title: Vitamin D and health in pregnancy, infants, children and adolescents in Australia and New Zealand: a position statement.
abstract: • The recommended level for serum 25-hydroxyvitamin D (25(OH)D) in infants, children, adolescents and during pregnancy and lactation is ≥ 50 nmol/L. This level may need to be 10-20 nmol/L higher at the end of summer to maintain levels ≥ 50 nmol/L over winter and spring. • Sunlight is the most important source of vitamin D. The US recommended dietary allowance for vitamin D is 600 IU daily in children aged over 12 months and during pregnancy and lactation, assuming minimal sun exposure. • Risk factors for low vitamin D are: lack of skin exposure to sunlight, dark skin, southerly latitude, conditions affecting vitamin D metabolism and storage (including obesity) and, for infants, being born to a mother with low vitamin D and exclusive breastfeeding combined with at least one other risk factor. • Targeted measurement of 25(OH)D levels is recommended for infants, children and adolescents with at least one risk factor for low vitamin D and for pregnant women with at least one risk factor for low vitamin D at the first antenatal visit. • Vitamin D deficiency can be treated with daily low-dose vitamin D supplements, although barriers to adherence have been identified. High-dose intermittent vitamin D can be used in children and adolescents. Treatment should be paired with health education and advice about sensible sun exposure. Infants at risk of low vitamin D should be supplemented with 400 IU vitamin D₃ daily for at least the first year of life. • There is increasing evidence of an association between low vitamin D and a range of non-bone health outcomes, however there is a lack of data from robust randomised controlled trials of vitamin D supplementation.
authors: Department of General Medicine, Royal Children's Hospital, Melbourne, VIC, Australia. georgia.paxton@rch.org.au
authors: Georgia A
authors: GA
authors: Paxton
authors: Glyn R
authors: GR
authors: Teale
authors: Caryl A
authors: CA
authors: Nowson
authors: Rebecca S
authors: RS
authors: Mason
authors: John J
authors: JJ
authors: McGrath
authors: Melanie J
authors: MJ
authors: Thompson
authors: Aris
authors: A
authors: Siafarikas
authors: Christine P
authors: CP
authors: Rodda
authors: Craig F
authors: CF
authors: Munns
mesh_terms: D000293:Adolescent; D001315:Australia / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009520:New Zealand / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D014807:Vitamin D / Q000097:blood* / Q000502:physiology; D014808:Vitamin D Deficiency / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D014815:Vitamins / Q000097:blood* / Q000502:physiology
chemical_list: D014815:Vitamins; D014807:Vitamin D