title: Prevention of Vitamin D deficiency in infancy: daily 400 IU vitamin D is sufficient.
abstract: CONCLUSIONS
  AIM-OBJECTIVE: Vitamin D deficiency and rickets in developing countries continues to be a major health problem. Additionally, the increase of cases of rickets in children of some ethnic groups in the United States and European countries has provided this issue to be updated. Obviously, powerful strategies are necessary to prevent vitamin D deficiency nation-wide. In 2005, a nationwide prevention program for vitamin D deficiency was initiated, recommending 400 IU vitamin D per a day. This study was designed to evaluate the efficacy of the prevention program.
  
  
  METHODS
  Eighty-five infants who were recalled as part of the national screening program for congenital hypothyroidism between February 2010 and August 2010 at Kocaeli University Children's Hospital were evaluated in terms of their vitamin D status as well. All babies had been provided with free vitamin D (Cholecalciferol) solution and recommended to receive 400 IU (3 drops) daily. Information regarding the age at start of supplementation, the dosage and compliance were obtained from the mothers with face-to-face interview. Serum 25-hydroxy vitamin D (25-OH-D), alkaline phosphatase (AP), parathormone (PTH) levels were measured.
  
  
  RESULTS
  The mean age at which Vitamin D3 supplementation began was 16.5 ± 20.7 (3-120) days. Ninety percent of cases (n:76) were receiving 3 drops (400 IU) vitamin D3 per day as recommended; 70% of cases (n:59) were given vitamin D3 regularly, the remainder had imperfect compliance. Among those children who are older than 12 months, only 20% continued vitamin D supplementation. No subject had clinical signs of rickets. The mean 25-OH-D level was 42,5 ± 25,8 (median: 38.3) ng/ml. Ten subjects (12%) had their serum 25-OH-D levels lower than 20 ng/ml (6 between 15-20 ng/ml, 3 between 5-15 ng/ml and only one < 5 ng/ml).
  
  
  CONCLUSIONS
  400 U/day vitamin D seems adequate to prevent vitamin D deficiency. However, we believe that the program for preventing vitamin D deficiency in Turkey, needs to be reinforced to start immediately after birth, and to continue beyond 1 year of age at 400U regular daily dosage.
authors.affiliation: Department of Pediatrics, Division of Pediatric Endocrinology and Diabetes, Medical Faculty, Kocaeli University, Kocaeli, Turkey.
authors.forename: Gul Yesiltepe
authors.initials: GY
authors.lastname: Mutlu
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Kusdal
authors.forename: Elif
authors.initials: E
authors.lastname: Ozsu
authors.forename: Filiz M
authors.initials: FM
authors.lastname: Cizmecioglu
authors.forename: Sukru
authors.initials: S
authors.lastname: Hatun