Prevention and treatment of infant and childhood vitamin D deficiency in Australia and New Zealand: a consensus statement

Craig Munns, Margaret R Zacharin, Christine P Rodda, Jennifer A Batch, Ruth Morley, Noel E Cranswick, Maria E Craig, Wayne S Cutfield, Paul L Hofman, Barry J Taylor, Sonia R Grover, Julie A Pasco, David Burgner and Christopher T Cowell
Med J Aust 2006; 185 (5): 268-272.
  • Craig Munns1
  • Margaret R Zacharin2
  • Christine P Rodda3
  • Jennifer A Batch4
  • Ruth Morley2
  • Noel E Cranswick2
  • Maria E Craig1,5,6
  • Wayne S Cutfield7
  • Paul L Hofman7
  • Barry J Taylor8
  • Sonia R Grover9
  • Julie A Pasco10
  • David Burgner11
  • Christopher T Cowell1,5

  • 1 The Children's Hospital at Westmead, Sydney, NSW.
  • 2 The Royal Children's Hospital, Melbourne, VIC.
  • 3 Monash Medical Centre, Melbourne, VIC.
  • 4 The Royal Children's Hospital, Brisbane, QLD.
  • 5 Department of Paediatrics and Child Health, University of Sydney, Sydney, NSW.
  • 6 School of Women's and Children's Health, University of New South Wales, Sydney, NSW.
  • 7 Department of Endocrinology and Diabetes, Starship Hospital, Auckland, New Zealand.
  • 8 Dunedin School of Medicine, Paediatrics and Child Health, University of Otago, Dunedin, New Zealand.
  • 9 Mercy Hospital for Women, Melbourne, VIC.
  • 10 Barwon Health, University of Melbourne, Geelong, VIC.
  • 11 School of Paediatrics and Child Health, University of Western Australia, Perth, WA.


Competing interests:

None identified.

  • 1. Nozza JM, Rodda CP. Vitamin D deficiency in mothers of infants with rickets. Med J Aust 2001; 175: 253-255. <MJA full text>
  • 2. Pillow JJ, Forrest PJ, Rodda CP. Vitamin D deficiency in infants and young children born to migrant parents. J Paediatr Child Health 1995; 31: 180-184.
  • 3. Robinson PD, Hogler W, Craig ME, et al. The re-emerging burden of rickets: a decade of experience from Sydney. Arch Dis Child 2006; 91: 564-568.
  • 4. Blok BH, Grant CC, McNeil AR, Reid IR. Characteristics of children with florid vitamin D deficient rickets in the Auckland region in 1998. N Z Med J 2000; 113: 374-376.
  • 5. Greenway A, Zacharin M. Vitamin D status of chronically ill or disabled children in Victoria. J Paediatr Child Health 2003; 39: 543-547.
  • 6. DeLuca HF, Zierold C. Mechanisms and functions of vitamin D. Nutr Rev 1998; 56 (2 Pt 2): S4-S10; discussion S54-S75.
  • 7. Nowson CA, Margerison C. Vitamin D intake and vitamin D status of Australians. Med J Aust 2002; 177: 149-152. <MJA full text>
  • 8. Armstrong BK. How sun exposure causes skin cancer. In: Hill D, Elwood JM, English DR, editors. Prevention of skin cancer. Dordrecht: Kluwer Academic Publishers, 2004.
  • 9. Risks and benefits of sun exposure position statement. 2005. Approved by the Australian and New Zealand Bone and Mineral Society, Osteoporosis Australia, Australasian College of Dermatologists and the Cancer Council Australia. (accessed Jul 2006).
  • 10. Working Group of the Australian and New Zealand Bone and Mineral Society, Endocrine Society of Australia and Osteoporosis Australia. Vitamin D and adult bone health in Australia and New Zealand: a position statement. Med J Aust 2005; 182: 281-285. <MJA full text>
  • 11. Riggs BL. Role of the vitamin D-endocrine system in the pathophysiology of postmenopausal osteoporosis. J Cell Biochem 2003; 88: 209-215.
  • 12. Clemens TL, Adams JS, Henderson SL, Holick MF. Increased skin pigment reduces the capacity of skin to synthesise vitamin D3. Lancet 1982; 1: 74-76.
  • 13. Holick MF. Vitamin D: the underappreciated D-lightful hormone that is important for skeletal and cellular health. Curr Opin Endocrinol Diabetes 2002; 9: 87-98.
  • 14. Holick MF. McCollum Award Lecture, 1994: vitamin D — new horizons for the 21st century. Am J Clin Nutr 1994; 60: 619-630.
  • 15. Pettifor JM. Nutritional rickets: deficiency of vitamin D, calcium, or both? Am J Clin Nutr 2004; 80 (6 Suppl): 1725S-1729S.
  • 16. Reeve LE, Chesney RW, DeLuca HF. Vitamin D of human milk: identification of biologically active forms. Am J Clin Nutr 1982; 36: 122-126.
  • 17. Hollis BW, Roos BA, Draper HH, Lambert PW. Vitamin D and its metabolites in human and bovine milk. J Nutr 1981; 111: 1240-1248.
  • 18. Gartner LM, Greer FR. Prevention of rickets and vitamin D deficiency: new guidelines for vitamin D intake. Pediatrics 2003; 111: 908-910.
  • 19. Glendenning P. Issues of standardization and assay-specific clinical decision limits for the measurement of 25-hydroxyvitamin D. Am J Clin Nutr 2003; 77: 522-523.
  • 20. Docio S, Riancho JA, Perez A, et al. Seasonal deficiency of vitamin D in children: a potential target for osteoporosis-preventing strategies? J Bone Miner Res 1998; 13: 544-548.
  • 21. Jones G, Dwyer T, Hynes KL, et al. Vitamin D insufficiency in adolescent males in Southern Tasmania: prevalence, determinants, and relationship to bone turnover markers. Osteoporos Int 2005; 16: 636-641.
  • 22. Jones G, Blizzard C, Riley MD, et al. Vitamin D levels in prepubertal children in Southern Tasmania: prevalence and determinants. Eur J Clin Nutr 1999; 53: 824-829.
  • 23. Holick MF. Sunlight and vitamin D for bone health and prevention of autoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 2004; 80 (6 Suppl): 1678S-1688S.
  • 24. DeLuca HF. Overview of general physiologic features and functions of vitamin D. Am J Clin Nutr 2004; 80 (6 Suppl): 1689S-1696S.
  • 25. Mason RS, Diamond TH. Vitamin D deficiency and multicultural Australia. Med J Aust 2001; 175: 236-237. <MJA full text>
  • 26. Thomson K, Morley R, Grover SR, Zacharin MR. Postnatal evaluation of vitamin D and bone health in women who were vitamin D-deficient in pregnancy, and in their infants. Med J Aust 2004; 181: 486-488. <MJA full text>
  • 27. Wharton B, Bishop N. Rickets. Lancet 2003; 362: 1389-1400.
  • 28. Abdullah M, Bigras JL, McCrindle BW. Dilated cardiomyopathy as a first sign of nutritional vitamin D deficiency rickets in infancy. Can J Cardiol 1999; 15: 699-701.
  • 29. Mathieu C, Gysemans C, Giulietti A, Bouillon R. Vitamin D and diabetes. Diabetologia 2005; 48: 1247-1257.
  • 30. Ladhani S, Srinivasan L, Buchanan C, Allgrove J. Presentation of vitamin D deficiency. Arch Dis Child 2004; 89: 781-784.
  • 31. Hochberg Z, Bereket A, Davenport M, et al. Consensus development for the supplementation of vitamin D in childhood and adolescence. Horm Res 2002; 58: 39-51.
  • 32. Pettifor JM. Nutritional and drug-induced rickets and osteomalacia. In: Favus MJ, editor. Primer on the metabolic bone diseases and disorders of mineral metabolism. 5th ed. Washington, DC: American Society of Bone and Mineral Research, 2003: 399-407.
  • 33. Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food and Nutrition Board, Institute of Medicine. Dietry reference intakes for calcium, phosphorus, magnesium, Vitamin D and fluoride. Washington, DC: National Academy Press, 1997.
  • 34. Hsu SC, Levine MA. Perinatal calcium metabolism: physiology and pathophysiology. Semin Neonatol 2004; 9: 23-36.
  • 35. Alyaarubi S, Rodd C. Treatment of malabsorption vitamin D deficiency myopathy with intramuscular vitamin D. J Pediatr Endocrinol Metab 2005; 18: 719-722.
  • 36. Shah BR, Finberg L. Single-day therapy for nutritional vitamin D-deficiency rickets: a preferred method. J Pediatr 1994; 125: 487-490.
  • 37. Moy R, Shaw N, Mather I. Vitamin D supplementation in pregnancy. Lancet 2004; 363: 574.
  • 38. Mahomed K, Gulmezoglu AM. Vitamin D supplementation in pregnancy. Cochrane Database Syst Rev 2000; (2): CD000228.


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