title: Severe vitamin D deficiency in 6 Canadian First Nation formula-fed infants.
abstract: BACKGROUND
  Rickets was first described in the 17th century and vitamin D deficiency was recognized as the underlying cause in the early 1900s. Despite this long history, vitamin D deficiency remains a significant health concern. Currently, vitamin D supplementation is recommended in Canada for breast fed infants. There are no recommendations for supplementation in formula-fed infants.
  
  
  OBJECTIVE
  The objective of this report is to bring attention to the risk of severe vitamin D deficiency in high risk, formula fed infants.
  
  
  METHODS
  A retrospective chart review was used to create this clinical case series.
  
  
  RESULTS
  Severe vitamin D deficiency was diagnosed in six formula-fed infants over a two-and-a-half year period. All six infants presented with seizures and they resided in First Nation communities located at latitude 54 in the province of Manitoba. While these infants had several risk factors for vitamin D deficiency, they were all receiving cow's milk based formula supplemented with 400 IU/L of vitamin D.
  
  
  CONCLUSIONS
  This report suggests that current practice with regards to vitamin D supplementation may be inadequate, especially for high-risk infants. Health care professionals providing service to infants in a similar situation should be aware of this preventable condition. Hopefully this would contribute to its prevention, diagnosis and management.
authors.affiliation: Department of Paediatrics, Alberta Children's Hospital, Calgary, Canada.
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Gross
authors.forename: Milton
authors.initials: M
authors.lastname: Tenenbein
authors.forename: Elizabeth A C
authors.initials: EA
authors.lastname: Sellers
mesh_terms: D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D001110:Arctic Regions / Q000453:epidemiology; D002117:Calcitriol / Q000008:administration & dosage; D002118:Calcium / Q000008:administration & dosage; D002170:Canada / Q000453:epidemiology; D002762:Cholecalciferol / Q000008:administration & dosage; D019587:Dietary Supplements; D006996:Hypocalcemia / Q000209:etiology; D041943:Infant Formula; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D014808:Vitamin D Deficiency / Q000150:complications / Q000188:drug therapy / Q000208:ethnology
chemical_list: D002117:Calcitriol; D002118:Calcium; D002762:Cholecalciferol
keywords: First Nation; hypocalcaemia; infant; seizures; vitamin D