Vitamin D supplementation in the healthy pediatric population

Objective

To review the current scientific evidence on the efficacy of universal vitamin D supplementation in healthy children with no risk factors and to propose updated modifications to the recommendations provided in the main clinical practice guidelines.

Methods

Scoping review through a literature search conducted in PubMed for articles published in English or Spanish in the past 15 years using the following MeSH search terms: (vitamin D) AND (supplementation). The search yielded 2133 articles, of which 22 were selected.

Results

In infants aged less than 1 year without risk factors, administration of 400 IU/day improves serum levels of calcifediol, but most studies have not found an association with improved bone health assessed by dual-energy X-ray absorptiometry. In children aged more than 1 year with calcifediol levels of less than 35 ng/mL, supplementation with 400 to 800 IU/day of vitamin D decreases the risk of respiratory infection. There is still no evidence in the pediatric population that vitamin D supplementation either decreases the risk or severity of other infections or offers any other clinically significant extraskeletal benefits.

Conclusion

Based on the main clinical practice guidelines, supplementation with vitamin D at a dose of 400 IU/day is recommended for breastfed infants aged less than 1 year or infants who do not achieve the recommended daily intake through infant formula. In children aged more than 1 year, supplementation should be individualized.