Vitamin D and health in pregnancy, infants, children and adolescents in Australia and New Zealand: a position statement

Med J Aust. 2013 Feb 18;198(3):142-3. doi: 10.5694/mja11.11592.

Abstract

• The recommended level for serum 25-hydroxyvitamin D (25(OH)D) in infants, children, adolescents and during pregnancy and lactation is ≥ 50 nmol/L. This level may need to be 10-20 nmol/L higher at the end of summer to maintain levels ≥ 50 nmol/L over winter and spring. • Sunlight is the most important source of vitamin D. The US recommended dietary allowance for vitamin D is 600 IU daily in children aged over 12 months and during pregnancy and lactation, assuming minimal sun exposure. • Risk factors for low vitamin D are: lack of skin exposure to sunlight, dark skin, southerly latitude, conditions affecting vitamin D metabolism and storage (including obesity) and, for infants, being born to a mother with low vitamin D and exclusive breastfeeding combined with at least one other risk factor. • Targeted measurement of 25(OH)D levels is recommended for infants, children and adolescents with at least one risk factor for low vitamin D and for pregnant women with at least one risk factor for low vitamin D at the first antenatal visit. • Vitamin D deficiency can be treated with daily low-dose vitamin D supplements, although barriers to adherence have been identified. High-dose intermittent vitamin D can be used in children and adolescents. Treatment should be paired with health education and advice about sensible sun exposure. Infants at risk of low vitamin D should be supplemented with 400 IU vitamin D₃ daily for at least the first year of life. • There is increasing evidence of an association between low vitamin D and a range of non-bone health outcomes, however there is a lack of data from robust randomised controlled trials of vitamin D supplementation.

Publication types

  • Practice Guideline

MeSH terms

  • Adolescent
  • Australia / epidemiology
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Male
  • New Zealand / epidemiology
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Complications / epidemiology
  • Pregnancy Complications / therapy
  • Vitamin D / blood*
  • Vitamin D / physiology
  • Vitamin D Deficiency / diagnosis
  • Vitamin D Deficiency / epidemiology
  • Vitamin D Deficiency / therapy
  • Vitamins / blood*
  • Vitamins / physiology

Substances

  • Vitamins
  • Vitamin D