Persistent Deficiency for 40% of Toddlers Who Were Vitamin D Deficient as Neonates, Which Cannot Be Assessed by Examining Symptoms of Rickets

Abstract

We studied a group of 74 toddlers, mean age 16 months, diagnosed with severe vitamin D deficiency at birth (cord blood <20 nmol/L 25OH vitamin D for neonates). Of 74 initially deficient toddlers, 30 did not reach sufficiency at 50 nmol/L level of serum vitamin D, suggesting persistent vitamin D deficiency over on average 16 months. Boys remained deficient more often than girls. Even in severely deficient toddlers (25OH vitamin D <30 nmol/L), no clinical evidence of symptoms of rickets, growth and development retardation, or abnormal serum calcium levels was observed.

Keywords

perinatal - vitamin D deficiency - rickets - toddlers

• References

• 1 Wielders JPM, van Dormaël PD, Eskes PF, Duk MJ. Severe vitamin-D deficiency in more than half of the immigrant pregnant women of non-Western origin and their newborns [in Dutch]. Ned Tijdschr Geneeskd 2006; 150 (9) 495-499
• 2 Wagner CL, Greer FR. American Academy of Pediatrics Section on Breastfeeding; American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics 2008; 122 (5) 1142-1152
• 3 de Minister van Volksgezondheid, Welzijn en Sport, de Staatssecretaris van Landbouw, Natuurbeheer en Visserij. Voedingsnormen Calcium, Vitamine D, Thiamine, Riboflavine, Niacine, Pantotheenzuur en Biotine. The Hague, The Netherlands: Health Council of the Netherlands; 2000. ; publication no. 2000/12. Available online at: http://www.gezondheidsraad.nl/sites/default/files/[e-mail]
• 4 Braegger C, Campoy C, Colomb V , et al; ESPGHAN Committee on Nutrition. Vitamin D in the healthy European paediatric population. J Pediatr Gastroenterol Nutr 2013; 56 (6) 692-701
• 5 Gordon CM, Feldman HA, Sinclair L , et al. Prevalence of vitamin D deficiency among healthy infants and toddlers. Arch Pediatr Adolesc Med 2008; 162 (6) 505-512
• 6 Ross AC, Manson JE, Abrams SA , et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab 2011; 96 (1) 53-58
• 7 Wharton B, Bishop N. Rickets. Lancet 2003; 362 (9393) 1389-1400
• 8 Holick MF. Resurrection of vitamin D deficiency and rickets. J Clin Invest 2006; 116 (8) 2062-2072