Neonatal vitamin D supplementation: are the protocols getting ahead of the evidence?

To the Editor: We recently reviewed the individual policies of seven Australian tertiary maternity hospitals, from across all states, regarding neonatal vitamin D supplementation. An Australian 2006 consensus statement concerning the treatment and prevention of vitamin D deficiency in children and neonates identified the need to implement vitamin D supplementation in neonates born to mothers with serum 25-hydroxyvitamin D (25-OHD) levels of ≤ 50 nmol/L.1 Despite this, we found that a number of institutions have recently adopted a policy of treating infants of mothers with an antenatal serum 25-OHD level of < 75 nmol/L. Treatment of the neonate is with oral stoss therapy (50 000 IU vitamin D as a single dose) and/or daily oral vitamin D therapy (1000 IU) until cessation of breastfeeding. It should be noted that previous research has suggested that a substantial proportion of Australian women of childbearing age have a serum 25-OHD level < 75 nmol/L.2