Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Pediatr. Mar 9, 2024; 13(1): 86693
Published online Mar 9, 2024. doi: 10.5409/wjcp.v13.i1.86693
Prevalence of vitamin D deficiency in exclusively breastfed infants at Charoenkrung Pracharak Hospital
Supawut Suksantilerd, Rotchanart Thawatchai, Nattapol Rungrojjananon
Supawut Suksantilerd, Rotchanart Thawatchai, Nattapol Rungrojjananon, Department of Pediatrics, Charoenkrung Pracharak Hospital, Bangkok 10120, Krung Thep Maha Nakhon Bangkok, Thailand
Author contributions: Suksantilerd S perform the research, analyzed and wrote the manuscript; Rungrojjananon N and Thawatchai R collected and analyzed data.
Supported by Charoenkrung Pracharak Hospital, No. S008h/63.
Institutional review board statement: The study was approved by Bangkok Metropolitan Administration Human Research Ethics Committee (S008h/63) on April 20, 2020.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: Dr. Supawut Suksantilerd has received research funding from Charoenkrung Pracharak Hospital that could have influenced the outcome of this work.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at supawut.bma@gmail.com.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Supawut Suksantilerd, MD, Assistant Professor, Department of Pediatrics, Charoenkrung Pracharak Hospital, 8 Charoenkrung road, Bagkholaem, Bangkok 10120, Krung Thep Maha Nakhon Bangkok, Thailand. supawut.bma@gmail.com
Received: August 26, 2023
Peer-review started: August 26, 2023
First decision: December 11, 2023
Revised: January 2, 2024
Accepted: February 2, 2024
Article in press: February 2, 2024
Published online: March 9, 2024
Processing time: 194 Days and 1.2 Hours
Abstract
BACKGROUND

Vitamin D deficiency is a common problem in exclusively breastfed infants, with supplementation recommended by various international medical organizations. However, in Thailand, no advice for routine vitamin D supplementation is available. Thus, this study investigated the prevalence of vitamin D deficiency and its associated factors in exclusively breastfed infants in Bangkok, Thailand.

AIM

To investigated the prevalence of vitamin D deficiency and its associated factors in exclusively breastfed infants in Bangkok, Thailand.

METHODS

This descriptive observational cross-sectional study assessed 109 4-month-old infants at Charoenkrung Pracharak Hospital from May 2020 to April 2021. The 25-OH vitamin D level of the infants was measured using an electrochemiluminescence binding assay. Vitamin D deficiency was defined as 25-OH level < 20 ng/mL, with vitamin D insufficiency 20-30 ng/mL. The sun index and maternal vitamin D supplementation data were collected and analyzed using the independent t-test, univariate logistic regression, and multivariate logistic regression to identify the associated factors.

RESULTS

The prevalences of vitamin D deficiency and vitamin D insufficiency were 35.78% and 33.03%, respectively with mean serum 25-OH vitamin D levels in these two groups 14.37 ± 3.36 and 24.44 ± 3.29 ng/mL. Multivariate logistic regression showed that the main factors associated with vitamin D status were maternal vitamin D supplementation and birth weight, with crude odds ratios 0.26 (0.08–0.82) and 0.08 (0.01–0.45), respectively. The sun index showed no correlation with the 25-OH vitamin D level in exclusively breastfed infants (r = −0.002, P = 0.984).

CONCLUSION

Two-thirds of healthy exclusively breastfed infants had hypovitaminosis D. Vitamin D supplementation prevented this condition and was recommended for both lactating women and their babies.

Keywords: Breastfeeding; Sunlight; Vitamin D deficiency; Thailand

Core Tip: Vitamin D deficiency is a common problem in exclusively breastfed infants, so vitamin D supplementation was recommended by various international organizations but it has not been established in Thailand because of the limitation of study. This study showed high prevalence of vitamin D deficiency at 35.78% in exclusively breastfed infants at Charoenkrung Pracharak Hospital and its main associated factor was maternal vitamin D supplementation while the sun index in infants showed no correlation with the 25-OH vitamin D level. So, routine Vitamin D supplementation was recommended for both lactating women and their babies to prevent vitamin D deficiency.