A systematic review was commissioned to support an international expert group charged to update the Food and Agriculture Organisation of the United Nations (FAO)/World Health Organisation (WHO)'s ...vitamin D intake recommendations for children aged 0-4 years.
Multiple electronic databases were searched to capture studies published from database inception to the 2
nd
week of June 2020 according to key questions formulated by the FAO/WHO. Relevant studies were summarised and synthesised by key questions and by health outcomes using the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach.
The 146 included studies examined the effects of different vitamin D intake levels on a variety of health outcomes (e.g. infectious disease, growth, neurodevelopment, rickets, and bone mineral density), and on outcomes for setting vitamin D upper limits (e.g. hypercalcemia, hypercalciuria, and nephrocalcinosis). For most outcomes, the strength of evidence was low or very low. Evidence was rated moderate for the effect of daily vitamin D supplementation on raising serum 25(OH)D concentrations, and a random-effects meta-regression analysis of 28 randomised controlled trials (mostly in infants 0-12 months) showed that each 100 IU/d increase in vitamin D supplementation was associated with an average of 1.92 (95% CI 0.28, 3.56) nmol/L increase in achieved 25-hydroxy-vitaminn D (25OHD) concentration (n = 53 intervention arms; p = .022) with large residual heterogeneity (I
2
= 99.39%). Evidence was very low on two of the upper limit outcomes - hypercalcemia and hypercalciuria.
The evidence report provided the expert group with a foundation and core set of data to begin their work to set vitamin D nutrient reference values. To move the field forward, future studies should use standardised 25(OH)D assay measurements and should examine the relationship between long-term vitamin D status and health outcomes.
Key Messages
Results of a large complex systematic review suggest the current totality of evidence from trials and prospective observational studies do not reach sufficient certainty level to support a causal relationship between vitamin D intake and asthma, wheeze, eczema, infectious diseases, or rickets (most trials reported no rickets) in generally healthy infants and young children.
In this systematic review, the only body of evidence that reached a moderate level of certainty was regarding the effect of daily vitamin D supplementation (vitamin D
3
or D
2
supplements to infants/children) on increasing serum 25(OH)D concentrations. However, currently there is no consensus on the definitions of vitamin D status, e.g. deficiency, insufficiency, sufficiency and toxicity, based on serum 25(OH)D concentrations.
This systematic review provided an international expert group a foundation and core set of data through intake-response modelling to help set vitamin D nutrient reference values for infants and children up to 4 years of age.
Background
Maternal mental problems can interfere with the overall health and care of the child; some oral health studies have been trying to elucidate whether there is a relationship between ...maternal common mental disorders (CMD) and children's oral health status.
Aim
The aim was to investigate the influence of mothers that present CMD symptoms on their child's dental caries status.
Design
This cross‐sectional study was carried out in Pelotas with 530 mother/child (aged 2‐5 years old) dyads recruited from an epidemiological survey in August 2015 during the national vaccination campaign. A questionnaire was used to determine mother's CMD symptoms using the Self‐Reporting Questionnaire (SRQ‐20) and socioeconomic/demographic variables which were used for adjustment. Dental caries examination was performed. The outcome was obtained using the dmfs (decayed, missing, filled surfaces) index, based on OMS guidelines. Poisson regression with robust variance was used to estimate the risk ratio and 95% confidence interval (CI).
Results
Maternal CMD was positively associated with dental caries prevalence in children; the adjusted relative risk for every 1 SRQ‐20 score increase was 1.06 (95% CI 1.00‐1.12).
Conclusions
Our findings suggest that maternal mental health can impair children's oral health in relation to dental caries.
Aim
To assess vitamin D status and its predictors in a representative population sample of pre‐school children in Adelaide (latitude of 35°S).
Methods
Cross‐sectional survey of children aged between ...1 and 5 years from areas of low, medium and high socio‐economic status as identified from the 2001 Census data, Australian Bureau of Statistics. Children were recruited between September 2005 and July 2007 using a door knocking protocol based on a stratified sampling method to obtain a representative sample of this age group. Serum 25‐hydroxyvitamin D (25(OH)D) was determined using a radio‐immunoassay kit. Vitamin D deficiency was defined as serum 25(OH)D) <30 nmol/L and insufficiency defined as serum 25(OH)D ≥30 and <50 nmol/L according to the Institute of Medicine.
Results
Fifty‐two per cent of eligible children took part in the study. Mean (standard deviation) serum 25(OH)D was 73 (26) nmol/L (n = 221). The prevalence of vitamin D deficiency and insufficiency was 4% and 16%, respectively, with the prevalence being higher in winter (8% and 22%, respectively). Season of the year of blood collection and mother being born in Australia were significant predictors of serum 25(OH)D concentration, but age, sex, socio‐economic status, BMI category or dietary supplement use were not related to vitamin D status.
Conclusions
Vitamin D status of this representative sample of pre‐school children in Australia is adequate, and the prevalence of vitamin D deficiency is low based on the Institute of Medicine criteria.
OBJECTIVESTo develop a tool to assess pre-writing skills of 2-5 y old children in India. METHODSThe tool development process followed the recommendations by Fitzpatrick et al. and the Consensus based ...Standards for the selection of health Measurement Instruments (COSMIN), and included 4 phases. In Phase I, an initial 35-item draft tool was developed by an expert panel for the tool-development. In Phase II, the 35-item draft tool was prevalidated through peer and expert reviews, pilot-study to assess the tool-comprehensibility, and assessment of test-retest and inter-rater reliability. In Phase III, the 35-item draft tool was administered on the 575 typically developing children aged 2-5 y, recruited from rural, urban, slum, and coastal areas through stratified random sampling. In Phase IV, the normative age-range for development of each item was generated by calculating the age-percentiles (10th, 25th, 50th, 75th, 90th). Factor analysis and item reduction was done for items in 2-3, 3-4, and 4-5 y age-groups. The final tool was converted to graphic format with 10th-90th age-percentile bars. RESULTSThe final tool had 26 items with a three-factor structure. Cronbach's alpha was within acceptable limits for all three age-groups (0.723, 0.778, and 0.823 in 2-3 y, 3-4 y, and 4-5 y respectively). Kappa coefficients of the items ranged from 0.6-1 in interrater reliability and 0.64-1 test-retest reliability analysis reflecting substantial agreement between ratings. CONCLUSIONSA 26-item screening tool "Prewriting skills Assessment Tool" (PAT) to assess writing readiness of 2-5 y old children was developed. Tool reliability and construct validity have been established.
Because of the COVID-19 pandemic, the Indonesian Government enacted a study at home policy for all students. This policy also applied to preschool children aged 2 to 6 years old. The purpose of the ...research was to examine the duration and impact of digital media use by preschool children in urban areas in Indonesia during weekdays and weekends. Data were collected using a validated questionnaire called the Surveillance of digital-Media hAbits in earLy chiLdhood Questionnaire (SMALLQ®). A total of 951 parents or guardians (17-70 years old) who had preschool children volunteered to complete the questionnaire online. Preschool children have been using screen media since infancy, and the time they spend on-screen time is more than 1 hour per day. The digital media most used were mobile phones (91.6%), followed by television (86.1%) and computers (61%). The parents realized the impact and the importance of limiting time of screen media, but it difficult to prevent their children from using it, especially when learning from home. Hence, there is a need different approach to learning from home, especially to manage the duration of screen time for preschool children.
The article aims to describe the situation in kindergartens in the period of coronavirus quarantine, focusing on distance learning as a form of education. The research aimed to find out the ...experiences of kindergarten teachers with distance learning of children implemented during the period of coronavirus quarantine and how these experiences influenced their opinions on distance learning of children in the future. The study is based on survey methodology. The research group consisted of 93 teachers who are formally trained at various levels, but all are qualified. Distance learning was carried out via e-mail, websites, mobile phones, providing materials to through their parents. The results revealed a number of issues: the need for Internet connection in kindergartens, IT technology, ideas for distance learning, as well as for training teachers to manage distance learning with IT technology. The respondents did not agree on the age group the pre-school distance learning should start from. They did not question the age limit for compulsory distance education.
Aim: To identify the leading causes of injury in children aged 0–4 years by single year of age using injury submechanisms and present a brief epidemiologic profile of each cause.
Methods: ...Hospitalisation data for New South Wales from 1999 to 2009 were used to identify the leading causes of injury for children aged 0–4 years by single year of age. For each leading cause, rates over time and by sex were calculated by single year of age. Associated age and sex risk ratios were estimated.
Results: The leading causes of injury for children aged <1, 1 and 2 years were falls while being carried, burns by hot non‐aqueous substances and poisoning by other and unspecified pharmaceutical substances, respectively. Falls involving playground equipment ranked first for children aged 3–4 years. Each leading injury cause exhibited an age pattern that remained stable over time and by sex. Age predicted falls while being carried and both age and sex predicted the remaining leading injury causes, with age and sex interacting to predict burns by hot non‐aqueous substances.
Conclusions: Epidemiologic analysis using single‐year age intervals and injury submechanisms results in a clearer picture of injury risk for young children. The findings of this study provide detailed information regarding the leading causes of hospitalised injury in young children by age and sex. Child health‐care providers can use this information to focus discussions of child development and injury risk with families of young children and suggest appropriate prevention measures in terms of a child's age and sex.
The study explored the associations between various childcare staff food practices and children's dietary intake at childcare. A total of 398 one- to four-year-old children and 24 childcare staff ...members from 24 Dutch childcare centers participated in the study. Children's dietary intake (fruit, vegetable, sweet snack, savory snack, water, and sweet drink intake) at childcare was registered on two weekdays, using observations by dieticians and childcare staff. Thirteen childcare staff practices were assessed using questionnaires administered by dieticians. Data were analyzed using multilevel regression analyses. Children consumed relatively much fruit and many sweet snacks at childcare, and they mainly drank sweet drinks. Various staff practices were associated with children's dietary intake. When staff explained what they were doing to the children during food preparation, children ate significantly more fruit. Children ate less sweet snacks when they were allowed to help prepare the meals. When staff encouraged children to continue eating, they ate more vegetables. In conclusion, the study showed the importance of childcare staff food practices for children's food intake at childcare. More research is needed to examine the specific conditions under which food practices can have a positive impact on children's dietary intake.
Objective:
To investigate vitamin A deficiency of pre-school children in central and western China for developing strategies to prevent and control vitamin A deficiency (VAD) among children.
Design:
...From November 2018 to September 2019, a total of 2,194 healthy children aged 2–6 years were enrolled. Serum retinol levels in the children were detected by liquid-phase tandem mass spectrometry. In addition, social demographic and dietary questionnaires were collected through interviews with children's caregivers.
Setting:
The participants were enrolled in 12 cities or their subordinate jurisdictions in the central and western regions of China.
Participants:
Two thousand one hundred and ninety four healthy children aged 2–6 years old.
Results:
Overall, 35.51% (779/2,194) of the children were found to be vitamin A insufficient (VAI, serum retinol < 1.05 μmol/L). Elder children had a higher risk to suffer from VAI, with proportions of 25.00% (87/348), 28.92% (142/491), 38.38% (256/667), and 42.73% (294/688) among children aged 2, 3, 4, and 5 years, respectively. Vitamin A levels were also positively correlated with per capita income (AOR = 1.18) and regional economic level (0.71), and the frequency of milk intake (0.91).
Conclusions:
The incidence of VAI was higher among children aged 2–6 years, and the incidence of VAI increases with age. VA levels were positively correlated with levels of economic development in the family and region. So prevention strategies for VAD need to focus on pre-school children, especially dairy intake and developing regions.
PDF
