Less than half of health providers recommend 600 to 1000 IU of vitamin D (age 1-18)

Vitamin D Prescribing Practices in Primary Care Pediatrics: Underpinnings From the Health Belief Model and Use of Web-Based Delphi Technique for Instrument Validity

Journal of Pediatric Health Care, online 24 May 2018, https://doi.org/10.1016/j.pedhc.2018.03.003

Nancy J. DelGiudice, DNP, RN, CPNP-PC, , Nancy Street, ScD, PPCNP-BC, Ronald J. Torchia, BS CE, MS EE, Susan S. Sawyer, PhD, RN, CPNP, Sylvia Allison Bernard, DNP, RN,

Vitamin D deficiency and insufficiency is a pandemic problem in children and adolescents in the United States. The problem may be aggravated by the inconsistent implementation of current clinical practice guidelines for vitamin D management by pediatric primary care providers. This study examines the relationship between primary care providers' prescribing vitamin D to children ages 1 through 18 years and their practice actions and knowledge. A descriptive correlation design was used. Participants were recruited from a purposive sample of pediatricians and pediatric nurse practitioners through an online invitation to participate in a survey. Reliability and validity was established for the survey developed by the principal investigator using a web-based Delphi technique.

Results from this study indicate that although most providers are aware that vitamin D insufficiency and deficiency are problems, fewer than half currently recommend 600- to 1,000-IU supplementation to their patients ages 1 through 18 years.

• Children need vitamin D - good global overview, poor recommendations for Italian children - May 2018

• Children getting 60,000 IU monthly got to vitamin D level of 33 ng – Sept 2015

  • which is about 2,000 IU daily, double of what the maximun that the survey found half to provide

• Russian children need 2,000-4,000 IU of Vitamin D to get most above 40 ng - Dec 2017

• Breastfed infant bones not helped by 800 IU of Vitamin D (not enough) – RCT Dec 2017

• Children helped by 2,000 IU of vitamin D, but not RDA amount (600 IU) – RCT Sept 2017

Infant-Child category starts with

{include}

Heavier than Children (adults)

• 2000 IU of vitamin D- doctors trained that it was too much, but it is often too little

• 6,000 IU needed for many to achieve 40 ng of Vitamin D - Feb 2017

• 1000 IU should be the new vitamin D RDA (if you think 20 ng is enough) - May 2017

• Vitamin D supplementation guidelines (adults – 50,000 IU per week) – Feb 2017

• Review of vitamin D recommendations around the world – April 2017

21 reasons why doctors are reluctant to accept Vitamin D has the following

{include}