Online Survey of Vitamin D Supplementation Practices in Children and Adolescents
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Online Survey of Vitamin D Supplementation Practices in Children and Adolescents
healthy adolescents, a sample size of 196 respondents was needed with an absolute precision of 5% and 95% level of confidence. A total of 230 (140 from private sector) responses were collected over two weeks. The majority (56%) of respondents had more than ten-year experience and only 10% were pursuing pediatric residency. Most (204, 79%) respondents were aware of the national or international guidelines for vitamin D supplementation. Table I shows the vitamin D supplementation practices of these respondents across different age-groups. Eight (3.5%) reported use of a monthly 60,000 IU dose across different age groups. Overall, 182 (79%) promoted sunlight exposure and 171 (74.3%) did not measure serum 25OH-D levels before supplementation.
We collected information regarding vitamin D supplementation practices of 230 pediatricians through an online survey. Routine supplementation was being practiced during infancy, 1-5 y, 6-10 y, and >10-19 y age by 187 (81.3%), 60 (26.1%), 34 (14.8%) and 41 (17.8%) respondents, respectively. 182 (79%) participants promoted sunlight exposure, and 171 (74.3%) did not measure serum 25-hydroxy vitamin D levels before supplementation. The survey highlights that majority of pediatricians prescribe routine vitamin D supplementation during infancy, but not beyond. Keywords: Deficiency, Management, Sunlight.
The present study highlights that the practice of routine vitamin D supplementation prescription was mostly limited to infancy, with a minority practicing routine vitamin D supplementation beyond infancy in the recommended doses [4]. The recent Comprehensive National Nutrition Survey [5] reported low prevalence (14-24%) of vitamin D deficiency (serum 25OH-D 1000 IU/ day) prescribed in 42.8% children with insufficient vitamin D levels, suggestive of poor compliance to national guidelines [6].
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itamin D deficiency is considered as a significant public health problem in Indian children, which can be prevented by supplementation, fortification and dietary recommendations [1,2]. The Global Consensus for Nutritional Rickets recommends 400 IU vitamin D supplementation daily during infancy [3]. Supplementation in older children is recommended only if symptomatic vitamin D deficiency or high-risk conditions are present. The Indian Academy of Pediatrics (IAP) recommends daily supplementation of vitamin D in healthy Indian children of all ages (newborns till adolescents) to meet the recommended daily allowance of vitamin D [4]. There are no recommendations yet by the Government of India for routine vitamin D supplementation. In view of varying recommendations, we conducted this survey among pediatricians in India to assess vitamin D supplementation practices for infants and children.
The meager supplementation rates in older children in the present study probably were related to absence of felt-need for vitamin D supplementation in this age-group. The limitation of this study was that the information was self-rep
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