From The Vitamin D Council Newsletter

When we talk about T scores, osteopenia and osteoporosis, we assume we are talking about older people, especially post-menopausal women. However, a group of obstetricians and pediatricians from the University of Sienna, led by Dr. Franco Bagnoli, reported that 42% of infants have osteopenia.

Bagnoli F, Casucci M, Rossetti A, Nappini S, Cecchi S, Toti S, Franci MB. Vitamin D as a drug. J Matern Fetal Neonatal Med. 2011 Oct;24 Suppl 1:7-11

What I like was that the authors said, “To be safe, vitamin D administration should be increased to 2,000 IU/day for neonates, 5,000 IU/day for children and 10,000 IU/day for all adults.” Obstetricians are generally regarded as the one group of physicians that seldom change their mind. My hat is off to these seven obstetricians.

So many infants have craniotabes, or softening of the fontanels, it is considered normal although such infants show signs of vitamin D deficiency. That is, about a third of our infants show evidence of having low vitamin D during their development in the womb.

Yorifuji J, Yorifuji T, Tachibana K, Nagai S, Kawai M, Momoi T, Nagasaka H, Hatayama H, Nakahata T. Craniotabes in normal newborns: the earliest sign of subclinical vitamin D deficiency. J Clin Endocrinol Metab. 2008 May;93(5):1784-8.

Finally, if you look at the incidence of rickets inside the womb by ultrasound, about a third of infants have signs of intrauterine rickets (splaying or widening of the femur) during their pregnancy.

Mahon P, Harvey N, Crozier S, Inskip H, Robinson S, Arden N, Swaminathan R, Cooper C, Godfrey K; SWS Study Group. Low maternal vitamin D status and fetal bone development: cohort study.J Bone Miner Res. 2010 Jan;25(1):14-9.

Then there is the evidence that vitamin D deficiency during pregnancy is associated infection, toxemia and caesarean section, not to mention a host of diseases as the child ages, including diabetes, asthma, and infections. If you know any pregnant or breastfeeding woman, make sure she is taking at least 6,000 IU/day (10,000 IU/day is fine) and then make sure the child takes 2,000 IU/day of vitamin D when he is weaned and progressively more as he ages, until he is on 5,000 IU/day as a teenager.

However, you and I both know many people will not take supplements or give them to their children, which is why Professor Walter Willett of Harvard believes this is a public health problem that will only be solved through adequate food fortification. Also, prenatal vitamin makers could easily increase the vitamin D in their products up to 4,000 IU/day and stay within the safety guidelines of the Food and Nutrition Board. Many more foods need to be fortified, and these foods need to be foods that all subgroups of people eat in similar amounts, such as cheese and cereals. These foods need to have 400 IU per serving, not 100 IU per serving. I wish I could tell you that I think I will live to see it.

Dr John Cannell

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