Vitamin D supplementation in theory and daily practice – implementation of new updated Polish recommendations on the example of one pediatric centre
Barbara Wasyl-Nawrot, Małgorzata Wójcik, Krzysztof Kasperczyk, Jerzy B. Starzyk
Pediatr Endocrinol Diabetes Metab 2018; 24 (4): 174-178
DOI: https://doi.org/10.5114/pedm.2018.83363
Note: 40 ng in the summer for those children taking vitamin D
Infant-Child category has
- 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
606 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
148 items along with related searches Infant-Child Intervention trials using Vitamin D:
- Little weight loss in obese children from very small amount of vitamin D (1200 IU) – RCT April 2020
- Lower Respiratory Tract Infection in Infants reduced 5.9 X by daily 600 IU of vitamin D (China) - March 2020
- Bones of white children not helped by 1,000 IU of vitamin D (Northern latitudes) – RCT Sept 2018
- Vitamin D levels in children optimized with six Vitamin D biscuits – RCT Nov 2018
- Tic disorder reduced by Vitamin D supplementation – Aug 2019
- Preemie immunity (Treg) vastly improved by 800 IU of Vitamin D daily – RCT July 2019
- Allergic Rhinitis in infants treated by 1,000 IU vitamin D daily – June 2019
- Treatment of neonate sepsis greatly aided by Vitamin D – RCT June 2019
- 400 IU of Vitamin D in food provided virtually no benefit to children - March 2018
- Children need 2000 IU of Vitamin D (India) - RCT May 2019
- Preterm babies have low vitamin D, but recover in 6 weeks with 800 IU supplementation – Jan 2019
- 1200 IU vs 400 IU of vitamin D did not improve bone health or immunity of children who were sufficient – RCT July 2018
- Childhood Respiratory Health hardly improved with 600 IU of vitamin D (need much more) – May 2018
- 430 genes changed when 3,800 IU Vitamin D added in late second trimester – RCT May 2018
- Severe Non-Alcoholic fatty liver disease treated by Omega-3 – RCT April 2018
- 400 IU of Vitamin D provided no benefit to children (not a surprise) – RCT March 2018
- Allergic rhinitis in children reduced somewhat during pollen season by just 1,000 IU of vitamin D – RCT Jan 2018
- Half the risk of Influenza -A in infants taking 1200 IU of vitamin D for 4 months – RCT Jan 2018
- Risk of infant Asthma cut in half if mother supplemented Vitamin D to get more than 30 ng – RCT Oct 2017
- Preemies getting 800 IU of vitamin D were 3X less likely to have low bone density 4 weeks later – RCT Oct 2017
- Preemies need 1,000 IU of vitamin D – RCT Sept 2017
- Fatty liver disease in children nicely treated by combination of Vitamin D and Omega-3 – RCT Dec 2016
- Vitamin D needed to get children to just 20 ng in winter 800 IU white skin, 1100 IU dark (Sweden) – RCT June 2017
- Childhood asthma problems eliminated for months by 600,000 IU of Vitamin D injection – June 2017
- Breastfeeding mothers and Vitamin D: supplement only themselves usually, 4 out of 10 used monthly rather than daily – Jan 2017
- Premature infants (30 weeks) who got 800-1000 IU of vitamin D were much healthier – March 2017
- Newborn Vitamin D - single 50,000 IU is better than daily – RCT Sept 2016
- Mother got 100,000 IU of vitamin D monthly, breastfeeding infant got a little – RCT Aug 2016
- Monthly 120,000 IU of Vitamin D during lactation worked well - May 2016
- Infant infection reduced by half with vitamin D supplementation – RCT May 2016
- Five times less mite allergy when vitamin D added in mid pregnancy and to infant – RCT April 2016
- Vitamin D improved child muscle mass even without varying dose with weight – RCT Feb 2016
- Breastfeeding mother getting 6400 IU of Vitamin D is similar to infant getting 400 IU – RCT Sept 2015
- Children getting 60,000 IU monthly got to vitamin D level of 33 ng – Sept 2015
- Breast-feeding mothers need 2000 IU of vitamin D to get infants to even 12 ng – July 2015
- 2,000 IU of vitamin D reduced schizophrenia chance by 77 percent (male infants) - 2004
- Growing pains reduced 57 percent by vitamin D therapy – May 2015
- T1 diabetes in children helped with two doses of 150,000 IU of vitamin D and Calcium – March 2015
- 50,000 IU Vitamin D one time after birth helped – RCT Jan 2015
- Type 1 diabetes helped with 50,000 IU of vitamin D every two weeks – Nov 2014
- Growing pains reduced 60 percent by monthly Vitamin D – March 2014
- Respiratory Tract visits 2.5 less likely with vitamin D: Pregnancy 2000 IU, Infant 800 IU – RCT Oct 2014
- 2000 IU vitamin D during pregnancy and 800 IU to infant resulted in less use of antibiotics – RCT April 2014
- Neonate loading dose of 30,000 IU vitamin D helped a lot – May 2014
- 2000 IU of vitamin D should improve toddlers health in winter – RCT almost completed Feb 2014
- 800 IU vitamin D for infant and 2000 IU for mother is good, not great – RCT Dec 2013
- Breast milk resulted in 20 ng of vitamin D for infant if mother had taken 5,000 IU daily – RCT Dec 2013
- Severe tooth decay in children unless supplemented with Vitamin D drops – Oct 2013
- Middle ear infection (Otitis Media) and Vitamin D – many studies
- Many preemies need at least 800 IU of vitamin D – RCT May 2013
Vitamin D in Europe category listing has208 items has the following % of Europeans with < 30 nanograms – after adjustment of readings
Study Countries < 30 ng HELENA 9 EU 97% OPUS Denmark 87% Tromsø Study: Fit Futures Norway 96% HGS Greece 97% INNS Greece 90% Cork BASELINE Birth Ireland 84% NDNS 1–18 y United Kingdom 90% NDNS >18 y United Kingdom 91% DEG4 Germany 91% Tromsø Study–6th Survey Norway 75% NHS Netherlands 78% LASA Netherlands 68% AGES–Reykjavik Iceland 86% Finnish Migrant Health . . Finland 89% NANS Ireland 81% Health 2011 Finland 76% HUBRO Norway 66% Health 2006 Denmark 68%  Download the PDF from Vitamin D Life
Note: 60% (not shown in pie chart) did not get ANY vitamin D supplementation
Introduction: According to updated evidence-based national recommendations which have been published recently vitamin D deficiency remains still highly prevalent in Poland and requires supplementation.Aim of the study: was to evaluate the effectiveness of implementation of the new national recommendations into daily practice.
Material and methods: An analysis of medical records of 100 children aged from 6 months to 14 years admitted to the Department of Pediatrics, Hospital in Brzesko, Lesser Poland, from 1st July 2018 to 31st August 2018.
Results
41% patients declared vitamin D supplementation.- Among patients under 1 year of age 3 (60%) received recommended supplementation of 400-600 IU daily,
- in the group of 1-11 years old 15 (19.5%) used a 600-1000 IU dose daily, 13 (17%) < 600 IU/daily, and 2 (2.5%) > 1000 IU daily, 1 patient did not remember the dose.
- In the group >11 years of age 6 (37.5%) supplemented 800-2000 IU/day, 1 (6.3%) less than 800 IU, no one overdosed supplementation. In the group without supplementation, there were 3 patients with a de-creased 25(OH)D blood serum level (< 20 ng/ml).
- Mean 25(OH)D serum level was significantly higher in the group with vitamin D supplementation (42 vs. 33.9 ng/ml; p = 0.0006).
- There was no significant difference between mean 25(OH)D level in patients receiving adequate (40.5 ng/ml), to low (43 ng/ml), or to high vitamin D doses (49 ng/ml).
- There was no significant correlation between vitamin D dose and the 25(OH)D serum level [R = (–) 0.24, p > 0.05)].
Conclusions
There is an urgent need for physicians to provide an education concerning general rules of vitamin D supplementation, because the pre-sent guidelines of the vitamin D supplementation are not implemented well enough.Polish pediatric center: 40 percent took vitamin D – March 2019758 visitors, last modified 11 Apr, 2019, This page is in the following categories (# of items in each category)