Are Vitamin D Drops Containing 400 IU Daily Adequate for Preventing Vitamin D Deficiency?

Ad dress for Cor res pon den ce Hüseyin Anıl Korkmaz MD, Balıkesir Atatürk State Hospital, Clinic of Pediatric Endocrinology, Balıkesir, Turkey Phone: +90 266 221 35 10 E-mail: [email protected] ©Jo ur nal of Cli ni cal Re se arch in Pe di at ric En doc ri no logy, Pub lis hed by Ga le nos Pub lis hing. Dear Editor, The adequacy of vitamin D intake is necessary to optimize the bone health during the rapid growing phase of infancy. Vitamin D also affects many organs playing an important role in maintaining general health. Vitamin D deficiency may be associated with cardiovascular disease, diabetes, cancer, and autoimmune diseases (1). The incidence of vitamin D insufficiency and nutritional rickets has decreased in Turkey following the nationwide vitamin D prophylaxis programme undertaken by the Turkish Ministry of Health in 2005. This programme provides free vitamin D drops containing 400 IU daily for all children under 12 months of age (2). Our study demonstrated that this dose is not adequate for preventing vitamin D deficiency and insufficiency (3). Although İzmir has an abundance of sunshine almost throughout the year, our study showed that 40.9% of infants were sufficient, 28.4% of infants were insufficient, and 30.7% of infants were deficient in vitamin D levels on 400 IU of vitamin D supplementation (2). Halicioglu et al (4) also found that the rates of vitamin D deficiency and insufficiency were high in infants from a temperate region of Turkey who received daily 400 IU vitamin D supplementation. Because we found a high prevalence of vitamin D insufficiency and deficiency in infants who received 400 IU of vitamin D supplementation, we speculated that vitamin D prophylaxis dose should be increased from 400 IU to 600 or 800 IU in infants aged 0-12 months. We observed no patients with signs of hypocalcaemia, fits or tetany, and rickets in our study because dietary calcium intake was adequate in our patients despite vitamin D deficiency or insufficiency. We also reported high rates of maternal vitamin D deficiency and insufficiency in our study (2). The infants are at a high risk of vitamin D deficiency in the first year of life. Vitamin D supplementation is also important for decreasing the prevalence of severe early childhood caries with maintaining normal serum 25-hydroxy vitamin D (5). Vitamin D prophylaxis dose might spark a debate in infants for maintaining general health. Further investigations would therefore be needed to clarify the optimal amount of vitamin D supplementation to the infants aged 0-12 months.