Preference for formulations containing calcium and vitamin D(3) in childhood: a randomized-sequence, open-label trial.

Background: Children who experience adverse reactions to cow's milk or who have diseases predisposing them to low bone mass are often prescribed a supplementation of calcium and vitamin D(3), but adherence can be poor. Age-specific preferences for different formulations may exist and at least partially explain poor compliance.

Objective: The aim of this study was to compare the preference of Swiss children at risk for low bone mass for either a single-serving sachet or a suspension containing calcium and vitamin D(3).

Methods: Two different commercial formulations containing calcium and vitamin D(3), either as a lemon-flavored single-serving sachet or as a banana-flavored commercial suspension, were tested for preference by means of a 5-point facial hedonic scale in children aged 4 to 7 and 8 to 11 years. A concealed random allocation procedure was used. The investigator asking about preference was blinded to the sequence.

Results: A total of 40 Swiss children (13 boys and 7 girls aged 4-7 years; 11 boys and 9 girls aged 811 years) were assessed in this study. Low bone mass risks included adverse reactions to cow's milk (n = 25); cerebral palsy (4), juvenile idiopathic arthritis (4), cystic fibrosis (3), inflammatory bowel diseases (2), anorexia nervosa (1), and osteogenesis imperfecta (1). Two children (10%) aged 4 to 7 years were not able to express their preference. Twelve of the remaining 18 children (67%) aged 4 to 7 years preferred the suspension, 5 (28%) did not express a clear preference, and 1 (5%) preferred the sachet (P < 0.002). In children aged 8 to 11 years, 15 (75%) preferred the sachet, 4 (20%) did not express a clear preference, and 1 (5%) preferred the suspension (P < 0.001). The results were not significantly different between boys and girls or between children initially presented the suspension and those initially presented the sachet.

Conclusions: In this small study, significantly more Swiss children aged 4 to 7 years who were prescribed a supplementation of calcium and vitamin D(3) preferred a banana-flavored suspension compared with those who preferred a lemon-flavored single-serving sachet. However, significantly more children aged 8 to 11 years prescribed the same supplementation preferred the single-serving sachet compared with the suspension.