Calls for NICE to rethink guidance on vitamin D

Updated NICE guidance on antenatal care continues to advise against the routine use of vitamin D supplements in pregnancy. This comes despite calls for all pregnant women to be given vitamin D supplements.

Earlier this year, Dr Maggie Blott, a consultant obstetrician and spokeswoman for the Royal College of Obstetricians and Gynaecologists, told GP that there was a body of evidence to say that NICE should be rethinking its policy on vitamin D supplements (GP, 9 March).

Her comments followed Belgian research presented at a meeting of the British Endocrine Societies in Birmingham, which found that low vitamin D in pregnancy could leave babies with a higher risk of type-1 diabetes.

'Our concern is that if mothers have low vitamin D in pregnancy, the babies will also,' Dr blott said.

However the updated NICE guidance, due to be released shortly, will say: 'Although there is some evidence of benefit for the use of vitamin D supplementation in women at risk of deficiency, it is less good in the case of women regarded as low risk.'

NICE recommends that oral vitamin D supplements, 10mg per day, should only be offered to healthy pregnant women at risk of vitamin D deficiency. This includes women with dark skin, women who usually cover their skin, women who eat a vegan diet and women between the ages of 19-24.

However, NICE concedes that future research into the effectiveness of routine vitamin D supplementation for pregnant and breastfeeding women is needed.

Professor of obstetrics for the baby charity Tommy's, Andrew Shennan, said that it was important for pregnant women to have vitamin D in their diet.

'The WHO recommends that all pregnant women should have a daily intake of 10mg of vitamin D. The NICE guidance is cautious and does not want all pregnant women to take vitamin D supplements for fear that they may overdose,' he said.

'Taking an excess of vitamin D can be damaging as it has been linked with growth problems.'

The problem is that, there is no hard evidence for advising all pregnant women to take vitamin D supplements, said Professor Shennan.

'It is a controversial decision to make because too much vitamin D can cause problems but then too little vitamin D can be equally damaging,' he added.

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