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Indian Pediatr 2017;54: 513 |
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Sunlight Exposure and Vitamin D Status in
Breastfed Infant
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Tapas Bandyopadhyay
Department of Neonatology, Superspeciality Pediatric
Hospital and Postgraduate Teaching Institute, Noida, India.
Email:
[email protected]
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I read with interest the recent article by Meena, et al. [1]
published in Indian Pediatrics which concluded that there is a
significant positive correlation between afternoon sunlight exposure and
infant’s vitamin D levels, independent of maternal vitamin D status. We
appreciate that it was the first study of its kind for Indian infants,
which could estimate the duration of sun exposure required to achieve
sufficient vitamin D levels in breastfed infants at 6 months of age.
These findings are important in the present scenario given the
recommendation by American Academy of Pediatrics to supplement 200-400
IU/d of oral vitamin D to all newborns till 1 year of age.
But the prime limitation of cost of therapy in low
income countries and poor adherence rates to supplementation in both
high- and low-income countries precludes the optimization of its use in
neonates. This trial was need based and addressed a very important and
clinically relevant issue. However, we have few concerns related to the
article.
Vitamin D level were measured using radioimmunoassay
whose sensitivity is considered to be inferior as compared to tandem
mass spectrometry which is now considered to be the ‘gold standard’ for
measuring serum 25(OH)D levels. This should appear as limitation of this
study [2].
In Table II of the article, the coefficient of
determination is highest for morning sun index i.e model II (R 2=0.367)
followed by afternoon sun index i.e. model III (R2=0.354),
and least in cumulative sun index i.e. model I (R2=0.337).
Hence, according to this table, model II is superior to model I and III
– contrary to the results mentioned by the author in result and
discussion section.
References
1. Meena P, Dabas A, Shah D, Malhotra RK, Madhu SV,
Gupta P. Sunlight exposure and vitamin D status in breastfed infants.
Indian Pediatr. 2017;54:105-11.
2. Huynh J, Lu T, Liew D, Doery JC, Tudball R, Jona
M, et al. Vitamin D in newborns. A randomised controlled trial
comparing daily and single oralbolus vitamin D in infants. J Paediatr
Child Health. 2016. doi: 10.1111/jpc.13338. [Epub ahead of print]
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