Introduction: Vitamin D deficiency is a global public health issue and large health agencies encourage the use of vitamin D supplementation. Vitamin D is an essential hormone which is responsible for both musculoskeletal development and systemic health. The goal of this narrative review was to investigate the following clinical issues: 1) Impact of Vitamin D on the developing musculoskeletal system in the pediatric patient and the growing child’s need for nutritional intake or supplementation, 2) Factors important to determine the need for supplementation and appropriate supplementation, 3) Risk for overdose of Vitamin D.
Methods: Literature search of large search engines. Limits used: age 0-18 years, English language and published in the last 10 years. Key words used ‘Vitamin D and pediatric’, Vitamin D and development’, ‘Vitamin D and deficiency’, ‘Vitamin D and side effects’.
Results: One Cochrane review, two global epidemiological reviews on nutritional rickets, six guidelines on Vitamin D supplementation, and several articles on vitamin D and musculoskeletal development were identified and considered in the study. The American Academy of Pediatrics and the Canadian Pediatric Society and European guidelines recommended 400 IU/day for infant - adolescent. The US Institute of Medicine and World Health Organization recommended adequate nutritional intake prior to supplementing children 0 –1 and 1–18 years old with 400 and 600 IU/day, respectively. Clinicians must be aware of key points that would significantly affect the correct recommendation and supplementation of Vitamin D. These are history, anthropometric measurements, physical activity levels, dietary habits and sun exposure parameters to achieve optimal musculoskeletal results.
Conclusion: At present, 400-600IU/day Vitamin D supplementation is the daily recommendation for pediatric population based on the global healthcare agencies. Understanding the great impact of vitamin D on the musculoskeletal system, future work must be done to examine the prophylactic use of vitamin D and its appropriate adapted supplementation.
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