모유수유아의 비타민 D 섭취에 대한 한국형 가이드라인 제안
Korean Guidelines for Breast-fed Infants for Vitamin D Supplements
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초록
(1)목적 :최근 해외 뿐 아니라 국내에서도 모든 모유수유아에게 비타민 D보충제가 권유되고 있지만 그것의 안정성과 유효성에 대한 평가가 부족하다. 이에 본 논문은 모유수유아의 비타민 D섭취에 대한 한국형 가이드라인(임상지침)을 제안하고자 한다. (2)방법:국내외문헌조사를 통하여 영유아의 골대사와 관련된 비타민 D의 역할과 모유의 상관관계를 살펴보고 보충제를 통한 비타민 D 섭취의 유효성과 안정성을 검토하였다. (3)결과:비타민 D 보충제에 의한 구루병예방 효과는 아직 불분명하다. 또한 시중 유통되는 비타민D보충제 의한 섭취의 안정성에 대한 우려가 제기되고 있다. 뿐만 아니라 국내 모유수유아는 피부를 통해 안전하게 비타민 D를 섭취할 수 있으며 출산전 엄마가 햇볕과 식이요법으로 비타민 D섭취를 늘리는 것이 더 효과적이고 안전하다. (4)결론:모유수유아에 대한 인종과 문화적 특성을 고려하지 않은 무조건적인 일광제한 및 비타민 D보충제 권고의 해외 임상지침을 그대로 국내에 적용시키는 것은 타당하지 않다.
Abstract
Objectives Recently, vitamin D supplements to breast-fed infants are being encouraged in Korea, and other countries. However, the reliability and validity assessment of supplements is insufficient. Therefore, this study suggests new Korean guidelines for vitamin D supplements of breast-fed infant. Methods The roles of Vitamin D for bone metabolism in children and the correlation between breast milk and Vitamin D were examined throughout domestic and international literature review. In addition, the efficacy and safety of vitamin D supplements were reviewed. Results Preventive effects of rickets by vitamin D supplementation remain unclear. Furthermore, concerns about the safety of vitamin D supplements intake have been raised. Korean guideline suggests breast-fed infants can get vitamin D through the skin safely, but maternal intake of vitamins through sunbath and diet is more effective and safe. Conclusions Limiting sunlight excessively and applying foreign countries’ medical guideline for vitamin D supplements are not valid to apply as a domestic guideline for Korean breast-fed infants without considering ethnic and cultural characteristics.
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