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correspondence

Indian Pediatr 2013;50: 1160

Vitamin D: The Emerging Superstar


There are certain issues that need to be emphasized in the recent review article on Vitamin D deficiency [1].

The authors’ recommendation of 400 IU daily to toddlers and adolescents is erroneous. The current recommendation for this group is at least 600 IU per day [2]. Commercial preparations of 1000 IU per drop have the potential for Vitamin D toxicity.

The authors also state that "Supplementation in newborn period: For infants who are exclusively breastfed a minimum daily intake of 400 IU/day should be initiated within a few days after birth. Since most of the infant formulas contain 400 IU/L, infants who are on formula feeds also need supplementation unless they consume more than 1000 mL of formula per day."

Careful scrutiny of the commercial infant formulae available in the Indian market tells us a different story. Virtually no preparation has the concentration mentioned by the authors.

M Sanklecha and S Sundaresan

Bombay Hospital Institute of Medical Sciences, Mumbai, India.
Email: [email protected]

References

1. Balasubramanian S, Dhanalakshmi K, Amperayani S. Vitamin D deficiency in childhood – A review of current guidelines on diagnosis and management. Indian Pediatr. 2013;50:669-75.

2. Shah B, Finberg L. Single-day therapy for nutritional vitamin D-deficiency rickets: a preferred method. J Pediatr. 1994;125:487–90.
 

Reply

We agree that the recommended intake above 1 year is 600 IU as per Endocrine society guidelines. This has been taken into consideration in the article wherein the maintenance dose has been recommended as 600 to 1000 IU for 1 to 18 years old. Concentrated drops are best avoided as daily supplements because of risk of toxicity due to erroneous administration. Indian infant milk formulas provide vitamin D ranging from 288 to 378 IU/L, lower than the products available abroad.

S Balasubramanian

Email: [email protected] 
 


 

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