title: Vitamin D deficiency in healthy breastfed term infants at 3 months & their mothers in India: seasonal variation & determinants.
abstract: OBJECTIVE
  Vitamin D deficiency with a resurgence of rickets and tetany are increasingly being reported in young infants from temperate regions, African Americans and also from India. The data on vitamin D status of healthy term breastfed Indian infants and mothers are scant. Therefore, we undertook this study to determine the prevalence of vitamin D deficiency and insufficiency [serum 25 hydroxyvitamin D (25OHD) ≤ 15 ng/ml and 15-20 ng/ml, respectively] among healthy term breastfed 3 month old infants and their mothers, evaluate for clinical and radiological rickets in those infants having 25OHD < 10 ng/ml, and check for seasonal variation and predictors of infants' vitamin D status.
  
  
  METHODS
  A total of 98 infants aged 2.5 to 3.5 months, born at term with appropriate weight and their mothers were enrolled; 47 in winter (November- January) and 51 in summer (April-June). Details of infants' feeding, vitamin D supplementation, sunlight exposure and mothers' calcium and vitamin D intake were recorded. Serum calcium, phosphate, alkaline phosphatase, 25 hydroxyvitamin D (25OHD) and parathormone were estimated.
  
  
  RESULTS
  Vitamin D deficiency was found in 66.7 per cent of infants and 81.1 per cent of mothers; and insufficiency in an additional 19.8 per cent of infants and 11.6 per cent of mothers. Radiological rickets was present in 30.3 per cent of infants with 25OHD < 10 ng/ml. 25OHD did not show seasonal variation in infants but maternal concentrations were higher in summer [11.3 (2.5 - 31) ng/ml] compared to winter [5.9 (2.5-25) ng/ml, P=0.003]. Intake of vitamin supplement, sunlight exposure and mother's 25OHD were predictors of infants' 25OHD levels.
  
  
  CONCLUSIONS
  Prevalence of vitamin D deficiency and insufficiency was found to be high in breastfed infants and their mothers, with radiological rickets in a third of infants with 25OHD < 10 ng/ml in this study. Studies with large sample need to be done in different parts of the country to confirm these findings.
authors: Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India. drvandanajain@gmail.com
authors: Vandana
authors: V
authors: Jain
authors: Nandita
authors: N
authors: Gupta
authors: Mani
authors: M
authors: Kalaivani
authors: Anurag
authors: A
authors: Jain
authors: Aditi
authors: A
authors: Sinha
authors: Ramesh
authors: R
authors: Agarwal
mesh_terms: D000328:Adult; D001942:Breast Feeding; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D015995:Prevalence; D012621:Seasons; D014808:Vitamin D Deficiency / Q000453:epidemiology*