For now, clinicians can feel comfortable in recommending a daily vitamin D dose of 400 IU for infants.
But some questions still remain.
While there are no studies suggesting that 50 nmol/L is an inadequate plasma concentration of 25(OH)D, there are also none that examine whether 75 nmol/L could be a useful goal for infants who have some special needs, Dr. Abrams noted.
"Another question that needs to be answered is whether there are non–bone health reasons to target a plasma 25(OH)D concentration greater than 75 nmol/L," he said. "Although such outcomes of vitamin D supplementation in infants might include respiratory or infectious end points in infancy, it is likely that the real potential major benefits would be long-term outcomes, such as the risk of asthma or autoimmune disorders such as type 1 diabetes mellitus."
According to the U.S. Institute of Medicine, there are not enough data for any childhood age group to recommend certain dosages of vitamin D based on bone health outcome.
"It is not likely that substantial data based on such trials will be available in the near future, but this research should be advocated and supported as key to providing true answers to these critical questions."
Dr. Steven A. Abrams is a professor of pediatrics at the Baylor College University of Medicine, and a neonatologist at Texas Children’s Hospital, both in Houston. He has financial relationships with Abbott Nutrition and Mead-Johnson Nutrition. He made these comments in an editorial accompanying Dr. Weiler’s study (JAMA 2013;309:1830-31).
