The Goldilocks Dose of D for Preemies

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Vitamin D supplements for preemies may be best at 800 IU dosage

May 4, 2013 / Author:  / Reviewed by: Robert Carlson, M.D

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(dailyRx News) Preemies are at higher risk for various health problems, depending on how early they are born. One possible health risk is insufficient vitamin D levels.

Getting too little vitamin D can cause a condition called rickets. Rickets involves softened or weakened bones.

A recent study found that an appropriate dosage of vitamin D may be 800 IU rather than the 400 IU recommended by some medical groups.

"Ask your pediatrician about vitamin D supplements."

The study, led by Chandra Kumar Natarajan, DM, of the Division of Neonatology at the All India Institute of Medical Sciences in New Delhi, India, aimed to determine the best dose of vitamin D supplements for preemies.

The researchers divided 87 breastfed newborns into two groups. The newborns had all been born early, between 28 and 34 weeks of pregnancy.

One group received 800 IU of oral vitamin D each day, and the other group received 400 IU of oral vitamin D each day.

At the start of the study, 79 percent of the babies in the 800 IU group had insufficient vitamin D levels, and 83 percent of the babies in the 400 IU group had insufficient vitamin D levels.

Then, the researchers measured the levels of vitamin D in the babies' blood during the week that would have been the 40th week of pregnancy if the babies had been born at term.

In the group receiving 800 IU daily, 16 babies (38 percent) were found to have insufficient vitamin D levels at what would have been the 40th week of pregnancy.

In the group receiving 400 IU daily, 30 of the babies (67 percent) had insufficient vitamin D levels at the 40-week point.

The researchers measured the babies' vitamin D levels again when the babies would have been 3 months old, had they been born at full term. This measure is called the 3-month corrected age.

At the 3-month corrected age, 5 of the babies (12 percent) in the 800 IU group had insufficient vitamin D levels.

In the 400 IU group, 14 of the babies (35 percent) had insufficient vitamin D levels, and one baby had an excess of vitamin D (between 100 and 150 ng/mL).

Having too much vitamin D can decrease a child's appetite and muscle tone and can cause constipation and irritability, but Dr. Natarajan noted in a press statement that the baby did not experience negative effects.

When the researchers measured the babies' bone mineral density and bone mineral content, they did not find any major differences among the babies in each group.

There were also no major differences in the babies' weight, length and head circumference across both groups.

Overall, the researchers concluded that 800 IU appears to be the more appropriate dose to reduce vitamin D insufficiency in preterm babies.

However, the babies should be monitored to ensure they do not develop an excess of vitamin D. After 3-months corrected age, the babies could probably receive only 400 IU, Dr. Natarajan said in the prepared statement.

These research findings are preliminary. It was presented at a conference and has not yet been published in a peer-reviewed journal.

The research was presented May 5 at the Pediatric Academic Societies annual meeting in Washington, D.C. Information regarding funding and disclosures were unavailable.