Prevention and treatment of infant and childhood vitamin D deficiency in Australia and New Zealand: a consensus statement.
Vitamin D deficiency has re-emerged as a significant paediatric health issue, with complications including hypocalcaemic seizures, rickets, limb pain and fracture. A major risk factor for infants is maternal vitamin D deficiency. For older infants and children, risk factors include dark skin colour, cultural practices, prolonged breastfeeding, restricted sun exposure and certain medical conditions. To prevent vitamin D deficiency in infants, pregnant women, especially those who are dark-skinned or veiled, should be screened and treated for vitamin D deficiency, and breastfed infants of dark-skinned or veiled women should be supplemented with vitamin D for the first 12 months of life. Regular sunlight exposure can prevent vitamin D deficiency, but the safe exposure time for children is unknown. To prevent vitamin D deficiency, at-risk children should receive 400 IU vitamin D daily; if compliance is poor, an annual dose of 150,000 IU may be considered. Treatment of vitamin D deficiency involves giving ergocalciferol or cholecalciferol for 3 months (1000 IU/day if < 1 month of age; 3000 IU/day if 1-12 months of age; 5000 IU/day if > 12 months of age). High-dose bolus therapy (300,000-500,000 IU) should be considered for children over 12 months of age if compliance or absorption issues are suspected.
Munns
Craig
C
The Children's Hospital at Westmead, Sydney, NSW, Australia. craigm2@chw.edu.au
Zacharin
Margaret R
MR
Rodda
Christine P
CP
Batch
Jennifer A
JA
Morley
Ruth
R
Cranswick
Noel E
NE
Craig
Maria E
ME
Cutfield
Wayne S
WS
Hofman
Paul L
PL
Taylor
Barry J
BJ
Grover
Sonia R
SR
Pasco
Julie A
JA
Burgner
David
D
Cowell
Christopher T
CT
D000293:Adolescent; D001315:Australia; D002648:Child; D002675:Child, Preschool; D004032:Diet; D019587:Dietary Supplements; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009520:New Zealand; D013472:Sunlight; D014807:Vitamin D / Q000097:blood / Q000627:therapeutic use*; D014808:Vitamin D Deficiency / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*
D014807:Vitamin D