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Adherence to the infant vitamin D supplementation policy in Ireland

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Abstract

Purpose

From September 2010 until November 2019, Ireland’s infant vitamin D supplementation policy recommended administration of 5 μg/day of vitamin D3 from birth to 12 months to all infants, regardless of feeding method. This study aims to examine policy adherence.

Methods

In the prospective COMBINE birth cohort study (recruited 2015–2017), detailed longitudinal supplement data were examined in 364 infants across the first year of life, according to product type, dose, frequency, and duration. Vitamin D supplement use at 2, 6, and 12 months in COMBINE was compared with the BASELINE cohort (recruited 2008–2011, n = 1949).

Results

In COMBINE, 92% of infants initiated supplementation at birth. The median supplementation duration was 51 (40, 52) weeks, with a range of 3–52 weeks. While supplementing, most parents (92%) used an exclusive vitamin D supplement as recommended and 88% gave 5 µg/day. Half (51%) gave vitamin D daily and a further 33% supplemented at least 3–6 times/week. Overall, 30% adhered fully to the policy, providing 5 µg vitamin D3 daily from birth to 12 months. A further 16% were broadly compliant, giving 5 µg frequently for the full 12 months. Vitamin D supplement use at 2, 6, and 12 months in COMBINE was 93%, 89%, and 72%, considerably higher than our earlier BASELINE cohort at 49%, 64%, and 44% at the same time points (all P < 0.001).

Conclusions

We report a high level of vitamin D supplementation initiation at birth, with full to broad policy adherence among more than half of infants. There is scope to improve overall compliance by focusing on supplementation frequency.

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Acknowledgements

The authors wish to gratefully acknowledge the families of the COMBINE and BASELINE birth cohort studies for their participation.

Funding

COMBINE is funded through a grant from Science Foundation Ireland (grant number INFANT/B3067), which is co-funded by the European Regional Development Fund (ERDF) under Ireland’s European Structural and Investment Funds Programmes 2014–2020. The Cork BASELINE Birth Cohort Study was funded by the National Children’s Research Centre Ireland.

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Authors and Affiliations

  1. INFANT Research Centre, University College Cork, Cork, Ireland

    A. Hemmingway, D. Fisher, T. Berkery, D. M. Murray & M. E. Kiely

  2. Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland

    A. Hemmingway & M. E. Kiely

  3. Department of Paediatrics and Child Health, University College Cork, Cork, Ireland

    D. M. Murray

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  1. A. Hemmingway
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  2. D. Fisher
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  5. M. E. Kiely
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Contributions

MEK designed the COMBINE cohort study and is Principal Investigator. AH and MEK conceptualized and designed this research. DF conducted COMBINE study visits. DMM provided clinical advice and governance to COMBINE and is Principal Investigator of BASELINE. TB and AH conducted quality control and constructed the database. AH analysed the data and drafted the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to M. E. Kiely.

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Conflict of interest

The authors have no conflicts of interest to report.

Ethical approval

Ethical approval for the COMBINE cohort was obtained from the UCC Clinical Research Ethics Committee [ECM 4 (hh) 06/01/15 and ECM3(bbb)10/04/18]. Ethical approval for the BASELINE birth cohort study was obtained from the Clinical Research Ethics Committee of the Cork Teaching Hospitals [ECM 5 (9) 01/07/2008]. COMBINE and BASELINE were conducted in accordance with the Declaration of Helsinki guidelines and written informed consent was obtained for all participants prior to study commencement. Both cohorts are registered at https://www.birthcohorts.net/.

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Hemmingway, A., Fisher, D., Berkery, T. et al. Adherence to the infant vitamin D supplementation policy in Ireland. Eur J Nutr 60, 1337–1345 (2021). https://doi.org/10.1007/s00394-020-02334-w

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