Cleghorn Shelley
Dietetic Department, Central Middlesex Hospital, London, UK.
J Hum Nutr Diet. 2006 Jun;19(3):203-8. doi: 10.1111/j.1365-277X.2006.00690.x.
Increasing numbers of children are presenting with nutritional rickets. Rickets affects mainly dark-skinned infants being breastfed for prolonged periods without vitamin supplementation. The main aim of this study was to assess health visitors' (HV) knowledge of the government guidelines for vitamin supplementation for infants and children and the advice given to mothers.
Questionnaires were sent to all HV in Brent, Harrow and Westminster Primary Care Trusts (PCT). Information received was collated and used to assess HV knowledge.
A total of 98 (69%) questionnaires were returned from HV. Seventy-nine HV (81%) recommend vitamins for the breastfed infant at 6 months or younger, 18 of which would recommend at 1 month of age. Fifty-six HV (57%) recommend vitamins until 5 years of age. Seventy-nine HV correctly identified Asians to be at risk of developing rickets. However, only 28 and 16 HV, respectively, identified Black Africans and Black Caribbeans to be at risk.
Rickets has become a national public health issue. The majority of HVs is advising vitamin supplements according to government guidelines for breastfeeding infants and the age to which children should continue vitamin supplements. However, ethnic minority groups are at increased risk of vitamin D deficiency. Consequently, greater awareness needs to be raised about the government guidelines for vitamin D supplementation for ethnic minorities to ensure all HVs are imparting consistent, correct advice to these families.
出现营养性佝偻病的儿童数量日益增多。佝偻病主要影响长期母乳喂养且未补充维生素的深色皮肤婴儿。本研究的主要目的是评估健康访视员（HV）对政府关于婴幼儿维生素补充指南的了解情况以及向母亲提供的建议。
向布伦特、哈罗和威斯敏斯特初级保健信托基金（PCT）的所有健康访视员发放问卷。对收到的信息进行整理并用于评估健康访视员的知识水平。
共收到98份（69%）健康访视员返回的问卷。79名健康访视员（81%）建议6个月及以下的母乳喂养婴儿补充维生素，其中18名会建议在1月龄时补充。56名健康访视员（57%）建议在5岁前补充维生素。79名健康访视员正确识别出亚洲人有患佝偻病的风险。然而，分别只有28名和16名健康访视员识别出非洲黑人及加勒比黑人有患佝偻病的风险。
佝偻病已成为一个全国性的公共卫生问题。大多数健康访视员正根据政府关于母乳喂养婴儿的指南以及儿童应持续补充维生素的年龄来建议补充维生素。然而，少数族裔群体维生素D缺乏的风险增加。因此，需要提高对政府针对少数族裔维生素D补充指南的认识，以确保所有健康访视员都能向这些家庭提供一致、正确的建议。
