Article Text
Abstract
Aim It has been over a year since the RCPCH circulated interim guidance regarding vitamin D supplements in childhood recommending that breastfed babies from birth and formula fed infants from 6 months should receive vitamin D until 5 years old. Our aim was to assess the percentage of eligible children that take supplements and secondarily vitamin D intake in pregnant and breastfeeding women.
Methods We performed a prospective audit in children presenting to the paediatric assessment unit aged from birth up to 5 years from 20/09/14 for 2 months. We recorded: age, ethnic group, gestational age at birth, breastfeeding history, whether patients have taken or taking vitamin D and the indication for that. We also recorded whether the child belonged to a risk group due to prematurity, neurodisability or gastrointestinal problem and whether the child ever presented with seizures due to vitamin D deficiency.
Secondary outcomes were percentage of women taking vitamin D supplements during pregnancy and breastfeeding.
Results We recruited 158 patients with a mean age of 18 months, 57% were males and 33% were either Afrocarribean or Asian. 15% of the children were at high risk: 13% due to prematurity and 2% due to neurodisability. At the time of the audit only 17% of children were taking vitamin D (image 1) and only 25% had ever taken vitamin D. Of those that were breastfed and less than 6 months 29% were on supplements (image 2); of those older than 6 months only 21% (image 3). Vitamin D was started by parents in 29% and the remaining majority by health professionals. Half of the mothers took vitamin D in pregnancy and only 20% during breastfeeding.
Conclusions Despite the circulation of the RCPCH guidelines to paediatricians only a quarter of children under five have ever been on vitamin D. All health care professionals in primary and secondary care should work together towards creating clear and updated policies regarding vitamin D supplements in childhood, pregnancy and lactation, and more work on implementing these policies is needed.