Survey on vitamin D supplementation in children in France: Evaluation of real-life practices following the new 2022 French recommendations

Arch Pediatr. 2024 Nov 19:S0929-693X(24)00189-1. doi: 10.1016/j.arcped.2024.09.006. Online ahead of print.

Abstract

Background and objective: In 2022, recommendations for vitamin D supplementation in children were updated in France. The objective of this study was to assess real-life practices of vitamin D supplementation in children following these recommendations.

Methods: A thirty-three-question questionnaire was distributed to members of the scientific societies of paediatrics and general medicine via an online platform.

Results: There were 966 respondents, of whom 87 % were paediatricians and 13 % were general practitioners. About half of the physicians (47 %) were in private practice, 49 % worked in a hospital centre and 6 % worked in a maternal and child health centre. As recommended and regardless of the professional practice, vitamin D supplementation was almost systematically prescribed in all age groups (over 90 % of respondents), in daily doses up to 2 years of age (97 % of all respondents) and then every 3 months in older children (year-round in 38 % and winter/spring only in 40 %). Contrary to the new recommendations, loading doses of 200,000 units of vitamin D were prescribed by 5 % of respondents and non-pharmaceutical forms of vitamin D (e.g. unlicensed food supplements) were prescribed by 10 % of respondents. Although risk factors such as low sun exposure and dark skin were well known by respondents (75 % and 74 % respectively), obesity and veganism were only reported by half the respondents (40 % and 53 % respectively). Two-thirds (61 %) of respondents reported assessing calcium intakes when following children; however, only 10 % of them use specific questionnaires or calcium equivalence tables. Finally, the calcium content of foods and its bioavailability appeared to be poorly understood by health professionals.

Conclusion: This survey shows that the practice of paediatricians and general practitioners are in accordance with the new recommendations for vitamin D supplementation in very young children. The identification by this survey of knowledge gaps will allow targeted information campaigns.

Keywords: Dietary intakes of calcium; Unlicensed food supplements; Vitamin D supplementation.