Vitamine D voor kinderen in Vlaanderen

Abstract

Vitamin D for children in Flanders Vitamin D plays a pivotal role in calcium/phosphate homeostasis and a subsequent healthy bone metabolism. In addition, vitamin D potentially has many other functions like a role in the regulation of the immune system. Across Europe, there is consensus to supplement infants under 1 year of age with (at least) 400 IU of vitamin D. However, there is no consensus regarding vitamin D supplementation for older children (as well as the desired levels of 25-OH vitamin D). Endogenous synthesis of vitamin D in the skin takes place under the influence of UVB sunlight. Therefore, in healthy fair-skinned children who spend sufficient time outdoors, a supplement is not necessary, yet harmless. The number of children at risk of deficiency has increased. Risk factors for vitamin D deficiency are dark skin, veiling, the use of complete sun-blocking agents and spending most time indoors. A uniform and straightforward recommendation could increase compliance. Therefore, the Vitamin D working group of the Flemish Association of Pediatricians confirms the recommendation of a universal supplementation of at least 400 IU per day for all children from birth until 6 years. In children with risk factors, this daily supplementation is advised until 18 years of age (and older) and an even higher supplemental dose could be considered. Dosing of serum 25-OH vitamin D as a screening test in healthy children is not recommended. This article should be considered as a narrative review with conclusions based on expert opinion, due to the limited evidence on this topic.