Vitamin D deficiency prevalence among healthy term infants at the age of 4–6 months: A cross-sectional observational study from tertiary care hospital setting

Abstract

itamin D has harnessed vast attention in medical research as well as clinical practice for the past few decades [1][2][3]. Role of Vitamin D has indeed expanded from bone health to a myriad of physiological as well as pathological conditions in humans. Classic childhood signature statement of Vitamin D deficiency (VDD) is a disorder called rickets which disproportionately targets growing bones [4][5][6][7]. Vitamin D deficiency with a resurgence of rickets is increasingly being reported in infants and toddlers from various parts of the world, especially from temperate regions and among African-American and Indian children [2][3][4][5]. A series of studies from different parts of our country have also pointed towards widespread VDD in Asian Indians of all age groups including neonates, toddlers, schoolchildren, pregnant women, and adults [8][9][10][11]. Most studies published from India showing wide ranging VDD (75-90%) had mainly focused on pregnant women, newborn babies, schoolchildren, and adolescents [12][13][14].Although Indian Academy of Pediatrics "Guideline for Vitamin D and Calcium in Children" Committee has recommended daily Vitamin D supplementation of 400 IU for infants beyond neonatal period [15], studies evaluating Vitamin D levels of infants before the initiation of complementary feeding are limited [16]. In a study by Seth et al., Vitamin D levels of exclusively breastfed infants and their mothers (n=180) were studied, but the age of the group of 4-6 months infants was less than one-fourth of the total study cohort and they did not study infants on breast milk substitutes [16]. In this backdrop, our study aimed to estimate prevalence of Vitamin D deficiency in healthy infants at 4-6 months of age (a period immediately before initiation of complementary feeding) attending tertiary care center for routine OPD consultations. In addition, we explored the demographic, anthropometric, and feeding related factors associated with Vitamin D deficiency in these young infants. MATERIALS AND METHODSWe carried out a cross-sectional survey in pediatric outpatient department of a tertiary care North Indian hospital between April