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APHA Scientific Session and Event Listing

Recorded presentation

Xena Grossman, MS¹, Anne Merewood, MPH, IBCLC¹, Howard Bauchner, MD, MPH², and Supriya Mehta, MHS, PhD³. (1) Division of General Pediatrics, Boston Medical Center, 91 E Concord St 4th Fl Rm 4121, Boston, MA 02118, (617) 414-3822, xegrossm@bmc.org, (2) Division of General Pediatrics, Boston University School of Medicine, Rm 4210, Boston, MA 02118, (3) Department of Emergency Medicine, Boston University School of Medicine, Dowling 1 South, Rm 1334, 1 Boston Medical Center Place, Boston, MA 02118

Background: In April 2003, the American Academy of Pediatrics stated that all exclusively breastfed infants should receive vitamin D supplements ‘beginning during the first 2 months of life'. Objective: To determine vitamin D prescription among infants in Boston, MA, after the new AAP guidelines. Design/Methods: Feeding and demographic data were extracted from the medical records of 248 infants born at an urban Boston hospital after February 15th, 2003. Infants included in the sub-analysis were exclusively breastfeeding at the 2-month visit, or were prescribed vitamin D during the first 6 months of life. Results: Of 62 included infants, 33 received vitamin D. 40 infants were exclusively breastfeeding at the 2-month visit, yet only 10 (25%) received vitamin D at or before that visit (median 49 days, 95% CI 9-73 days). Of the 22 infants not exclusively breastfeeding at 2 months, 15 received vitamin D at or before the 2-month visit, and 7 after that visit (median 40 days, 95% CI 9-72 days). Hispanic infants were most likely, and White infants least likely, to receive vitamin D (p=0.052). The most significant factor associated with vitamin D prescription was site of pediatric primary care (p=0.007). Vitamin D was prescribed to 38% of infants attending a hospital-based primary care service, but not to infants seen at 3 neighborhood health centers. Conclusions: In a northern, urban setting in 2003, Vitamin D was often not prescribed in accordance with AAP guidelines. Site of pediatric care was the most significant predictor of vitamin D prescription.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Identifty the new AAP guidelines for vitamin D.
• Explain the rationale behind the new AAP guideines.
• Discuss the various factors which affect vitamin D prescription.

Keywords: Breast Feeding, Vitamins

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation