Infants receiving 1600 IU of vitamin D were safe and healthy – RCT Aug 2012

High-Dose Vitamin D Intervention in Infants
--Effects on Vitamin D Status, Calcium Homeostasis, and Bone Strength.

J Clin Endocrinol Metab. 2012 Aug 29.
Holmlund-Suila E, Viljakainen H, Hytinantti T, Lamberg-Allardt C, Andersson S, Mäkitie O.
Children's Hospital (E.H.-S., H.V., S.A., O.M.), University of Helsinki and Helsinki University Central Hospital, 00029 Helsinki, Finland; Helsinki Maternity Hospital (T.H.), 00029 Helsinki, Finland; Calcium Research Unit (C.L.-A.), Department of Food and Environmental Sciences (Nutrition), University of Helsinki, 00014 Helsinki, Finland; and Folkhälsan Research Center (O.M.), 00014 Helsinki, Finland.

Context:Guidelines in Finland recommend 10 ?g of vitamin D3 daily for all infants.
Recent observations suggest that this may be insufficient to maintain optimal serum 25-hydroxyvitamin D (S-25-OHD).

Objective:The aim of the study was to evaluate effects of various vitamin D doses and determine a dose ensuring S-25-OHD of at least 80 nmol/liter in infants without signs of vitamin D excess.

Design:We conducted a randomized double-blind intervention study.
Cord blood was obtained at birth for S-25-OHD; 113 infants were randomized to receive vitamin D3 10, 30, or 40 ?g/d from age 2 wk to 3 months.

Setting:An investigator-initiated study was performed in a single maternity hospital in Helsinki, Finland.

Main Outcome Measures:S-25-OHD, calcium homeostasis, and skeletal characteristics were evaluated with peripheral quantitative computed tomography at age 3 months.

Results:Baseline S-25-OHD was similar in all three groups (median, 53 nmol/liter).
At 3 months, the mean S-25-OHD values were 88, 124, and 153 nmol/liter, and the minimum values were 46, 57, and 86 nmol/liter in the groups receiving 10, 30, and 40 ?g (ANOVA; P < 0.001).
No hypercalcemia occurred; plasma calcium, serum PTH, and urine calcium excretion was similar between the groups.
Peripheral quantitative computed tomography showed a trend toward larger tibial total bone and cortical bone area with higher vitamin D doses.

Conclusion:Vitamin D3 supplementation with up to 40 ?g/d from age 2 wk to 3 months was safe and caused no hypercalcemia or hypercalciuria.
The 40-?g dose maintained S-25-OHD above 80 nmol/liter in all infants.
More extensive and longer intervention studies are necessary to assess long-term effects.

PMID: 22933541

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Summary by Vitamin D Life

1600 IU of vitamin D was need to keep levels above 32 nanograms in all infants.
It is great that they considered > 20 nanograms to be needed
Strange that they did not seem to consider a dosing level proportional to weight

See also Vitamin D Life

• Third study found that Infants needed 1600 IU of vitamin D – JAMA RCT May 2013
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• Third study found that Infants needed 1600 IU of vitamin D – JAMA RCT May 2013
• Vitamin D prior to and after birth if wish to provide all the vitamin D from breast milk
• Vitamin D for children – translated from Spanish – July 2012
• Comparison of Vitamind D supplementation guidelines for children – China 400 IU 2012
• Reminder – 400 IU is enough only when infant already had a good level of vitamin D – Nov 2012
• Overview Pregnancy which has a section on infants
• UK pediatricians have a lot to learn about vitamin D – May 2012
• Infants getting 1400 IU vitamin D weekly grew better – RCT May 2011
• Absurdity of 600 IU vitamin D for 10 lb infant or 300 lb adult - Mar 2011
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• Recommend 100 IU of vitamin D per kg of infant - Poland July 2011 which includes the following graph