Shah Nawaz1, Shafiq ur Rehman2, Rab Nawaz3, Kulsoom Tariq4, Mudassir Ahmad Khan4

1Department of Biochemistry, Nowshera Medical College, Nowshera - Pakistan
2Department of Physiology, Khyber Medical College, Peshawar - Pakistan
3Department of Community Medicine, Pak-International Medical College, Peshawar - Pakistan
4Department of Biochemistry, Khyber Medical College, Peshawar - Pakistan


Objective: To determine the frequency of Vitamin D deficiency in lactating mothers of infants presenting with rickets
Material and Methods: This was a cross sectional descriptive study conducted at Biochemistry Department, Khyber
Medical College Peshawar from October 2013 to January 2014. 100 breastfeeding mothers of infants (children beyond
neonatal age) with nutritional or vitamin D deficiency rickets were included. Mothers of infants with nutritional rickets
fed on formula milk wholly or partially and those with secondary rickets were excluded. Blood samples from mothers
were collected in Khyber Teaching Hospital (KTH) and Hayatabad Medical Complex (HMC) Peshawar. All the analyses
were performed on Semi-Automatic Clinical Chemistry Analyzer Metrolab 1600. 25-OH Cholecalciferol levels in the
serum were determined by ELISA method.
Results: Hypovitaminosis D was found in 73% of breastfeeding mothers of infants with rickets. This included 26% of
Vitamin D Deficiency and 47% of Vitamin D Insufficiency. Minimum level of 25-OH Vitamin D was 10ng/ml and maximum
58ng/ml with a mean value of 26.94 ng/ml. 71% of mothers with low Vitamin D status belonged to urban areas,
52% were uneducated, 56% were of the highest income group, 42% had a dress preference for being “unveiled” when
outdoors, 19% had maximal exposure to sunlight, 73% had no vitamin D supplementation and 86% of such mothers
with hypovitaminosis D were housewives. 44% low vitamin D status mothers were either obese or overweight. High
serum Alkaline Phosphatase level was associated with hypovitaminosis D in 84% cases, low serum calcium found in
59% and high phosphate in 25% of mothers with low vitamin D status.
Conclusion: Breastfeeding mothers of infants with rickets are usually vitamin D deficient/having low vitamin D status.

Keywords: Hypovitaminosis D, 25 OH Vitamin D, Vitamin D insufficiency, Vitamin D Deficiency, Rickets

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