Nutrition Research Division, Bureau of Nutritional Sciences, Food Directorate, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada.
Office of Nutrition Policy and Promotion, Health Products and Food Branch, Health Canada, Ottawa, Ontario, Canada.
J Nutr. 2024 May;154(5):1665-1675. doi: 10.1016/j.tjnut.2024.03.016. Epub 2024 Mar 26.
In Canada, nutrition policy, as outlined in the Nutrition for Healthy Term Infants recommendations, includes a daily vitamin D supplement of 10 μg (400 IU) for breastfed infants and young children to support adequate vitamin D status.
This study aimed to report on adherence to vitamin D supplementation recommendations for breastfed infants (≤12 months); and for children breastfed >12 mo.
Canadian Community Health Survey (paired-cycles 2015/2016 and 2017/2018) maternal experiences data for infants born 2012-2018 who received any breastmilk formed the sample (n = 7079). Whether the infant was given a vitamin D supplement (yes/no) and the frequency (daily/almost every day, 1-2/wk, or <1/wk) were surveyed. Weighted data (95% CI) were summarized according to breastfeeding history (exclusive to 6 mo and continuing; partial to 6 mo and continuing; and stopped ≤6 mo). Correlates of supplement adherence were explored using logistic regression.
Overall, 87.1% (95% CI: 85.9%, 88.3%) of participants reported giving their infant (≤12 mo) a vitamin D supplement, and of these, 83.3% (95% CI: 81.9%, 84.7%) did so daily/almost every day, 12.4% (95% CI: 11.1%, 13.7%) did so 1-2/wk, and 4.3% (95% CI: 3.6%, 5.0%) did so <1/wk. Lower adjusted odds of adherence were observed among participants reporting: stopped breastfeeding ≤6 mo, lower education or income, recent immigration, and overweight prepregnancy body mass index; higher odds of adherence were observed in the western provinces. Regarding mothers of children >12 mo and breastfed (n = 2312), 58.0% (95% CI: 54.9%, 61.1%) gave a vitamin D supplement daily/almost every day.
Adherence to providing a vitamin D supplement to breastfed infants is high in Canada. Nonetheless, we estimate that ∼27% of mothers are nonadherent to daily/almost every day administration of a vitamin D supplement and that adherence declines in children breastfed >12 mo. Further promotion to support uptake of the current guidance may be necessary, particularly for parents of recent immigration or lower socioeconomic status.
在加拿大，营养政策（如《健康足月婴儿营养建议》中所述）包括为母乳喂养的婴儿和幼儿提供每日 10μg（400IU）的维生素 D 补充剂，以维持足够的维生素 D 水平。
本研究旨在报告加拿大母乳喂养的婴儿（≤12 个月）和母乳喂养超过 12 个月的儿童（≤12 个月）对维生素 D 补充剂的使用情况。
利用 2015/2016 年和 2017/2018 年加拿大社区健康调查（配对周期）中，2012-2018 年出生、接受过任何母乳的婴儿（n=7079）的母亲经历数据作为样本。调查婴儿是否接受了维生素 D 补充剂（是/否）以及补充剂的频率（每日/几乎每天、每周 1-2 次、每周少于 1 次）。根据母乳喂养史（6 个月内完全母乳喂养和继续母乳喂养、6 个月内部分母乳喂养和继续母乳喂养、6 个月内停止母乳喂养），总结了加权数据（95%置信区间）。使用逻辑回归探讨补充剂使用的相关性。
总体而言，87.1%（95%置信区间：85.9%，88.3%）的参与者报告给婴儿（≤12 个月）服用了维生素 D 补充剂，其中 83.3%（95%置信区间：81.9%，84.7%）是每日/几乎每天服用，12.4%（95%置信区间：11.1%，13.7%）是每周 1-2 次服用，4.3%（95%置信区间：3.6%，5.0%）是每周少于 1 次服用。与报告 6 个月内停止母乳喂养、教育程度或收入较低、最近移民和超重的妊娠前体重指数的参与者相比，调整后的维生素 D 补充剂使用的可能性较低；在西部省份，使用维生素 D 补充剂的可能性较高。关于 12 个月以上且母乳喂养的儿童（n=2312），58.0%（95%置信区间：54.9%，61.1%）每日/几乎每天给予维生素 D 补充剂。
加拿大为母乳喂养的婴儿提供维生素 D 补充剂的依从性较高。然而，我们估计约 27%的母亲不遵循每日/几乎每天服用维生素 D 补充剂的建议，而且在母乳喂养超过 12 个月的儿童中，这种依从性下降。可能需要进一步宣传以支持当前指南的实施，特别是对新移民或社会经济地位较低的父母。
