Loading...
The Endocrine Society has published a new practice guideline on vitamin D deficiency. This summary covers key points of the guideline relevant to children (the adult portion can be found at JW Gen Med Jun 23 2011).
Screening for vitamin D deficiency is recommended only for high-risk individuals. However, risk in the pediatric population is poorly defined. Risk factors for vitamin D deficiency in children include breast-feeding without vitamin D supplementation, dark skin pigmentation, and maternal vitamin D deficiency.
Vitamin D deficiency is defined as serum 25-hydroxyvitamin D (25[OH]D) level <20 ng/mL (50 nmol/L).This definition is consistent with the Institute of Medicine report.
Infants (age range, 1–12 months) require at least 400 IU/day of vitamin D.
Children (age range, 1–18 years) require 600 IU/day of vitamin D.
Infants and children who are vitamin D–deficient should receive 2000 IU/day of vitamin D2 or vitamin D3, or 50,000 IU of vitamin D2 or vitamin D3 once weekly for 6 weeks.
Holick MF et al. Evaluation, treatment, and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. J Clin Endocrinol Metab 2011 Jun 6; [e-pub ahead of print]. (http://dx.doi.org/10.1210/jc.2011-0385)
Comment
Despite the plethora of recent publications on vitamin D and the apparent association between vitamin D deficiency and many diseases, the only fundamental change in vitamin D recommendations in the pediatric population has been an increase in the requirement from 400 IU to 600 IU in children older than 1 year. Population-wide screening for vitamin D deficiency is not recommended.