Infections in children reduced a bit by 2,000 IU of vitamin D - meta-analysis July 2023

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High-dose oral vitamin D supplementation for prevention of infections in children aged 0 to 59 months: a systematic review and meta-analysis

Nutrition Reviews, nuad082, https://doi.org/10.1093/nutrit/nuad082
Janet Adede Carboo, Robin Claire Dolman-Macleod, Linda Malan, Martani Johanni Lombard

Context
Vitamin D plays an important role in immune function, and the deficiency thereof has been associated with several infections, most notably respiratory tract infections. However, data from intervention studies investigating the effect of high-dose vitamin D supplementation on infections have been inconclusive.

Objective
The aim of this study was to evaluate the level of evidence regarding the efficacy of vitamin D supplementation above the standard dose (400 IU) in preventing infections in apparently healthy children < 5 years of age.

Data Sources
PubMed, Scopus, Science Direct, Web of Science, Google Scholar, CINAHL, and MEDLINE electronic databases were searched between August 2022 and November 2022. Seven studies met the inclusion criteria.

Data Extraction
Meta-analyses of outcomes in more than one study were performed using Review Manager software. Heterogeneity was evaluated using the I2 statistic. Randomized controlled trials in which vitamin D was supplemented at > 400 IU compared with placebo, no treatment, or standard dose were included.

Data Analysis
Seven trials that enrolled a total of 5748 children were included. Odds ratios (ORs) with 95%CIs were calculated using random- and fixed-effects models. There was no significant effect of high-dose vitamin D supplementation on the incidence of upper respiratory tract infection (OR, 0.83; 95%CI, 0.62–1.10). There was a 57% (95%CI, 0.30–0.61), 56% (95%CI, 0.27–0.07), and 59% (95%CI, 0.26–0.65) reduction in the odds of influenza/cold, cough, and fever incidence, respectively, with daily supplementation of vitamin D > 1000 IU. No effect was found on bronchitis, otitis media, diarrhea/gastroenteritis, primary care visits for infections, hospitalizations, or mortality.

Conclusion
High-dose vitamin D supplementation provided

• no benefit in preventing upper respiratory tract infections (moderate certainty of evidence) but
• reduced the incidence influenza/cold (moderate certainty of evidence),
• cough, and fever (low certainty of evidence).

These findings are based on a limited number of trials and should be interpreted with caution. Further research is needed.
 Download the PDF from VitaminDWiki

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VitaminDWiki - 18 studies in both categories Immunity and Infant/Child

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VitaminDWiki - 25 Meta-analyses of Infant/Child

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53+ VitaminDWiki Infant/Child pages have INFECTION OR COVID OR TONSILLITIS in the title

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VitaminDWiki – Infant-Child category has 831 items and contains

• No consensus on MINIMUM International Units (IU) for healthy infant of normal weight
• 400 IU Vitamin D is no longer enough
  Was OK in the past century, but D levels have been dropping for a great many reasons.
  FDA doubles the amount of vitamin D permitted in milk – July 2016
• No consensus: range is 600 to 1600 IU – based on many randomized controlled trials
• Review of 400 IU to 2000 IU daily and higher if non-daily
• Fewer pre-infants were vitamin D deficient when they got 800 IU – RCT Feb 2014
• 1600 IU was the conclusion of three JAMA studies
     1000 IU recommended in France and Finland – 2013 - appears to be a good level
• 5X less mite allergy after add vitamin D
• Child bone fractures with low vitamin D were 55X more likely to need surgery
• 75 % of SIDS had low vitamin D
• Children stayed in ICU 3.5 days longer if low vitamin D – Dec 2015
• 5 out of 6 children who died in pediatric critical care unit had low vitamin D – May 2014
• Infants have gotten free 400 IU of vitamin D in Turkey since 2005, More for longer would be even better – Feb 2022
• Preemies should have vitamin D supplements – reaching an agreement – April 2021
• Vitamin D loading dose was as effective as daily dosing (rickets in this case) – RCT July 2021

Having a good level of vitamin D cuts in half the amount of:

• Asthma, Chronic illness, Doctor visits, Allergies, infection
  Respiratory Tract Infection, Growing pains, Bed wetting

Need even more IUs of vitamin D to get a good level if;

• Have little vitamin D: premie, twin, mother did not get much sun access
• Get little vitamin D: dark skin, little access to sun
• Vitamin D is consumed faster than normal due to sickness
• Older (need at least 100 IU/kilogram, far more if obese)
• Not get any vitamin D from formula (breast fed) or (fortified) milk
  Note – formula does not even provide 400 IU of vitamin D daily

Infants-Children need Vitamin D

• Sun is great – well known for 1,000’s of years.
  US govt (1934) even said infants should be out in the sun
• One country recommended 2,000 IU daily for decades – with no known problems
• As with adults, infants and children can have loading doses and rarely need tests
• Daily dose appears to be best, but monthly seems OK
• Vitamin D is typically given to infants in the form of drops
     big difference in taste between brands
     can also use water-soluable form of vitamin D in milk, food, juice,
• Infants have evolved to get a big boost of vitamin D immediately after birth
  Colostrum has 3X more vitamin D than breast milk - provided the mother has any vitamin D to spare
• 100 IU per kg of infant July 2011, Poland etc.
  
  More than 100 IU/kg is probably better
• 831 items in the category Infant/Child See also
• 34 pages in VitaminDWiki had BREASTFE*in title as of Jan 2022
• "BIRTH DEFECTS" 172 items as of July 2016
• Stunting OR “low birth weight” OR LBW OR preemie OR preemies OR preterm 1940 items as of Oct 2018
• 96 VitaminDWiki pages contained PRETERM or PREEMIE in title as of Aug 2021
• "SUDDEN INFANT DEATH" OR SIDS 214 items as of Dec 2020
• Overview of Rickets and Vitamin D
• Youth category listing has 174 items along with related searches
• Down syndrome and low vitamin D - several studies
• Rett syndrome associated with low vitamin D, treated by Omega-3