Department of Pediatrics, University of Washington, Seattle, Washington 98195, USA.
Pediatrics. 2010 Jan;125(1):105-11. doi: 10.1542/peds.2009-1195. Epub 2009 Nov 30.
To determine the rate of vitamin D supplementation in predominantly breastfed children. To identify patient characteristics, parental beliefs, and practitioner policies associated with supplementation.
A prospective observational study was conducted in a practice-based research network. Network pediatricians completed a survey regarding their policy on vitamin D supplementation for breastfed infants. Parents of children 6 to 24 months old completed a survey on the initial type of feeding given to the child, length of breastfeeding, formula supplementation, and use of multivitamins. Parents indicated their level of agreement with statements regarding vitamin D supplementation.
Among 44 responding pediatricians, 36.4% indicated that they recommended vitamin D supplementation for all breastfed infants. A total of 2364 surveys were completed on age-eligible children; 1140 infants were breastfed for at least 6 months with little or no formula supplementation. The rate of vitamin D use for these infants was 15.9%. Use of vitamin D was significantly associated with parental agreement that their child's pediatrician recommended supplementation (odds ratio [OR]: 7.8), and that vitamins are unnecessary because breast milk has all needed nutrition (OR: 0.12). Among parents of predominantly breastfed infants who indicated that their child's doctor recommended vitamin D, 44.6% gave the supplementation to their child. Conversely, 67% of parents agreed that breast milk has all needed nutrition, and only 3% of these parents gave vitamin D to their children.
A minority of breastfed infants received vitamin D supplementation. Educational efforts directed at both physicians and parents are needed to increase compliance with vitamin D supplementation guidelines.
确定以母乳喂养为主的儿童补充维生素 D 的比率。确定与补充相关的患者特征、父母信念和医生政策。
在一个基于实践的研究网络中进行了一项前瞻性观察研究。网络儿科医生完成了一项关于他们为母乳喂养婴儿补充维生素 D 政策的调查。6 至 24 个月大的儿童的父母完成了一份关于孩子最初喂养类型、母乳喂养时间、配方奶补充和使用多种维生素的调查。父母表示他们对有关维生素 D 补充的陈述的同意程度。
在 44 名回应的儿科医生中，36.4%表示他们建议所有母乳喂养的婴儿补充维生素 D。共有 2364 名符合年龄要求的儿童完成了调查；1140 名婴儿母乳喂养至少 6 个月，几乎没有或没有补充配方奶。这些婴儿使用维生素 D 的比率为 15.9%。使用维生素 D 与父母同意其孩子的儿科医生建议补充（优势比 [OR]：7.8）以及维生素是不必要的，因为母乳含有所有需要的营养（OR：0.12）显著相关。在表示孩子的医生建议补充维生素 D 的以母乳喂养为主的婴儿的父母中，44.6%给孩子补充了维生素 D。相反，67%的父母同意母乳含有所有需要的营养，而这些父母中只有 3%给孩子补充了维生素 D。
少数母乳喂养的婴儿接受了维生素 D 补充。需要针对医生和父母进行教育，以提高遵守维生素 D 补充指南的程度。
