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Published in: Italian Journal of Pediatrics 1/2017

Open Access 01-12-2017 | Research

How should we give vitamin D supplementation? evaluation of the pediatricians’ knowledge in Turkey

Authors: Gizem Kara Elitok, Lida Bulbul, Umut Zubarioglu, Evrim Kıray Bas, Duygu Acar, Sinan Uslu, Ali Bulbul

Published in: Italian Journal of Pediatrics | Issue 1/2017

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Abstract

Background

We aimed to determine the knowledge and attitudes of Turkish pediatricians concerning vitamin D supplement.

Methods

The study was planned cross-sectional to be carried out between April–May 2015 in Turkey. A questionnaire form that determined the participants’ opinions and practices concerning vitamin D supplement was completed via face-to-face interview.

Results

A total of 107 pediatricians (49.3%) and 110 pediatric residents (50.7%) participated in the study. Of the physicians, 85.2% recommended vitamin D supplement for all infants and children regardless of diet, 13.4% recommended for the infants which are solely breastfed. Vitamin D supplement is recommended at a dose of 400 IU/day by 88.8% of pediatricians and by 90% of pediatric residents. Of the pediatricians and pediatric residents, 72% and 68.2%, respectively commence vitamin D supplement when the newborn is 15 days old. The rates of recommending vitamin D supplement until the age of one and two years were higher among pediatricians (48.6% and 41.1%, respectively) than pediatric residents (40.9% and 32.7%, respectively). The rate of starting vitamin D supplement for fontanelle closure was significantly higher among pediatric residents (15.5%) than pediatricians (3.7%) (p = 0.002). It was determined that the rate of prescribing vitamin D supplement until fontanelle closure was higher among pediatric residents (18.2%) than pediatricians (0.9%).

Conclusions

The present study suggest that the knowledge of pediatricians about recommendation of vitamin D needs to be enhanced by education programs in addition to free vitamin D supplement provided by the Ministry of Health.
Literature
1.
go back to reference Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Drug and therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122:398–417.CrossRefPubMed Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M. Drug and therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122:398–417.CrossRefPubMed
2.
go back to reference Pludowski P, Holick MF, Pilz S, Wagner CL, Hollis BW, Grant WB, et al. Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence. Autoimmun Rev. 2013;12:976–89.CrossRefPubMed Pludowski P, Holick MF, Pilz S, Wagner CL, Hollis BW, Grant WB, et al. Vitamin D effects on musculoskeletal health, immunity, autoimmunity, cardiovascular disease, cancer, fertility, pregnancy, dementia and mortality-a review of recent evidence. Autoimmun Rev. 2013;12:976–89.CrossRefPubMed
4.
go back to reference Specker BL, Valanis B, Hertzberg V, Edwards N, Tsang RC. Sunshine exposure and serum 25-hydroxyvitamin D concentrations in exclusively breast-fed infants. J Pediatr. 1985;107:372–6.CrossRefPubMed Specker BL, Valanis B, Hertzberg V, Edwards N, Tsang RC. Sunshine exposure and serum 25-hydroxyvitamin D concentrations in exclusively breast-fed infants. J Pediatr. 1985;107:372–6.CrossRefPubMed
5.
go back to reference Holick MF. Vitamin D. In: Shills ME, Olson JA, Shike M, Ross CA, editors. Modern nutrition in health and disease. 9nd ed. Baltimore: Williams& Williams; 1999. p. 329–45. Holick MF. Vitamin D. In: Shills ME, Olson JA, Shike M, Ross CA, editors. Modern nutrition in health and disease. 9nd ed. Baltimore: Williams& Williams; 1999. p. 329–45.
6.
go back to reference Hatun S, Ozkan B, Orbak Z, Doneray H, Cizmecioglu F, Toprak D, et al. Vitamin D deficiency in early infancy. J Nutr. 2005;135:279–82.PubMed Hatun S, Ozkan B, Orbak Z, Doneray H, Cizmecioglu F, Toprak D, et al. Vitamin D deficiency in early infancy. J Nutr. 2005;135:279–82.PubMed
7.
go back to reference Kreiter SR, Schwartz RP, Kirkman HN Jr, Charlton PA, Calikoğlu AS, Davenport ML. Nutritional rickets in African American breast-fed infants. J Pediatri. 2000;137:153–7.CrossRef Kreiter SR, Schwartz RP, Kirkman HN Jr, Charlton PA, Calikoğlu AS, Davenport ML. Nutritional rickets in African American breast-fed infants. J Pediatri. 2000;137:153–7.CrossRef
9.
go back to reference Hatun Ş, Özkan B, Bereket A. Vitamin D deficieny and prevention: Turkish experience. Acta Paediatr. 2011;100:1195–9.CrossRefPubMed Hatun Ş, Özkan B, Bereket A. Vitamin D deficieny and prevention: Turkish experience. Acta Paediatr. 2011;100:1195–9.CrossRefPubMed
10.
go back to reference Hatun Ş, Bereket B, Çalıkoğlu AS, Özkan B. Günümüzde D vitamini yetersizliği ve nutrisyonel rikets. Çocuk Sağlığı ve Hastalıkları Dergisi. 2003;46:224–41. Hatun Ş, Bereket B, Çalıkoğlu AS, Özkan B. Günümüzde D vitamini yetersizliği ve nutrisyonel rikets. Çocuk Sağlığı ve Hastalıkları Dergisi. 2003;46:224–41.
11.
go back to reference Özkan B, Büyükavcı M, Aksoy H, Tan H, Akdağ R. Incıdence of rickets among 0 to 3 year old children in Erzurum. Çocuk Sağlığı ve Hastalıkları Dergisi. 1999;42:389–96. Özkan B, Büyükavcı M, Aksoy H, Tan H, Akdağ R. Incıdence of rickets among 0 to 3 year old children in Erzurum. Çocuk Sağlığı ve Hastalıkları Dergisi. 1999;42:389–96.
12.
go back to reference Tezer H, Şıklar Z, Dallar Y, Doğankoç Ş. Early and severe presentation of vitamin D deficiency and nutritional rickets among hospitalized infants and the effective factors. Turk J Pediatr. 2009;51:110–5.PubMed Tezer H, Şıklar Z, Dallar Y, Doğankoç Ş. Early and severe presentation of vitamin D deficiency and nutritional rickets among hospitalized infants and the effective factors. Turk J Pediatr. 2009;51:110–5.PubMed
13.
go back to reference Ozkan B, Doneray H, Karacan M, Vançelik S, Yildirim ZK, Ozkan A, et al. Prevalence of vitamin D deficiency rickets in the eastern part of Turkey. Eur J Pediatr. 2009;168:95–100.CrossRefPubMed Ozkan B, Doneray H, Karacan M, Vançelik S, Yildirim ZK, Ozkan A, et al. Prevalence of vitamin D deficiency rickets in the eastern part of Turkey. Eur J Pediatr. 2009;168:95–100.CrossRefPubMed
14.
go back to reference Türkiye’de 6–17 Aylık Çocuklarda ve Annelerinde Hemoglobin Ferritin D -Vitamini Düzeyi ve Demir Eksikliği Anemisi Durum Belirleme Yürütülen Programların Değerlendirilmesi Araştırması. Ankara: Sağlık Bakanlığı Yayınları, 2011:79–88. Türkiye’de 6–17 Aylık Çocuklarda ve Annelerinde Hemoglobin Ferritin D -Vitamini Düzeyi ve Demir Eksikliği Anemisi Durum Belirleme Yürütülen Programların Değerlendirilmesi Araştırması. Ankara: Sağlık Bakanlığı Yayınları, 2011:79–88.
15.
go back to reference Carol L. Wagner and frank R. Greer. Prevention of rickets and vitamin D deficiency in İnfants, children and adolescents. Pediatrics. 2008;122:1142–52.CrossRef Carol L. Wagner and frank R. Greer. Prevention of rickets and vitamin D deficiency in İnfants, children and adolescents. Pediatrics. 2008;122:1142–52.CrossRef
16.
go back to reference Perrine CG, Sharma AJ, Jefferds ME, Serdula MK, Scanlon KS. Adherence to vitamin D recommendations among US infants. Pediatrics. 2010;125:627–32.CrossRefPubMed Perrine CG, Sharma AJ, Jefferds ME, Serdula MK, Scanlon KS. Adherence to vitamin D recommendations among US infants. Pediatrics. 2010;125:627–32.CrossRefPubMed
17.
go back to reference Toprak GD, Hatun Ş. D Vitamini Yetersizliği ve D Vitamini Desteği Konusunda Pratisyen Hekimlerin Tutumları. Sürekli Tıp Eğitimi Dergisi. 2004;13:16–8. Toprak GD, Hatun Ş. D Vitamini Yetersizliği ve D Vitamini Desteği Konusunda Pratisyen Hekimlerin Tutumları. Sürekli Tıp Eğitimi Dergisi. 2004;13:16–8.
18.
go back to reference Pehlivan İ, Toprak DG, Hatun Ş. Ülkemizdeki Çocuk Hekimlerinin D Vitamini Desteği ve Raşitizm Konusundaki Tutumları. Çocuk Dergisi. 2004;4:42–5. Pehlivan İ, Toprak DG, Hatun Ş. Ülkemizdeki Çocuk Hekimlerinin D Vitamini Desteği ve Raşitizm Konusundaki Tutumları. Çocuk Dergisi. 2004;4:42–5.
19.
go back to reference Garcia-Careaga M, Kerner JA. Evaluation of children with suspected intestinal malabsorption. In: Behrman RE, Kliegmen RM, Jenson HB, editors. Nelson textbook of pediatrics. 17.Th ed. Philadelphia: Saunders; 2003. p. 1257–72. Garcia-Careaga M, Kerner JA. Evaluation of children with suspected intestinal malabsorption. In: Behrman RE, Kliegmen RM, Jenson HB, editors. Nelson textbook of pediatrics. 17.Th ed. Philadelphia: Saunders; 2003. p. 1257–72.
20.
go back to reference Bouillon R. Comparative analysis of nutritional guidelines for vitamin D. Nat Rev Endocrinol. 2017 Aug;13(8):466–79. Epub 2017 Apr 7 Bouillon R. Comparative analysis of nutritional guidelines for vitamin D. Nat Rev Endocrinol. 2017 Aug;13(8):466–79. Epub 2017 Apr 7
21.
go back to reference Dietary Reference Intakes for Calcium and Vitamin D. Committe to review dietary reference intakes for vitamin D and calcium, food and nutrition board. Catharine Ross A, Taylor CL, Yaktine AL, editors. Washington DC: The National Academies Press; 2011. p. 362–402. Dietary Reference Intakes for Calcium and Vitamin D. Committe to review dietary reference intakes for vitamin D and calcium, food and nutrition board. Catharine Ross A, Taylor CL, Yaktine AL, editors. Washington DC: The National Academies Press; 2011. p. 362–402.
22.
go back to reference Ergür AT, Berberoğlu M, Atasay B, Şıklar Z, Bilir P, Arsan S, et al. Vitamin D deficiency in Turkish mothers and their neonates and in women of reproductive age. J Clin Res Pediatr Endocrinol. 2009;1:266–9.CrossRefPubMed Ergür AT, Berberoğlu M, Atasay B, Şıklar Z, Bilir P, Arsan S, et al. Vitamin D deficiency in Turkish mothers and their neonates and in women of reproductive age. J Clin Res Pediatr Endocrinol. 2009;1:266–9.CrossRefPubMed
23.
go back to reference Alp H, Tekgündüz KŞ, Akkar MK. Maternal and cord blood vitamin D status in high-altitude pregnancy. J Matern Fetal Neonatal Med. 2016;29:571–5.CrossRefPubMed Alp H, Tekgündüz KŞ, Akkar MK. Maternal and cord blood vitamin D status in high-altitude pregnancy. J Matern Fetal Neonatal Med. 2016;29:571–5.CrossRefPubMed
24.
go back to reference Gür G, Abaci A, Köksoy AY, Anik A, Catli G, Kişlal FM, et al. Incidence of maternal vitamin D deficiency in a region of Ankara, Turkey: a preliminary study. Turk J Med Sci. 2014;44:616–23.CrossRefPubMed Gür G, Abaci A, Köksoy AY, Anik A, Catli G, Kişlal FM, et al. Incidence of maternal vitamin D deficiency in a region of Ankara, Turkey: a preliminary study. Turk J Med Sci. 2014;44:616–23.CrossRefPubMed
25.
go back to reference Andıran N, Yordam N, Özön A. The risk factors for vitamin D deficiency in breastfed newborns and their mothers. Nutrition. 2002;18:47–50.CrossRefPubMed Andıran N, Yordam N, Özön A. The risk factors for vitamin D deficiency in breastfed newborns and their mothers. Nutrition. 2002;18:47–50.CrossRefPubMed
26.
go back to reference Mutlu EC, Akın L, Akın MA, Kardaş F, Tuna İS, Alan S, et al. Closed fontanel due to wormian borne: case report. Erciyes Med J. 2011;33:65–8. Mutlu EC, Akın L, Akın MA, Kardaş F, Tuna İS, Alan S, et al. Closed fontanel due to wormian borne: case report. Erciyes Med J. 2011;33:65–8.
28.
go back to reference Özer S, Kazancı NÖ, Karaaslan N, Yılmaz R. Fontanel değerlendirmesi. Pediatr Practice Res. 2013;1:4–9. Özer S, Kazancı NÖ, Karaaslan N, Yılmaz R. Fontanel değerlendirmesi. Pediatr Practice Res. 2013;1:4–9.
29.
go back to reference Halicioglu O, Sutcuoglu S, Koc F, Yildiz O, Akman SA, Aksit S, Vitamin D. Status of exclusively breastfed 4-month-old infants supplemented during different seasons. Pediatrics. 2012;130:921–7.CrossRef Halicioglu O, Sutcuoglu S, Koc F, Yildiz O, Akman SA, Aksit S, Vitamin D. Status of exclusively breastfed 4-month-old infants supplemented during different seasons. Pediatrics. 2012;130:921–7.CrossRef
30.
go back to reference Gross ML, Tenenbein M, Sellers EA. Severe vitamin D deficiency in 6 Canadian first nation formula-fed infants. Int J Circumpolar Health. 2013;72:20244.CrossRefPubMed Gross ML, Tenenbein M, Sellers EA. Severe vitamin D deficiency in 6 Canadian first nation formula-fed infants. Int J Circumpolar Health. 2013;72:20244.CrossRefPubMed
31.
go back to reference John C. Godel, Canadian Paediatric society first nations, Inuit and Métis health committee. Vitamin D supplementation: recommendations for Canadian mothers and infants. Paediatr Child Health. 2007;12:583–9. John C. Godel, Canadian Paediatric society first nations, Inuit and Métis health committee. Vitamin D supplementation: recommendations for Canadian mothers and infants. Paediatr Child Health. 2007;12:583–9.
32.
go back to reference Yeşiltepe Mutlu G, Kusdal Y, Ozsu E, Cizmecioglu FM, Hatun S. Prevention of vitamin D deficiency in infancy: daily 400 IU vitamin D is sufficient. Int J Pediatr Endocrinol. 2011;2011:4.CrossRef Yeşiltepe Mutlu G, Kusdal Y, Ozsu E, Cizmecioglu FM, Hatun S. Prevention of vitamin D deficiency in infancy: daily 400 IU vitamin D is sufficient. Int J Pediatr Endocrinol. 2011;2011:4.CrossRef
Metadata
Title
How should we give vitamin D supplementation? evaluation of the pediatricians’ knowledge in Turkey
Authors
Gizem Kara Elitok
Lida Bulbul
Umut Zubarioglu
Evrim Kıray Bas
Duygu Acar
Sinan Uslu
Ali Bulbul
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Italian Journal of Pediatrics / Issue 1/2017
Electronic ISSN: 1824-7288
DOI
https://doi.org/10.1186/s13052-017-0415-3

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