Vitamin D supplements in infants: What is the evidence?

Abstract

Objective: To determine if there is evidence of clinical benefit for vitamin D supplementation in infants. Sources: MEDLINE data base and Evidence Based Medicine electronic sites. Review methods: A search for clinical practice guidelines, meta-analyses, systematic reviews, evidence-based reviews and clinical trials published before January 2010, in English, French, Spanish and Portuguese was performed using the MeSH terms: vitamin D and dietary supplements. The Strength of Recommendation Taxonomy scale of the American Family Physician was used to assess the quality of the studies and the strength of the recommendation. Results:We identified 340 articles, but only nine met all of our inclusion criteria. These consisted of three clinical practice guidelines, two systematic reviews, an evidence-based review, a consensus statement of two experts and one cohort study. No agreement was found regarding the need for vitamin D supplements or the recommended dose. Vitamin D supplementation with 400 IU per day for all infants who are exclusively breastfed or who ingest less than one liter of formula milk per day seems beneficial and safe. Conclusion: Currently, the most common recommendation for preventing rickets is the provision of 400 IU of vitamin D per day to infants who are exclusively breastfed, or who are fed with at least one liter of milk a day. Additional controlled, randomized, long-term high quality studies are necessary to assess the need for vitamin D supplementation in different populations.