What is the recommended Vitamin D (Cholecalciferol) dose for a child with Vitamin D insufficiency weighing 33.9 kg according to the British National Formulary for Children (BNFC)?

BNFC Vitamin D Dosage for Vitamin D Insufficiency in a 33.9 kg Child

For a child weighing 33.9 kg with vitamin D insufficiency, the recommended cholecalciferol (vitamin D3) dose according to the British National Formulary for Children (BNFC) is 600 IU daily. 1

Dosage Recommendations Based on Age and Weight

The dosing of vitamin D supplements for children follows these general guidelines:

• Infants 0-12 months: 400 IU/day
• Children 1-18 years: 600 IU/day 1

For a child weighing 33.9 kg (which typically corresponds to a school-aged child), the standard recommended daily dose is 600 IU of cholecalciferol.

Treatment Considerations for Vitamin D Insufficiency

When treating vitamin D insufficiency (as opposed to deficiency), the following factors should be considered:

• Severity of insufficiency: The exact serum 25-hydroxyvitamin D level will determine whether standard supplementation is adequate or if higher doses are needed initially
• Duration of treatment: Supplementation should continue until normal vitamin D levels are achieved and then maintained with regular supplementation
• Monitoring: Periodic monitoring of serum 25(OH)D concentration is recommended for children on long-term supplementation 1

Administration Guidelines

• Vitamin D supplements are available as drops or tablets that can be taken once daily
• Daily administration is preferred over intermittent dosing for consistent blood levels 1
• The supplement should be taken with food to enhance absorption

Special Considerations

For Children with Additional Risk Factors

For children with conditions that affect vitamin D metabolism or absorption, higher doses may be required:

• Children with malabsorption syndromes may need higher doses (up to 1000-2000 IU/day) 2
• Children with chronic kidney disease may require specialized vitamin D regimens 1

Target Serum Concentration

The goal of supplementation is to achieve and maintain a serum 25(OH)D concentration greater than 50 nmol/L (20 ng/mL) 1

Safety Considerations

• The tolerable upper intake level for children ages 1-3 years is 2,500 IU/day, and for children 4-8 years is 3,000 IU/day 1
• Exceeding these upper limits is not recommended without medical supervision
• Monitoring calcium levels may be necessary with higher doses to prevent hypercalcemia

Follow-up Recommendations

• Reassess vitamin D status after 3-6 months of supplementation
• Once normal levels are achieved, continue with maintenance dosing of 600 IU daily
• Consider seasonal variations in sun exposure when determining maintenance dosing

By following these guidelines, vitamin D insufficiency can be effectively treated while maintaining safety and optimizing bone health and overall well-being in children.