Babies need vitamin D for healthy growth and development. It helps them build strong, healthy bones and teeth. Babies who don’t get enough vitamin D are said to have a deficiency. If the levels are low enough, they are at risk of getting rickets, a disease that affects the way bones grow and develop. You can make sure your baby has enough vitamin D by giving a daily supplement (a dose of drops every day). This should start as soon as your baby is born. How do we get vitamin D? Vitamin D comes from different sources: Sunlight: Vitamin D is formed naturally when skin is exposed to sunlight. Because Canada is located so far north, sunlight isn’t enough at certain times of the year and in certain places. Also, sunscreen and clothing, which protect babies from the harmful effects of the sun, won’t allow vitamin D to be formed. Foods: In Canada, vitamin D is added to cow’s milk and margarine during production. Some foods—like salmon, tuna, and liver—are good sources of vitamin D.
Vitamin supplement: For babies, it comes in liquid form and is given daily with a dropper. It’s important to give your baby a supplement that is meant for babies. Read the instructions carefully to be sure you give your baby the right amount. If you are unsure, talk to your pharmacist. How do I know if my baby is at risk of vitamin D deficiency? Babies are most at risk of vitamin D deficiency if: Their mothers don’t have enough vitamin D. They have darker skin. They live in northern communities. All breastfed babies should get a daily supplement of vitamin D. How much vitamin D should my baby receive? Babies who are breastfed should get 400 IU (international units) per day. Babies in northern communities (north of 55° latitude, which is about the level of Edmonton) or who have other risk factors (such as dark skin) should get 800 IU per day between October and April, when there is less sunlight. If you aren’t sure about the right amount to give your baby, talk to your health care provider.
Why do breastfed babies need a vitamin D supplement? Breast milk is the best food you can offer your growing baby. Even when your baby starts eating other foods, you can continue to breastfeed until 2 years of age and beyond. But breast milk has only small amounts of vitamin D (4 to 40 IU per litre), which may not be enough to meet your baby’s needs. That’s why babies who are breastfed should receive a daily supplement of vitamin D from birth until they get enough from their diet. If I am breastfeeding and I eat foods rich in vitamin D, do I still need to give my baby a supplement?Although some foods are good sources of vitamin D, they won’t provide enough vitamin D to enrich your breast milk to the level your baby needs. If you are breastfeeding, talk to your doctor about whether a supplement of 2000 IU/day is right for you. Do babies who are formula-fed need extra vitamin D? Since vitamin D is already added to infant formula, most full-term babies who are formula-fed don’t need a supplement.
However, formula-fed babies in northern communities should receive a supplement of 400 IU/day from October to April to ensure they have enough vitamin D. Should pregnant women take vitamin D supplements? How much vitamin D you get while you’re pregnant will affect how much vitamin D your baby has at birth. A baby born to a mother who is vitamin D deficient is more likely to have a vitamin D deficiency. You are more likely to be vitamin D deficient if: you don’t use products like milk and margarine, which in Canada are fortified with vitamin D. you do not have much exposure to the sun, or if your skin is covered much of the time. you do not take vitamin D supplements. If you are pregnant, talk to your doctor about whether a supplement of 2000 IU/day is right for you. More information from the CPS: Feeding your baby in the first year Vitamin D supplementation: Recommendations for Canadian mothers and infants (position statement) Reviewed by the following CPS committees:
First Nations, Inuit and Métis Health Committee Nutrition and Gastroenterology Committee Last Updated: November 2012In most cases, breast milk or formula provides just about everything a baby needs for the first four to six months. The exception is vitamin D, which is recommended as a supplement for breastfed babies and babies who drink less than 32 ounces of formula per day. (See below for more details.)After age 4 to 6 months, as your baby's diet gradually changes from an all-liquid diet to one that contains more and more solid food, your doctor may or may not recommend additional vitamin supplements.Babies who eat a variety of foods over time shouldn't need them, but there are exceptions. For example, supplements may be necessary if your baby was born prematurely, at a low birth weight, or small for gestational age; consistently drinks less breast milk or formula than other babies his age and doesn't make up the difference with food: or has chronic health problems that affect his ability to eat.
Be sure to ask your baby's healthcare provider if you have special concerns.Your own health picture may come into play too. For example, women who have had gastric bypass surgery or who take certain medications daily may absorb fewer nutrients. This can reduce the nutrient content of their breast milk.If you follow a vegan diet, tell your baby's healthcare provider. Vitamin B12, iron, zinc, calcium, and omega-3 fatty acids are nutrients that vegan moms and babies may need to make an extra effort to consume through diet or a multivitamin-mineral supplement.In general, though, even if your diet isn't perfect (and whose is?), your breast milk will likely contain the nutrients your baby needs. That said, your own nutrient stores may suffer if your diet is less than stellar, so consider taking a multivitamin while you're breastfeeding.Once you start serving solid food, your baby may be getting more vitamins and minerals than you think – especially if he eats fortified foods, which often have added vitamin A, zinc, and folate.
A study by the American Dietetic Association showed that while supplements were helpful for infants who had marginal intakes of some nutrients, other infants received excessive amounts.Also, keep in mind that the U.S. Food and Drug Administration (FDA) doesn't regulate vitamins, so quality and potency might vary between brands. (See our article on buying supplements for guidance.) Here are the supplements your baby's doctor may suggest:IronBreast milk and formula both contain iron, but about the time your baby starts solid foods, the iron requirement jumps (from 0.27 mg daily through 6 months to 11 mg daily from 7 to 12 months). At that point, it's important for your baby to have a good source of iron from food. Good sources include pureed meats, iron-fortified cereal, and pureed legumes such as lentils, kidney beans, lima beans, black beans, and pinto beans.Your baby's doctor may recommend an iron supplement if your baby doesn't eat iron-rich foods. Babies born prematurely have less stored iron at birth and usually need to take an iron supplement.
Vitamin DOnly small amounts of vitamin D are transferred in breast milk. That's why the American Academy of Pediatrics (AAP) now recommends that you give your breastfed baby a supplement of 400 IU per day of vitamin D, starting in the first few days of life. Babies who are fully or partially formula fed but drink less than 32 ounces of formula a day also need a daily 400 IU vitamin D supplement .Our bodies produce vitamin D after the skin is exposed to sunshine. But ideally your baby won't be sunbathing at all in the first six months, so he won't get enough vitamin D from the sun – even if you live in a relatively sunny place, such as Florida.The skin of very young babies is extra thin and delicate, and every minute of sun exposure contributes to skin cancer risk and wrinkling later in life – even if the skin doesn't burn. Sunscreen helps keep babies safe in the sun, but it also blocks the rays that enable the body to produce vitamin D.Vitamin B12Vitamin B12 is critical for development of the nervous system and to prevent anemia.
This vitamin is naturally found in fish, meat, poultry, eggs, milk, and milk products. If you're breastfeeding and you don't eat much (or any) animal protein, it's important to have a regular and reliable source of vitamin B12 – whether it's from a supplement or fortified foods – so that your baby's diet will also contain adequate amounts of the vitamin.DHA, an omega-3 fatty acid important for infant brain and eye development, shows up in your breast milk in proportion to the amount of DHA and essential fatty acids in your diet. (Formula is fortified with adequate amounts of DHA.)Learn more about omega-3s and omega-3 supplements and how to get this important fatty acid into your diet.DHA supplements aren't usually recommended for babies, but breastfeeding moms who don't consume a dietary source of DHA – vegetarians and vegans, in particular – may want to consider taking a supplement. Vegetarians and vegans and their infants have been found to have lower blood levels of DHA than those who eat meat.