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].

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.