Pediatrician patterns of prescribing vitamin supplementation for infants: do they contribute to rickets?

To the Editor. — There seems to be a resurgence of vitamin D (vitD) deficiency rickets in the United States.1–3 Decreasing sunlight exposure,4 an increasing number of women breastfeeding, and increasing maternal vitD deficiency1,5 are certainly some of the factors responsible for this resurgence. We postulated that a decline in the number of pediatricians who recommend vitD supplementation for breastfed infants might be another contributing factor. A questionnaire was mailed to all active members of the North Carolina Chapter of American Academy of Pediatrics (AAP) to determine their vitD supplementation practices in October, 1999. Of the 1040 questionnaires, 417 (40.1%) were returned, and 383 were suitable for analysis. Most respondents were primary care physicians (86.4%) and practiced in private offices (68.1%). They averaged 19.2 ± 10.4 years of experience (4–55 years) and graduated from medical school between 1944 …