Preterm infants may need 800 IU of vitamin D3 per day

May 5, 2013, American Academy of Pediatrics

Preterm infants may need to be given 800 international units (IU) of vitamin D a day to ensure they develop strong bones, according to a study to be presented Sunday, May 5, at the Pediatric Academic Societies (PAS) annual meeting in Washington, DC.

are known to be at risk for insufficiency. If levels of vitamin D are too low, infants and children can get rickets, which leads to softening and weakening of the bones.

Recommendations from medical organizations on how much vitamin D should be given to preemies range from 400 IU to 1000 IU per day. This lack of prompted researchers from All India Institute of Medical Sciences, New Delhi, to conduct the largest study to date on vitamin D supplementation in .

Subjects included 96 infants born between 28 and 34 weeks' gestation who were receiving milk feeding. were taken from the infants to determine their serum vitamin D levels. The infants then were randomly assigned to receive either 800 IU or 400 IU of oral . Neither the parents nor the primary investigator was aware of which dose the infants were receiving.

Researchers compared whether the prevalence of vitamin D insufficiency (VDI) at 40 weeks and at 3 months corrected age differed between the groups. They also looked at whether infants with higher vitamin D levels also had stronger bones at 3 months corrected age and whether supplementation led to vitamin D levels that were too high.

Results showed that VDI was common in both groups before they received (79 percent of the 800 IU group and 83 percent of the 400 IU group).

After supplementation, the prevalence of VDI at 40 weeks was 43 percent lower in the 800 IU group than the 400 IU group (38 percent vs. 67 percent). In addition, VDI was significantly lower in the 800 IU group when the infants were 3 months old (12 percent vs. 35 percent).

Four infants needed to be supplemented with 800 IU daily to reduce one case of vitamin D insufficiency, said lead author Chandra Kumar Natarajan, DM.

"The study results show conclusively that in preterm infants with high rates of vitamin D insufficiency at baseline, supplementation with 800 IU of vitamin D3 per day compared to 400 IU per day reduces vitamin D insufficiency at term equivalent age and at 3 months," Dr. Natarajan said. "There also is a trend toward a decrease in the prevalence of vitamin D insufficiency even in the 400 IU group at 3 months. Therefore, 400 IU per day may be sufficient after 3 months."

Despite significant improvement in vitamin D levels in the 800 IU group, higher levels did not result in better bone mineralization at 3 months of age as measured by dual energy X-ray absorptiometry (DEXA). In addition, weight, length and head circumference did not differ significantly between the groups.

Dr. Natarajan also noted that one infant in the 800 IU group had vitamin D levels that were higher than recommended levels at 3 months of age despite the levels at term age being normal. Excess vitamin D for at least one month can cause decreased muscle tone, decreased appetite, irritability and constipation, among other problems. The infant did not experience any major effects.

"The incidence of vitamin D excess in the 800 IU group may indicate the need for monitoring vitamin D levels in on supplementation, but we need larger studies to answer this," he said. "Similarly, larger studies with longer duration of follow-up may be needed to find out any meaningful difference in clinical outcomes such as mineralization."

Explore further: Optimal vitamin D dosage for infants uncertain

More information: To view the abstract, "Daily Vitamin D Supplementation with 800 IU vs. 400 IU in Preterm Infants: A Randomized Trial," go to www.abstracts2view.com/pas/vie … hp?nu=PAS13L1_2183.8

Related Stories

Optimal vitamin D dosage for infants uncertain

April 30, 2013
In a comparison of the effect of different dosages of vitamin D supplementation in breastfed infants, no dosage raised and maintained plasma concentrations within a range recommended by some pediatric societies. However, ...

Vitamin D supplements found to be safe for healthy pregnant women

June 28, 2011
Use of vitamin D supplements during pregnancy has long been a matter of concern but now researchers writing in the Journal of Bone and Mineral Research report that even a high supplementation amount in healthy pregnant women ...

Experts recommend screening for vitamin D deficiency in at-risk populations

June 6, 2011
Today, The Endocrine Society released "Evaluation, Treatment, and Prevention of Vitamin D Deficiency: An Endocrine Society Clinical Practice Guideline." The clinical practice guideline (CPG) is published in the July 2011 ...

Higher doses of vitamin D prevent fractures in older women

July 4, 2012
(HealthDay) -- In the latest study to look at the effect of vitamin D on fracture risk, Swiss researchers found that taking more than 800 international units (IU) of vitamin D daily could reduce the risk of hip fractures ...

USPSTF: Vitamin D, calcium supplements don't prevent fx

February 26, 2013
(HealthDay)—For non-institutionalized postmenopausal women, the U.S. Preventive Services Task Force (USPSTF) recommends against daily supplementation with ≤400 IU of vitamin D3 and ≤1,000 mg of calcium for primary prevention ...

Recommended for you

Baby brains help infants figure it out before they try it out

January 17, 2018
Babies often amaze their parents when they seemingly learn new skills overnight—how to walk, for example. But their brains were probably prepping for those tasks long before their first steps occurred, according to researchers.

NeuroNext biomarker study explores natural history of infantile-onset SMA

January 9, 2018
Research led by The Ohio State University Wexner Medical Center to define the natural history of infantile-onset spinal muscular atrophy (SMA) has been "critical" to accelerate the development of effective therapies and hasten ...

No link between childhood lead levels, later criminality

December 27, 2017
(HealthDay)— Exposure to higher levels of lead during early childhood can affect neurological development—but does that mean affected kids are doomed to delinquency?

Early puberty in girls may take mental health toll

December 26, 2017
(HealthDay)—A girl who gets her first menstrual period early in life—possibly as young as 7—has a greater risk for developing depression and antisocial behaviors that last at least into her 20s, a new study suggests.

Technology not taking over children's lives despite screen-time increase

December 21, 2017
With children spending increasing amounts of time on screen-based devices, there is a common perception that technology is taking over their lives, to the detriment and exclusion of other activities. However, new Oxford University ...

Higher blood sugar in early pregnancy raises baby's heart-defect risk

December 15, 2017
Higher blood sugar early in pregnancy raises the baby's risk of a congenital heart defect, even among mothers who do not have diabetes, according to a study led by researchers at the Stanford University School of Medicine.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.