Prescription of vitamin D among Swiss pediatricians

Abstract

The traditional recommendation that Swiss children receive vitamin D during the first year of life was recently extended to the second and third year of life and during winter for older children. The aim of the study was to identify how Swiss pediatricians prescribe vitamin D. Between December 2016 and March 2017, 795 (52%) of 1530 invited Swiss board-certified pediatricians answered a closed-ended questionnaire. Respondents routinely prescribe vitamin D supplements in infants ≤ 1 year of age, but infrequently in children ≥ 3 years of age. Only a minority of them prescribe vitamin D in children with conditions that predispose to poor vitamin D status. Oily vitamin D preparations are the most popular and are usually prescribed in a once-a-day regimen. In situations like intake of drugs interfering with vitamin D metabolism, intestinal malabsorption, and diabetes mellitus, Swiss pediatricians often seek the advice of a subspecialist. In cases with clinical suspicion of poor vitamin D status, the diagnosis is confirmed by the determination of 25-hydroxyvitamin D. Conclusion: Few pediatricians prescribe a vitamin D supplementation in children ≥ 3 years of age. Collaboration between policymakers and health care professionals is required to fill the gap between guidelines and clinical practice.What is Known:• In Switzerland, vitamin D supplementation is recommended during the first, second, and third year of life as well as during winter for older children.• Both alcoholic and oily preparations are currently available.What is New:• Swiss pediatricians routinely prescribe vitamin D in infants ≤ 1 year of age, but infrequently in children ≥ 3 years of age.• Oily vitamin D preparations are the most popular and are usually prescribed in a once-a-day regimen.