Dear en-net audience.
A question has come up in the context of the Jordanian response to the Syria crisis regarding whether there is an indication for Vitamin D supplementation in breastfed infants among Syrian refugees. This is a common recommendation by Jordanian doctors, in some instances recommending infant formula use to breastfed infants to ensure adequate vitamin D intake. No specific recommendations seem to be available from WHO (due to lack of sufficient evidence). Experiences and any research in this regard, particular from this region, would be appreciated.
Dear Marie,
Breastfeeding does not offer a good protection against vitamin D deficiency. Breastfed children do need vitamin D supplementation in countries with insufficient exposure to sun due either to insufficient UV light or to cultural factors. Vitamin D deficiency was common in North Africa and the Middle East before introduction of vitamin D supplementation. I am not surprised that Jordanian doctors want to prevent vitamin D deficiency. In these countries, you can apply current European recommendations for vitamin D supplementation which is 400 IU daily for breastfed children except in France (and some Nordic countries) where it has been higher for decades (1000 to 1200 IU daily) without any adverse effect.
You can find the abstract of the reference below on the web.
Braegger C1, Campoy C, Colomb V, Decsi T, Domellof M, Fewtrell M, Hojsak I, Mihatsch W, Molgaard C, Shamir R, Turck D, van Goudoever J; ESPGHAN Committee on Nutrition. Vitamin D in the healthy European paediatric population. J Pediatr Gastroenterol Nutr. 2013 Jun;56(6):692-701. doi: 10.1097/MPG.0b013e31828f3c05.
Vidailhet M1, Mallet E, Bocquet A, Bresson JL, Briend A, Chouraqui JP, Darmaun D, Dupont C, Frelut ML, Ghisolfi J, Girardet JP, Goulet O, Hankard R, Rieu D, Simeoni U, Turck D; Comité de nutrition de la Société française de pédiatrie. Vitamin D: still a topical matter in children and adolescents. A position paper by the Committee on Nutrition of the French Society of Paediatrics. Arch Pediatr. 2012 Mar;19(3):316-28. doi: 10.1016/j.arcped.2011.12.015. Epub 2012 Jan 27.
André Briend
Technical Expert
Answered:
10 years agoDear Marie,
Related to the prevalence of vit D deficiency in the region, please see the references below of vit D deficiency in Jordan. Perhaps this will be useful reference material. Best, James
1. 2010 Jordan Micronutrient Survey Report (has vit D prevalence for woman and children) http://www.gainhealth.org/reports/national-micronutrient-survey-jordan
2. Nichols et al. 2012. Vitamin D status and determinants of deficiency among non-pregnant Jordanian women of reproductive age. http://www.ncbi.nlm.nih.gov/pubmed/22415337
James Wirth
Answered:
10 years ago