Vitamin D in European children—statement from the European Academy of Paediatrics (EAP)
European Journal of Pediatrics, pp 1–3, First Online: 12 April 2017
doi:10.1007/s00431-017-2903-2
Zachi Grossman, Adamos Hadjipanayis adamos at paidiatros.com, Tom Stiris, Stefano del Torso, Jean-Christophe Mercier, Arunas Valiulis, Raanan Shamir
See also Vitamin D Life
- Quick restoration of vitamin D in children – 10,000 IU per kg loading dose was not enough – Jan 2017
Note - the study on this page only indicates 400 IU - Many US kids have less than 40 ng of Vitamin D – 99 out of 100 blacks, 91 out of 100 whites – Jan 2017
Many groups define optimal Vitamin D as > 40 nanograms - Takes a year to restore children and youths to good levels of vitamin D without loading dose - RCT Dec 2016
A year is a very long time for an infant
Infant-Child category starts with
- No consensus on MINIMUM International Units (IU) for healthy infant of normal weight
- 400 IU Vitamin D is no longer enough
Was OK in the past century, but D levels have been dropping for a great many reasons.
FDA doubles the amount of vitamin D permitted in milk – July 2016 - No consensus: range is 600 to 1600 IU – based on many randomized controlled trials
- Review of 400 IU to 2000 IU daily and higher if non-daily
- Fewer pre-infants were vitamin D deficient when they got 800 IU – RCT Feb 2014
- 1600 IU was the conclusion of three JAMA studies
1000 IU recommended in France and Finland – 2013 - appears to be a good level - 5X less mite allergy after add vitamin D
- Child bone fractures with low vitamin D were 55X more likely to need surgery
- 75 % of SIDS had low vitamin D
- Children stayed in ICU 3.5 days longer if low vitamin D – Dec 2015
- 5 out of 6 children who died in pediatric critical care unit had low vitamin D – May 2014
- Infants have gotten free 400 IU of vitamin D in Turkey since 2005, More for longer would be even better – Feb 2022
- Preemies should have vitamin D supplements – reaching an agreement – April 2021
- Vitamin D loading dose was as effective as daily dosing (rickets in this case) – RCT July 2021
Having a good level of vitamin D cuts in half the amount of:
- Asthma, Chronic illness, Doctor visits, Allergies, infection
Respiratory Tract Infection, Growing pains, Bed wetting
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.
More than 100 IU/kg is probably better 823 items in the category Infant/Child See also - 34 pages in Vitamin D Life had BREASTFE*in title as of Jan 2022
- "BIRTH DEFECTS" 172 items as of July 2016
- Stunting OR “low birth weight” OR LBW OR preemie OR preemies OR preterm 1940 items as of Oct 2018
- 96 Vitamin D Life pages contained PRETERM or PREEMIE in title as of Aug 2021
- "SUDDEN INFANT DEATH" OR SIDS 214 items as of Dec 2020
- Overview of Rickets and Vitamin D
- Youth category listing has
174 items along with related searches - Down syndrome and low vitamin D - several studies
- Rett syndrome associated with low vitamin D, treated by Omega-3
Items in both categories Infant-child and Europe are listed here:
- French pediatric consensus: 30 – 60 ng of Vitamin D – Feb 2022
- 26 X increase in Vitamin D prescriptions for youths in England in 8 years – Dec 2019
- European Food Safety Authority (EFSA) found “paucity” of Vitamin D data for infants – Nov 2019
- Polish pediatric center: 40 percent took vitamin D – March 2019
- 34 percent increase in hospital admissions for low vitamin D in a single year (UK) – Feb 2019
- Romania joins Turkey in giving free Vitamin D to all infants – 2018
- Young white children helped by 1500 IU of vitamin D – Jan 2019
- UK infants are the least likely to get Vitamin D in Europe – political action overdue – April 2018
- When to start Vitamin D after European births - UK 180 days, many 6-31 days, the rest 1-5 days - Sept 2017
- 10X increase in cost of vitamin D per child-year in UK in 6 years - Aug 2017
- Vitamin D in European children – no consensus on “adequate” levels – April 2017
- High vitamin D levels in Romanian children – wonder why – May 2015
- 3X increase in UK children who are vitamin D deficient in just 5 years – Nov 2015
- Only 1 in 10 UK parents had been told about vitamin D by their child’s doctor – April 2015
- Only 1 in 4 UK children had EVER gotten vitamin D supplements – April 2015
- UK program to increase Vitamin D (Healthy Start) continues to be a farce - Nov 2014
- UK people and doctors still clueless about vitamin D – Survey Oct 2014
- 3X more kids were vitamin D deficient when entering UK hospitals than 4 years before – Oct 2014
- Vitamin D levels in Europe – Sept 2014
- Even after informing mothers of the importance of vitamin D supplementation few did so – Aug 2014
- Post-mortem analysis of children in London Hospital – only 1 child had adequate level of vitamin D – July 2014
- Danish study of childhood diseases vs vitamin D fortification – May 2013
- Presentation: pre and post natal vitamin D, with audience comments – Manchester UK Sept 2013
- Most European infants get vitamin D supplements, vs only 1 in 50 in US – June 2013
- UK Milk producer sets vitamin D day, yet UK milk rarely has vitamin D – March 31 2013
- Fewer than 15 percent of 5 year-olds getting vitamin D prescriptions in France – Nov 2012
- UK Day-Cares being offered grants to develop vitamin D methods – July 2012
- UK pediatricians have a lot to learn about vitamin D – May 2012
- Death of Babies in UK due to vitamin D deficiency – Jan 2012
- Nutritional Rickets in Denmark especially among immigrant children- Feb 2012
- Recommend 100 IU of vitamin D per kg of infant - Poland July 2011
- All babies in Ireland should have 200 IU of vitamin D - Feb 2011
- Chief UK Medical Officer recommends only 280 IU for children - Jan 2011
Items in both categories Infant-child and High-Risk are listed here:
- Poor children were 2X more-likely to be vitamin D deficient (Ireland) – July 2022
- Children in Mongolia helped by 800 IU of Vitamin D (need a lot more) – RCT Oct 2019
- Children 41X more likely to be vitamin D deficient if both parents were deficient – Dec 2018
- Both parents smoke – child’s vitamin D level was 30 percent lower and worse asthma – May 2018
Items in both categories Infant-child and Testing are listed here:
- 42X increased vitamin D testing of children, no increase in levels (too little vitamin D prescribed to make a difference) – July 2021
- Vitamin D compliance 3X higher when children with fractures actually knew their low vitamin D level – March 2019
- Child died in hospital, death due to low vitamin D, mother is suing hospital – Nov 2018
Vitamin D is synthesized in human skin upon sun exposure and is also a nutrient. It regulates calcium and phosphate metabolism and is essential for the maintenance of bone health. Vitamin D supplementation during infancy, in order to prevent rickets, is universally accepted. Many human cell types carry vitamin D receptor, this being a drive for conducting studies on the possible association between vitamin D status and other diseases.Studies have affirmed that a considerable number of healthy European children may be vitamin D deficient, especially in high-risk groups (darker pigmented skin, living in areas with reduced sun exposure and other disorders). However, the definition of deficiency is unclear due to inter assay differences and due to a lack of consensus as to what is an “adequate” 25(OH)D level.
Therefore, there is no justification for routine screening for vitamin D deficiency in healthy children.
An evaluation of vitamin D status is justified in children belonging to high-risk groups. All infants up to 1 year of age should receive an oral supplementation of 400 IU/day of vitamin D. Beyond this age, seasonal variation of sunlight should be taken into account when considering a national policy of supplementation or fortification.
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