Prevalence of vitamin D deficiency among healthy infants and toddlers

Arch Pediatr Adolesc Med. 2008 Jun;162(6):505-12. doi: 10.1001/archpedi.162.6.505.


Objectives: To determine the prevalence of vitamin D deficiency and to examine whether 25-hydroxyvitamin D (25OHD) concentration varies as a function of skin pigmentation, season, sun exposure, breastfeeding, and vitamin D supplementation.

Design: Cross-sectional sample.

Setting: Urban primary care clinic.

Participants: Healthy infants and toddlers (N = 380) who were seen for a routine health visit.

Outcome measures: Primary outcomes were serum 25OHD and parathyroid hormone levels; secondary measures included data on sun exposure, nutrition, skin pigmentation, and parental health habits. Wrist and knee radiographs were obtained for vitamin D-deficient participants.

Results: The prevalence of vitamin D deficiency (< or =20 ng/mL) was 12.1% (44 of 365 participants), and 146 participants (40.0%) had levels below an accepted optimal threshold (< or =30 ng/mL). The prevalence did not vary between infants and toddlers or by skin pigmentation. There was an inverse correlation between serum 25OHD and parathyroid hormone levels (infants: r = -0.27, P < .001; toddlers: r = -0.20, P = .02). In multivariable models, breastfeeding without supplementation among infants and lower milk intake among toddlers were significant predictors of vitamin D deficiency. In vitamin D-deficient participants, 3 participants (7.5%) exhibited rachitic changes on radiographs, whereas 13 (32.5%) had evidence of demineralization.

Conclusions: Suboptimal vitamin D status is common among otherwise healthy young children. Predictors of vitamin D status vary in infants vs toddlers, information that is important to consider in the care of these young patients. One-third of vitamin D-deficient participants exhibited demineralization, highlighting the deleterious skeletal effects of this condition.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Child Welfare / statistics & numerical data*
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant Welfare / statistics & numerical data*
  • Infant, Newborn
  • Knee / diagnostic imaging
  • Life Style
  • Male
  • Nutritional Status
  • Prevalence
  • Primary Health Care*
  • Radiography
  • Risk Factors
  • Surveys and Questionnaires
  • United States / epidemiology
  • Urban Population / statistics & numerical data*
  • Vitamin D / analogs & derivatives
  • Vitamin D / blood
  • Vitamin D Deficiency / blood
  • Vitamin D Deficiency / epidemiology*
  • Wrist / diagnostic imaging


  • Vitamin D
  • 25-hydroxyvitamin D