Very high vitamin D supplementation rates among infants aged 2 months in Vancouver and Richmond, British Columbia, Canada

Abstract

BackgroundVitamin D deficiency during infancy may lead to rickets and possibly other poor health outcomes. The World Health Organization recommends exclusive breastfeeding for the first 6 months. Breast milk is the best food for infants but does not contain adequate vitamin D. Health Canada recommends all breastfed infants receive a daily vitamin D supplement of 400 IU; however, there appears to be limited current Canadian data as to whether parents or caregivers are following this advice. The aim of this study was to determine the rates of vitamin D supplementation among 2-month old infants in Vancouver and Richmond, British Columbia, Canada.MethodsMothers of all healthy infants born between April and May 2010 were approached to participate. Telephone surveys were conducted with 577 mothers (response rate 56%) when their infants turned 2 months.ResultsOver half of the infants received only breast milk in the week prior to the survey. One third received a mixture of breast milk and infant formula and 10% received only formula. About 80% of the infants were supplemented with vitamin D at 2 months. Infants who received only breast milk were most likely to be supplemented with vitamin D (91%). Over 60% of the infants had a total vitamin D intake of 300- < 500 IU/d from supplements and formula and only 5% did not receive any vitamin D. Most parents were advised to give vitamin D supplement by health professionals, such as public health nurses, midwives, and doctors.ConclusionsAbout 90% of the infants received breast milk at 2 months of age. The vitamin D supplementation rate was 80%. Future studies are needed to monitor breastfeeding duration and vitamin D supplementation rates as infants get older.

Programme to provide Quebec infants with free vitamin D supplements failed to encourage participation or adherence

“…Our findings are in contrast to the 2009–2010 report from the Canadian Community Health Survey, which demonstrated a high rate of supplementation (74.1%) and was recently corroborated by regional surveys in urban areas of Montreal, QC , and Vancouver, BC . The discrepancy may reflect recall or other biases among participants such as these surveys often sampling from large urban settings only overestimating the supplement rates.…”

“…Our comprehensive data allowed us to identify a number of predictors for obtaining and continuing vitamin D. Not surprisingly, higher education, older mothers, living as a couple, urban residence and paediatrician care increased the odds for participation and adherence. Our findings are in contrast to the 2009-2010 report from the Canadian Community Health Survey, which demonstrated a high rate of supplementation (74.1%) (1) and was recently corroborated by regional surveys in urban areas of Montreal, QC (22), and Vancouver, BC (23). The discrepancy may reflect recall or other biases among participants such as these surveys often sampling from large urban settings only overestimating the supplement rates.…”

Adherence to complementary feeding recommendations for infants and implications for public health

“…For example, 45·2 % of mothers introduced liquids other than breast milk or formula (most commonly water or fruit juices) before 6 months. Lastly, over 40 % of breast-fed infants were not supplemented with vitamin D, which is lower than reported in previous studies (33,34) , and necessary for infant health as breast milk is not a dependable source of this nutrient (28) . Results also indicate that almost a third of mothers introduced complementary food items not listed in the CFG to their infant before 1 year of age.…”

Maternal vitamin D3 supplementation at 50 μg/d protects against low serum 25-hydroxyvitamin D in infants at 8 wk of age: a randomized controlled trial of 3 doses of vitamin D beginning in gestation and continued in lactation

“…Breast milk is internationally recognized as the best source of nutrition for optimal infant growth and development (5), but it does not normally provide sufficient vitamin D. Numerous organizations, including Health Canada and the American Academy of Pediatrics, recommend direct infant supplementation with w10 mg vitamin D/d (6)(7)(8) rather than sun exposure (9). Rates of vitamin D supplementation in breast milk-fed infants have been reported as variable from 80% (10,11) to 10% (12). Although infant supplementation is effective, there are several concerns.…”