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Infants have low levels of vitamin D – associations with phototherapy and miscarriage – Dec 2016

Prevalence and risk factors for vitamin D insufficiency and deficiency at birth and associated outcome

BMC Pediatrics BMC series – 201616:208, DOI: 10.1186/s12887-016-0741-4, Published: 8 December 2016
Ian Marshall, Rajeev Mehta, Charletta Ayers, Smita Dhumal and Anna Petrova

See also Vitamin D Life

Infant-Child category starts with

Having a good level of vitamin D cuts in half the amount of:

Need even more IUs of vitamin D to get a good level if;

  • Have little vitamin D: premie, twin, mother did not get much sun access
  • Get little vitamin D: dark skin, little access to sun
  • Vitamin D is consumed faster than normal due to sickness
  • Older (need at least 100 IU/kilogram, far more if obese)
  • Not get any vitamin D from formula (breast fed) or (fortified) milk
    Note – formula does not even provide 400 IU of vitamin D daily

Infants-Children need Vitamin D

  • Sun is great – well known for 1,000’s of years.
    US govt (1934) even said infants should be out in the sun
  • One country recommended 2,000 IU daily for decades – with no known problems
  • As with adults, infants and children can have loading doses and rarely need tests
  • Daily dose appears to be best, but monthly seems OK
  • Vitamin D is typically given to infants in the form of drops
       big difference in taste between brands
       can also use water-soluable form of vitamin D in milk, food, juice,
  • Infants have evolved to get a big boost of vitamin D immediately after birth
    Colostrum has 3X more vitamin D than breast milk - provided the mother has any vitamin D to spare
  • 100 IU per kg of infant July 2011, Poland etc.
    1000 IU per 25 lbs.jpg
    More than 100 IU/kg is probably better

Getting Vitamin D into infants
Many infants reject vitamin D drops, even when put on nipple
I speculate that the rejection is due to one or more of: additives, taste, and oils.
Infants have a hard time digesting oils, 1999  1997   and palm oils W.A. Price 1 2 3
Coconut oil, such as in D-Drops, is digested by infants. 1,   2   3
Bio-Tech Pharmacal Vitamin D has NO additves, taste, oil
One capsule of 50,000 Bio-Tech Pharmacal Vitamin D could be stirred into monthly formula
   this would result in ~1,600 IUs per day for infant, and higher dose with weight/age/formula consumption


 Download the PDF from Vitamin D Life

Background
Occurrence and consequence of cord blood (CB) vitamin D insufficiency/deficiency has not been adequately explored despite rising concern regarding this topic in pediatrics. This study was designed to determine the rate, maternal risk factors, and clinical outcomes in infants in association with vitamin D insufficient/deficient status at birth.

Methods
American Academy of Pediatrics (AAP) defined levels (ng/mL) were utilized to categorize the vitamin D status in CB samples as deficient (5–15), insufficient (16–20), and sufficient (21–100). We used descriptive statistics and multiple regression models to identify the rate and factors associated with vitamin D deficiency/insufficiency and related outcomes in the enrolled mother-infant pairs.

Results
This prospective study was conducted at a single center on postpartum women and their infants. Vitamin D deficiency and insufficiency was recorded in 38.9 and 29.8% respectively of the 265 CB samples. Deficient CB vitamin D levels in infants were associated with maternal Black, Hispanic, or Asian race/ethnicity, younger age, and increased number of pregnancies. The likelihood for infants to be born with an insufficient vitamin D level increases with younger maternal age and the number of pregnancies as well as Asian ethnicity. We did not find an association between the vitamin D status at birth and pre-discharge clinical characteristics of the neonates.

Conclusions
The likelihood for an infant to be born with vitamin D deficiency/insufficiency is relatively high and is related mainly to younger maternal age, gravidity, and non-White race/ethnicity. Our findings raise a question regarding the adequacy of the AAP recommended vitamin D supplementation requirements without knowing the infant’s vitamin D status at birth.

Deficiency
5-15 ng
Insufficiency
16-20 ng
Sufficiency
>20 ng
P value
Mother # of pregnancies
(Gravidity)
3.4+/-2.4 2.8+/-1.9 2.4+/-1.3 <0.01
Infant/Mother? Vitamin D level 45%35%20%
Infant/Mother? Vitamin D level39% 30%31%
Infant Phototherapy performed 5.3%1.3%1.1%0.13
  • It appears that women with low vitamin D have more miscarriages
       Gravidity = # of times pregnant (not number of births)

It appears that infants with lowest vitamin D levels had more phototherapy

Attached files

ID Name Comment Uploaded Size Downloads
7607 Development of fat digestion in infancy - 1999.pdf PDF admin 01 Jan, 2017 19:48 131.11 Kb 135
7477 Birth BMC Dec 2016.pdf PDF 2016 admin 12 Dec, 2016 02:29 413.29 Kb 189
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