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Adherence to the infant vitamin D supplementation policy in Ireland
A Hemmingway1,2, D Fisher1, T Berkery1
1INFANT Research Centre, University College Cork, Cork, Ireland.
Insights
Most infants initiated vitamin D supplementation, with over half showing full or broad adherence to Ireland's 5 μg/day policy. Improving supplementation frequency can enhance overall compliance.
Area of Science:
- Pediatrics
- Public Health Nutrition
- Nutritional Immunology
Background:
- Ireland's national policy (2010-2019) recommended 5 μg/day of vitamin D3 for infants aged 0-12 months.
- This policy aimed to ensure adequate vitamin D intake irrespective of infant feeding method.
Purpose of the Study:
- To assess adherence to Ireland's infant vitamin D supplementation policy.
- To evaluate the actual practices of vitamin D supplementation among infants in Ireland.
Main Methods:
- Prospective data from 364 infants in the COMBINE birth cohort (2015-2017) were analyzed for supplement type, dose, frequency, and duration.
- Vitamin D supplement use at 2, 6, and 12 months in COMBINE was compared to the earlier BASELINE cohort (n=1949, 2008-2011).
Main Results:
- 92% of infants in COMBINE started vitamin D supplementation at birth, with a median duration of 51 weeks.
- While 30% fully adhered to the 5 μg/day daily policy, an additional 16% were broadly compliant.
- Vitamin D supplementation rates at 2, 6, and 12 months were significantly higher in COMBINE (93%, 89%, 72%) compared to BASELINE (49%, 64%, 44%).
Conclusions:
- High initiation rates of vitamin D supplementation were observed.
- Over half of infants demonstrated full or broad adherence to the national policy.
- Enhancing the frequency of supplementation presents an opportunity to improve overall compliance.
Purpose:
From September 2010 until November 2019, Ireland's infant vitamin D supplementation policy recommended administration of 5 μg/day of vitamin D3 from birth to 12 months to all infants, regardless of feeding method. This study aims to examine policy adherence.
Methods:
In the prospective COMBINE birth cohort study (recruited 2015-2017), detailed longitudinal supplement data were examined in 364 infants across the first year of life, according to product type, dose, frequency, and duration. Vitamin D supplement use at 2, 6, and 12 months in COMBINE was compared with the BASELINE cohort (recruited 2008-2011, n = 1949).
Results:
In COMBINE, 92% of infants initiated supplementation at birth. The median supplementation duration was 51 (40, 52) weeks, with a range of 3-52 weeks. While supplementing, most parents (92%) used an exclusive vitamin D supplement as recommended and 88% gave 5 µg/day. Half (51%) gave vitamin D daily and a further 33% supplemented at least 3-6 times/week. Overall, 30% adhered fully to the policy, providing 5 µg vitamin D3 daily from birth to 12 months. A further 16% were broadly compliant, giving 5 µg frequently for the full 12 months. Vitamin D supplement use at 2, 6, and 12 months in COMBINE was 93%, 89%, and 72%, considerably higher than our earlier BASELINE cohort at 49%, 64%, and 44% at the same time points (all P < 0.001).
Conclusions:
We report a high level of vitamin D supplementation initiation at birth, with full to broad policy adherence among more than half of infants. There is scope to improve overall compliance by focusing on supplementation frequency.
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