Nicholas Shaw, Justin T. Warner (10 September 2007)
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Justin Davies, Consultant Paediatric Endocrinologist British Paediatric and Adolescent Bone Group, S. Faisal Ahmed, Jeremy Allgrove, Nicholas J. Bishop, Christine Burren, Timothy D. Cheetham, Justin H. Davies, John W. Gregory, Sharon Lim, M. Zulf Mughal, Lucy Reynolds, Nicholas Shaw, Justin T. Warner
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justin.davies{at}suht.swest.nhs.uk Justin Davies, et al.
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Dear Editor, The recently published study (1) and accompanying perspectives (2, 3) follow the recent report of the RCPCH Standing Committee on Nutrition (4). With the recent introduction of the Healthy Start scheme in the UK, it is important for health care staff throughout the NHS to have a simple, yet effective, policy for prevention of Vitamin D deficiency that can be implemented in the community. Whilst we agree with the authors that further studies are required to determine the optimal Vitamin D supplementation regimen during pregnancy, there is a more immediate need to prevent hypocalcaemia secondary to Vitamin D deficiency in newborns. We would advocate the following as a policy that should be adopted throughout the UK:-: - 1. All infants from birth up to 6 months should be provided with Vitamin D, 200IU daily, as Healthy Start Vitamin Liquid/Abidec/Dalivit*. 2. All children from 6 months to 4 years, but particularly those with darker skin complexion, should be provided with Vitamin D, 400IU daily, as Healthy Start Vitamin Liquid/Abidec/Dalivit*. 3. All adolescents, but particularly girls with darker skin complexion, should be provided with Vitamin D, 400IU daily, as Healthy Start Vitamin Tablets/Calcium and Ergocalciferol tablets*. 4. During pregnancy, women with darker skin complexion or family history of vitamin D deficiency, in the second and third trimesters and also postnatally if breastfeeding, should be provided with Vitamin D, 400IU daily, as Healthy Start Vitamin Tablets/Calcium and Ergocalciferol tablets*. Pregnant women or breast feeding mothers with clear biochemical evidence of vitamin D deficiency (serum 25 OHD < 15 ng/ml) should be treated with at least 1000IU Vitamin D/day for 3 months. *These are approximate doses; the actual dose may vary depending on preparation used. SF Ahmed, J Allgrove, NJ Bishop, C Burren, TD Cheetham, JH Davies, JW Gregory, S Lim, MZ Mughal, L Reynolds, N Shaw, J Warner, on behalf of the British Paediatric and Adolescent Bone Group. References: 1. Dijkstra SH et al. High prevalence of vitamin D deficiency in newborn infants of high-risk mothers. Arch Dis Child. 2007;92:750-3. 2. Williams AF. Vitamin D in pregnancy: an old problem still to be solved? Arch Dis Child. 2007;92:740-1. 3. Dawodu A & Wagner CL. Mother-child vitamin D deficiency: an international perspective. Arch Dis Child. 2007;92:737-40. 4. Leaf A. Vitamins for babies and young children. Arch Dis Child. 2007;92:160-4. |
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