Prevalence of vitamin D deficiency in exclusively breastfed infants at a tertiary healthcare facility in Nairobi, Kenya

Abstract

Objective: To determine the prevalence of vitamin D deficiency (VDD) in exclusively breastfed infants at the Aga Khan University Hospital Nairobi, Kenya (AKUHN). The relationships between 25-hydroxyvitamin D; 25OHD, parathyroid hormone (PTH), maternal vitamin D supplementation, and sunlight exposure were also determined. Subjects and methods: Blood from 98 infants was assayed for 25OHD, calcium, phosphate, and PTH. Socio-demographic and clinical characteristics were analyzed using descriptive statistics and inferential analysis (p < 0.05). Results: The prevalence of VDD (25OHD <12 ng/mL), vitamin D insufficiency (VDI, 25OHD 12-20 ng/mL) and vitamin D sufficiency (VDS, 25OHD >20 ng/mL) was 11.2% (95% CI 8.0%-14.4%), 12.2% (95% CI 8.9%-15.5%), and 76.5% (95% CI 72.3%-80.8%) respectively. There was no difference in the mean age, head circumference, length, or weight of infants in VDD, VDI, and VDS groups. PTH was elevated when 25OHD was <12 ng/mL and normal when 25OHD was between 12-20 ng/mL. 25OHD and PTH were normal in infants whose mothers received vitamin D supplements. Infants who received <30 minutes/day of exposure to sunlight were 5 times more likely to have VDI than infants who received ≥30 minutes/day (p = 0.042). Conclusions: The prevalence of VDD in exclusively breastfed infants at AKUHN is low. The current national policy that recommends exclusive breastfeeding of infants in the first 6 months of life appears to be effective in staving off vitamin D deficiency but those infants with < 30 minutes sunlight exposure may benefit from low dose supplemental vitamin D during times of low sunlight exposure.

Vitamin D status in full-term exclusively breastfed infants versus full-term breastfed infants receiving vitamin D supplementation in Thailand: a randomized controlled trial

“…The prevalence of vitamin D insufficiency or deficiency among infants in tropical countries was previously expected to be low because of the large amount of sunlight in these areas. The prevalence of vitamin D insufficiency and deficiency (≤20 ng/mL) among unsupplemented breastfed infants in the present study are comparable with those reported in Hong Kong (60%) [ 13 ], but lower than those reported in India (90%) [ 14 ], Taiwan (86.1%) [ 15 ], Qatar (83%) [ 16 ], and Japan (76.9%) [ 17 ] but higher than those in Boston, MA, USA (40%) [ 18 ], Kenya (23.4%) [ 19 ], and Indonesia (16.7%) [ 20 ]. The variation in these reported prevalences was likely caused by multiple factors, such as the infants’ age, ethnicity, geographical location, and study methodology.…”

Vitamin D Status in Full-term Exclusively Breastfed Infants versus Full-term Breastfed Infants Receiving Vitamin D Supplementation in Thailand: A Randomized Controlled Trial

“…The prevalences of vitamin D insu ciency and de ciency (≤ 20 ng/mL) among unsupplemented breastfed infants in the present study are comparable with those reported in Hong Kong (60%) (13). The prevalences were lower than those reported in India (90%) (14), Taiwan (86.1%) (15), Qatar (83%) (16), and Japan (76.9%) (17) but higher than those in Boston, MA, USA (40%) (18), Kenya (23.4%) (19), and Indonesia (16.7%) (20). The variation in these reported prevalences was likely caused by multiple factors, such as the infants' age, ethnicity, geographical location, and study methodology.…”

Vitamin D status among infants attending Reproductive and Child Health Centre in Arusha, Tanzania; A cross-sectional study&nbsp;

“…The prevalence obtained in our study is similar to other studies carried out in near by regions (Dar es Salaam) Tanzania and (Nairobi) Kenya. This can be explained by the fact that they had similar study population, similar weather characteristics and socioeconomic status (4,13). The prevalence of Vitamin D de ciency among infants was ranging from 21.2% to 83.7% in various studies done in East Africa (4,5,13,14).…”

“…Younger infants appeared more likely to have Vitamin D de ciency and may be explained by signi cant number of them being exclusively breastfed (17). Breast milk has low level of vitamin D yet mothers in Arusha are not supplemented with Vitamin D and plausibly they could also be low in Vitamin D. Said N et al made similar observations associating vitamin D de ciency with age less than six month and exclusive breastfeeding (13).…”