[The current practice of prevention of rachitis in France. A survey of 600 physicians].
French legislation prohibiting vitamin D food supplementation, rachitism prophylaxis is based on specific infantile calciferol administration, according to an old ministerial recommendation published in 1963. Out of 1000 questioned physicians, 600 completed the present inquiry. Ninety-nine per cent of them indicated that they systematically prescribe vitamin D for infants, but 18% do not propose it to breast-fed babies; 36% begin prophylactic administration only after 2 weeks and 5% after one month of age; 16% stop prevention between 12 and 18 months, 72% between 2 and 6 years and 12% after 8 years. Expressed on a daily basis, vitamin D dosage is usually rather high, generally slightly higher than the officially recommended intake (1100 to 1400 versus 1000 IU/24 h) and can reach excessive levels, especially in coloured people for which the already large proposed dose (2500 IU/24 h) is exceeded by 13% of inquired physicians. Daily rhythm of supplementation is the most frequent (94% of physicians) before 2 years, semestral or annual afterwards. The mode of administration, diluted in milk (40%), water (27%) or fruit juice (14%) depends on the physicians. In free commentaries, none of them speaks about maternal supplementation during pregnancy. Very few propose special dosage for premature babies. These defects in rachitism prophylaxis are partly due to the obsolescence of official recommendations which postpone the beginning of vitamin D prevention until the age of 6 weeks, do not mention maternal supplementation during pregnancy and do not specify the necessity for vitamin D intake in breast fed infants.(ABSTRACT TRUNCATED AT 250 WORDS)
Feillet
F
F
Service de médecine infantile 3, Hôpital d'Enfants, Vandoeuvre-les-Nancy, France.
Vidailhet
M
M
Leheup
B
B
Morali
A
A
D005602:France; D006306:Health Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D010820:Physicians; D012279:Rickets / Q000453:epidemiology / Q000517:prevention & control*; D012621:Seasons; D014807:Vitamin D / Q000008:administration & dosage*
D014807:Vitamin D
Pratique actuelle de la prophylaxie du rachitisme en France. Enquête auprès de 600 médecins.