Sunshine exposure and serum 25-hydroxyvitamin D concentrations in exclusively breast-fed infants

Specker, Bonny; Valanis, Barbara; Hertzberg, Vicki; Edwards, Neil K.; Tsang, Reginald C.

doi:10.1016/s0022-3476(85)80509-6

Cited by 230 publications

(132 citation statements)

References 10 publications

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“…[8] A study that included black and white infants estimated that most breastfed infants need to be exposed to sunlight for at least 30 minutes/week while wearing only a nappy in order to maintain 25(OH)D levels at >20 ng/mL (50 nmol/L). [9] This amount of sun exposure is unlikely, given current recommendations to limit sun exposure in infants <6 months old.…”

Section: Vitamin D Metabolismmentioning

confidence: 99%

Vitamin D deficiency and insufficiency in Africa and the Middle East, despite year-round sunny days

et al. 2015

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Section: Vitamin D Metabolismmentioning

confidence: 99%

Vitamin D deficiency and insufficiency in Africa and the Middle East, despite year-round sunny days

et al. 2015

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“…Breast milk is indisputably the ideal food for infants; however, breast milk typically contains about 25 IU/L which is insufficient for rickets prevention. 15,16 Although there is evidence that limited sun exposure may prevent rickets in some breast-fed infants concerns over the health risk of sun exposure had led to the recommendation that all breast-fed infants receive supplemental vitamin D. 17,18 Thacher et al reported that children with rickets had a greater proportion of first degree relatives with a history of rickets. 19 A similar diet and environment may be the reason for rickets in families.…”

Section: Discussionmentioning

confidence: 99%

Nutritional rickets among children of Northern Kerala, India

Jose¹,

A²

2017

Int J Contemp Pediatr

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Background: Vitamin D deficiency is a very common micronutrient deficiency in our country and ranks among the 5 most common disease in children worldwide.Methods: To study the presentation and predisposing factors of rickets among children in Northern Kerala.Results: This study was conducted in the department of Pediatrics in a tertiary care hospital in Northern Kerala. Nutritional rickets diagnosis was based on clinical, radiological and biochemical parameters and appearance of provisional zone of calcification after vitamin D therapy. Data was analyzed and presented as percentage and mean. Student t-test was used for statistical analysis of the results.Conclusions: A total of 54 children having a variety of clinical presentations of rickets were seen during the study period. There were 46.3% males and 53.7% females. The mean age of diagnosis was 24 months.70.4% children were exclusively breast fed up to 6 months. None of the breast-fed infants had received vitamin D supplementation according to current guidelines. 66.7% children were not exposed to sunlight. Rickets was commonly found in children with no protein energy malnutrition. Genu varum and wrist widening were the most frequent clinical features observed in 92.6% patients. The radiological and biochemical characteristics of cases were ascertained before and after therapy. The biochemical changes were analyzed by student (t) test. There was a significant decrease in the ALP activity after vitamin D therapy (P= 0.000). Out of these 54 children with rickets 47(87.03%) responded to treatment with vitamin D3 and 7 (12.96%) were resistant to treatment with vitamin D3.

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“…There was a significant increase in 25(OH)D from winter to summer, but this did not adequately explain the age-related rise in infant 25(OH)D. The strong correlation between age and calendar day in the present study (due to births of enrolled infants occurring during only part of the calendar year), however, limited our ability to fully separate the effects of age and season. Specker et al attributed the age-associated rise in 25(OH)D to higher UV exposure in older infants (32) . Although deliberately exposing infants to sunlight, a custom that is often practised in South Asia (33,34) , may have contributed to cutaneous synthesis of vitamin D, self-reported sun exposure-related practices explained little variance in infant 25(OH)D in age-adjusted analyses in the present study.…”

Section: Discussionmentioning

confidence: 99%

Prenatal vitamin D supplementation and infant vitamin D status in Bangladesh

Perumal

Mahmud

Baqui

et al. 2015

Public Health Nutr.

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Objective: To determine the effect of prenatal maternal vitamin D supplementation on infant vitamin D status in a tropical region where vitamin D supplementation is not routine. Design: A prospective observational follow-up of a randomized trial. Setting: Maternal-child health facility in Dhaka, Bangladesh (23°N). Subjects: Infants born to pregnant women (n 160) randomized to receive 875 µg (35 000 IU) cholecalciferol (vitamin D 3 ) per week (VD) or placebo (PL) during the third trimester were followed from birth until 6 months of age (n 115). Infant serum 25-hydroxyvitamin D concentration (25(OH)D) was measured at <1, 2, 4 and 6 months of age. Results: Mean infant 25(OH)D was higher in the VD v. PL group at <1 month of age (mean (SD): 80 (20) nmol/l v. 22 (18) nmol/l; P < 0·001), but the difference was attenuated by 2 months (52 (19) nmol/l v. 40 (23) nmol/l; P = 0·05). Groups were similar at 4 months (P = 0·40) and 6 months (n 72; P = 0·26). In the PL group, mean infant 25(OH)D increased to 78 (95 % CI 67, 88) nmol/l by 6 months of age (n 34). 25(OH)D was higher with infant formula-feeding and higher in summer v. winter. Conclusions: Prenatal third-trimester vitamin D supplementation (875 µg (35 000 IU)/ week) significantly ameliorated infant vitamin D status during the neonatal period when the risk of vitamin D deficiency is greatest. Further research is warranted to determine factors that contribute to the rise in 25(OH)D during the first 6 months of life among breast-fed infants in this setting.

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Sunshine exposure and serum 25-hydroxyvitamin D concentrations in exclusively breast-fed infants

Cited by 230 publications

References 10 publications

Vitamin D deficiency and insufficiency in Africa and the Middle East, despite year-round sunny days

Vitamin D deficiency and insufficiency in Africa and the Middle East, despite year-round sunny days

Nutritional rickets among children of Northern Kerala, India

Prenatal vitamin D supplementation and infant vitamin D status in Bangladesh

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