Summary: According to a new study, only 1 in 3 infants enrolled in the governmentâs WIC program receive the recommended daily dose of vitamin D. Vitamin D deficiency plays a role in a number of disorders, including rickets, multiple sclerosis and diabetes type 2.
Source: University of Georgia
Most infants enrolled in the Special Supplemental Nutrition Program for Women, Infants and Children, also known as WIC, are likely not getting the recommended daily amount of vitamin D, according to a new study from the University of Georgia.
The researchers found that only about one in three infants enrolled in the WIC met the daily recommendation by age 13 months. But that shouldnât be surprising, given the low rate of childhood supplementation in the general US population.
Vitamin D deficiency can lead to rickets, a disease that softens and weakens bones, potentially leading to broken bones, stunted growth and skeletal deformities.
Recent research has also shown that the vitamin may play a role in diseases such as multiple sclerosis and type 1 diabetes.
Experts recommend that infants get 10 micrograms, or 400 international units, of vitamin D each day. Posted in the Journal of Nutrition Education and Behaviorthe study analyzed data collected from more than 2,300 infants participating in WIC during the first year of life.
To meet this recommendation, most breastfed infants need a vitamin D supplement because the amount in breast milk is low. The formula is fortified with vitamin D, so the American Academy of Pediatrics specifically recommends supplementation for breastfed babies. But infants need to drink about 32 ounces or a liter of formula a day to reach this recommended amount, which is difficult in the first few months of life when babies arenât eating much.
According to the study, only 6-12% of infants enrolled in WIC received a vitamin D supplement in their first year of life. And less than half of formula-fed infants and only 7% of breastfed infants who did not receive a vitamin D supplement met the recommendation at some point in their first year of life.
âThere is a critical need for adequate amounts of vitamin D, especially during infancy and childhood when children are building up their bone mass,â said Sina Gallo, lead study author and associate professor at the College of family and consumer sciences.
âVitamin D supplementation should be synonymous with breastfeeding. Whether you are exclusively or partially breastfeeding, infants will need vitamin D supplementation to meet their needs. This study also suggests that exclusively formula-fed infants may need additional vitamin D. »
Lack of education, cost may affect vitamin D supplementation rates
Experts have been recommending vitamin D supplements for breastfed babies for decades. The American Academy of Pediatrics increased its recommendation from 200 IU to the current standard in 2008.
But Gallo said parents are likely not getting information from their healthcare providers. Recent studies have shown that only 36% of health care providers counsel their patients about vitamin D deficiency and supplementation.
âParents may not know itâs a problem, and we know their doctors donât routinely tell them to take supplements,â Gallo said.
âWhen I conducted a study like this in Canada, we found that about 75% of infants received vitamin D supplements. In the United States, itâs less than 30% nationally. But I think itâs something we need to look at: why is there such low uptake of the recommendation in the United States? »
Another hurdle for low-income mothers: WIC does not cover supplemental vitamin D drops, which are available for purchase over the counter at most pharmacies. But Medicaid does if the drops are prescribed by a health care provider.
âI think a lot of people donât realize the drops are a Medicaid-approved drug,â Gallo said. âAnd paying for the drops out of pocket can be a significant cost to families, especially if they have lower incomes.â
An integrated approach to nutrition education could benefit infants, mothers
Education about the importance of vitamin D supplements is key, Gallo said. But it will take an integrated approach with healthcare providers, WIC resources and nutrition experts to get the message out.
âOnce someone gives birth in the hospital, that may be when a prescription for supplements should be kept for the infant,â Gallo said. âThen, after they are discharged, their pediatrician follows them to see if they have received the vitamin D supplement. And when they go to the WIC clinic, they are informed about the importance of a supplement, the types of supplements available and how to give it to their baby.
The study was co-authored by Yu Wang, PhD student in the Department of Statistics; Xianyan Chen, associate director of the UGA Statistical Advisory Center at Franklin College; and Janani Rajbhandari-Thapa, associate professor in the College of Public Health.
Additional co-authors include Jaime Gahche of the National Institutes of Health Office of Dietary Supplements and Panagiota Kitsantas and Priyal Makwana of George Mason University.
About this vitamin d deficiency research news
Author: Cole Sosebee
Source: University of Georgia
Contact: Cole Sosebee â University of Georgia
Picture: Image is in public domain
Original research: Access closed.
âVitamin D intake and meeting recommendations among infants participating in WIC nationwideâ by Sina Gallo et al. Journal of Nutrition Education and Behavior
Abstract
See also
Vitamin D intake and compliance recommendations among infants participating in WIC nationwide
Goal
To report and examine associations with infant vitamin D intake and adherence to recommendations among a national sample participating in Special supplementary nutrition program for women, infants and children (WIC).
Design
Secondary analysis of the WIC Toddler Feeding Practices Study 2013-2015-2.
Speakers
American infants.
Variables measured
Reported total vitamin D intake from diet and supplementation at the time of data collection.
Analysis
Descriptive statistics and generalized estimating equations.
Results
Median total vitamin D intake ranged from 5.43 (95% confidence interval, 5.40 to 5.46) mcg/d at month 1 to 8.18 (95% confidence interval, 8.11 to 8.20) mcg/d at month 13, with 16% to 36% of infants meeting the infant vitamin D recommendation during this period. Overall, 6% to 12% of all participants reported taking supplements at all times.
Although most (between 78% and 98%) of breastfed infants met the recommendation, very few received group supplementation. Therefore, breastfed infants were less likely to meet the recommendation than infants who were formula fed at specific times except month 1 (P
While infant age, feeding type, and/or their interaction were significant predictors of supplementation receipt and adherence to the recommendation, mother/caregiver birth (P = 0.006) and parity (P = 0.01 and P PP
Conclusions and implications
Among a national sample of infants participating in the WIC between 2013 and 2015, a high proportion did not meet the current vitamin D recommendation. The WIC program is a resource to promote strategies to increase the number of U.S. infants meeting the recommendations D, but a coordinated approach involving other health care providers is probably needed.
Future research exploring the reason for the lack of supplementation, both from the perspective of parents and providers and the clinical impact of low vitamin D intake, is warranted.
