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Vitamin D supplementation in the healthy pediatric population
David Gonzalez Jiménez1, Juan Rodríguez Delgado2, Cristina Campoy3
1Comité de Nutrición y Lactancia Materna de la AEP, Madrid, Spain; Área de Gestión Clínica de la Infancia y Adolescencia, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.
Objective:
To review the current scientific evidence on the efficacy of universal vitamin D supplementation in healthy children with no risk factors and to propose updated modifications to the recommendations provided in the main clinical practice guidelines.
Methods:
Scoping review through a literature search conducted in PubMed for articles published in English or Spanish in the past 15 years using the following MeSH search terms: (vitamin D) AND (supplementation). The search yielded 2133 articles, of which 22 were selected.
Results:
In infants aged less than 1 year without risk factors, administration of 400 IU/day improves serum levels of calcifediol, but most studies have not found an association with improved bone health assessed by dual-energy X-ray absorptiometry. In children aged more than 1 year with calcifediol levels of less than 35 ng/mL, supplementation with 400 to 800 IU/day of vitamin D decreases the risk of respiratory infection. There is still no evidence in the pediatric population that vitamin D supplementation either decreases the risk or severity of other infections or offers any other clinically significant extraskeletal benefits.
Conclusion:
Based on the main clinical practice guidelines, supplementation with vitamin D at a dose of 400 IU/day is recommended for breastfed infants aged less than 1 year or infants who do not achieve the recommended daily intake through infant formula. In children aged more than 1 year, supplementation should be individualized.
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