Use of supplemental vitamin d among infants breastfed for prolonged periods.
OBJECTIVE
To determine the rate of vitamin D supplementation in predominantly breastfed children. To identify patient characteristics, parental beliefs, and practitioner policies associated with supplementation.


METHODS
A prospective observational study was conducted in a practice-based research network. Network pediatricians completed a survey regarding their policy on vitamin D supplementation for breastfed infants. Parents of children 6 to 24 months old completed a survey on the initial type of feeding given to the child, length of breastfeeding, formula supplementation, and use of multivitamins. Parents indicated their level of agreement with statements regarding vitamin D supplementation.


RESULTS
Among 44 responding pediatricians, 36.4% indicated that they recommended vitamin D supplementation for all breastfed infants. A total of 2364 surveys were completed on age-eligible children; 1140 infants were breastfed for at least 6 months with little or no formula supplementation. The rate of vitamin D use for these infants was 15.9%. Use of vitamin D was significantly associated with parental agreement that their child's pediatrician recommended supplementation (odds ratio [OR]: 7.8), and that vitamins are unnecessary because breast milk has all needed nutrition (OR: 0.12). Among parents of predominantly breastfed infants who indicated that their child's doctor recommended vitamin D, 44.6% gave the supplementation to their child. Conversely, 67% of parents agreed that breast milk has all needed nutrition, and only 3% of these parents gave vitamin D to their children.


CONCLUSIONS
A minority of breastfed infants received vitamin D supplementation. Educational efforts directed at both physicians and parents are needed to increase compliance with vitamin D supplementation guidelines.
Taylor
James A
JA
Department of Pediatrics, University of Washington, Seattle, Washington 98195, USA. uncjat@u.washington.edu
Geyer
Leah J
LJ
Feldman
Kenneth W
KW
D000704:Analysis of Variance; D001291:Attitude of Health Personnel; D001942:Breast Feeding; D016001:Confidence Intervals; D019587:Dietary Supplements; D019317:Evidence-Based Medicine; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015999:Multivariate Analysis; D020380:Needs Assessment; D016017:Odds Ratio; D010372:Pediatrics / Q000592:standards / Q000639:trends; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends; D011336:Probability; D011446:Prospective Studies; D012279:Rickets / Q000517:prevention & control*; D018570:Risk Assessment; D013997:Time Factors; D014481:United States; D014807:Vitamin D / Q000008:administration & dosage*
D014807:Vitamin D