Vitamin D supplementation in infancy: a revisited systematic review

To systematically evaluate recent evidence on vitamin D supplementation during infancy, focusing on optimal dosing, population variability, and emerging nonskeletal effects. The review emphasizes current controversies and gaps that remain in translating evidence into policy and clinical practice.

Recent randomized trials and meta-analyses confirm that daily supplementation of 400 IU vitamin D maintains adequate 25-hydroxyvitamin D levels in most healthy, term infants. However, higher doses (600-1200 IU) may be required for infants at elevated risk of deficiency, including those with limited sunlight exposure, darker skin pigmentation, or residing in northern latitudes. Evidence for extra-skeletal benefits, such as immune modulation or respiratory protection, remains inconclusive. Methodological heterogeneity, differing baseline vitamin D status, and variable adherence complicate comparisons across studies.

Current evidence supports universal vitamin D supplementation during infancy to prevent deficiency and ensure skeletal health. The benefit of higher doses or supplementation beyond infancy remains uncertain. Future studies should clarify dose-response relationships, long-term safety, and potential systemic effects, while integrating population-specific determinants of deficiency into clinical and public health guidelines.