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If a mother was identified as at risk and treated for vitamin D deficiency in early pregnancy, the infant should be commenced on a vitamin D supplement (at least 400 IU/d), regardless of subsequent maternal levels. There is currently no consensus on the most effective and safest regimen and until this is studied further, a conservative approach is recommended.There are many stoss regimens with doses ranging from 100,000 to 600,000 units given as single or divided doses.High-dose vitamin D therapy (Stoss therapy) can be considered in patients with poor compliance, recalcitrant vitamin D deficiency or vitamin D deficient rickets.Stoss therapy (high-dose vitamin D therapy) Vitamin D supplementation is not required in infants that are fully formula fed. The supplement is commenced as soon as tolerating feeds after birth and continued for the first 12 months of life.

Note: Do not use Pentavite with Iron, as this contains about 1/20th the amount of vitamin D per millilitre. This dose is a physiological dose and the potential for hypervitaminosis D is negligible.

Pentavite (0.45 mL daily - equivalent to 400 units cholecalciferol/dose).

OsteVit-D (0.1 mL daily - equivalent to 500 units cholecalciferol/dose), or.

Preparations for vitamin D supplementation

other osseous signs (such as rickets) are not seen in the newborn but classical signs in the older infant include broadening of the metaphyses, bowing of the long bones once weight bearing and the rachitic rosary (prominent chostochondral joints).

Signs of vitamin D deficiency in newborns If a pregnant woman is vitamin D deficient, a vitamin D supplement in addition to the standard pregnancy multivitamin preparation will therefore be required. Note: Most pregnancy and BF multivitamins do not contain 1,000 units/dose for example, Elevit and Blackmore's pregnancy and BF Gold both contain only 500 units/day of cholecalciferol when taken at the recommended dose. A maternal dose of at least 1,000 U/d of cholecalciferol should be adequate for mild deficiency, but a higher dose will be appropriate for women with moderate to severe deficiency.

The normal adult concentration is > 50 nmol/L, although several sources use > 75 nmol/L for pregnant women.ĭepending on the vitamin D level, supplementation should be commenced and continued throughout pregnancy and lactation.

Serum 25-OHD concentration is the best indicator of vitamin D status.

limited sunlight exposure: cold climate, short winter days, indoor occupation, need for protective clothing.ĭiagnosis of vitamin D deficiency in the mother.

women who spend a lot of time indoors and who 'cover up'.

dark-skinned women, including Asian women.

Risk factors for maternal vitamin D deficiency include:

We recommend that you also refer to more contemporaneous evidence in the interim. Please note that all guidance is currently under review and some may be out of date.