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

Prevalence of Vitamin D Deficiency Among Healthy Infants and Toddlers

Free PMC article

Prevalence of Vitamin D Deficiency Among Healthy Infants and Toddlers

Catherine M Gordon et al. Arch Pediatr Adolesc Med. .
Free PMC article


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.


Nutritional factors associated with serum levels of 25-hydroxyvitamin D (25OHD) in 247 infants at their 9-month visit to a primary care clinic (A) and 133 toddlers at their 18-month visit (B). Bars indicate mean and standard error of the mean. D Suppl indicates vitamin D supplementation. To convert 25OHD to nanomoles per liter, multiply by 2.496.

Comment in

  • Defining vitamin D deficiency in infants and toddlers.
    Taylor JA. Taylor JA. Arch Pediatr Adolesc Med. 2008 Jun;162(6):583-4. doi: 10.1001/archpedi.162.6.583. Arch Pediatr Adolesc Med. 2008. PMID: 18524751 No abstract available.
  • Vitamin D and rickets beyond America.
    Fischer PR, Thacher TD, Pettifor JM. Fischer PR, et al. Arch Pediatr Adolesc Med. 2008 Dec;162(12):1193; author reply 1194. doi: 10.1001/archpedi.162.12.1193. Arch Pediatr Adolesc Med. 2008. PMID: 19047550 No abstract available.

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