Impact of vitamin D supplementation on gross motor development of healthy term infants: a randomized dose-response trial.
Reviewed by: Alan Gaby, MD
Author: Wicklow B, et al
Reference: Impact of vitamin D supplementation on gross motor development of healthy term infants: a randomized dose-response trial. Phys Occup Ther Pediatr 2016;36:300-342.
Design: Randomized, double-blind, placebo-controlled trial.
Participants: Fifty-five healthy, term breastfed infants in Montreal, Canada.
Study Medication and Dosage: Vitamin D3 at a dosage of 400, 800, or 1,200 IU per day, starting at 1 month of age and continuing until 12 months of age.
Primary Outcome Measure: Motor performance at 3 and 6 months of age, as assessed by the Alberta Infant Motor Scale (AIMS).
Key Findings: AIMS scores did not differ at 3 months. However, total AIMS scores and sitting sub-scores were significantly higher (better) at 6 months in infants receiving 400 IU per day of vitamin D than in those receiving 800 and 1,200 IU per day (p < 0.05).
Practice Implications: Breast milk usually contains inadequate amounts of vitamin D to meet the needs of the infant, even when the mother is taking a moderate dose of supplemental vitamin D. For that reason, the American Academy of Pediatrics recommends that all breastfed infants, regardless of whether they are being supplemented with formula, receive 400 IU per day of vitamin D, beginning within the first few days of life and continuing for the duration of breastfeeding. That dose of vitamin D has a long history of safe use in infants and children, and has been associated with improved bone mineral status. However, the results of the present study suggest that doses greater than 400 IU per day may be undesirable for infants. In this study, dosages of 800 or 1,200 IU per day, as compared with 400 IU per day, were associated with subtle impairments in motor development.