Do Breastfed Babies Need a Vitamin D Supplement

Overview

Vitamin and mineral supplements are non by and large necessary for the average healthy, total-term breastfed infant during the first year. Studies have shown that most vitamins, fluoride, atomic number 26, h2o, juice, formula and solid foods are not beneficial to healthy breastfed babies during the outset six months, and some tin even be harmful. In that location are sure cases where a vitamin supplement may exist needed for a breastfed baby during the first year (come across below for specifics).

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The American Academy of Pediatrics does recommend that all babies receive a vitamin K injection soon after birth to reduce the risk of hemorrhagic disease of the newborn, and routine vitamin D supplementation due to decreased sunlight exposure and an increase in rickets.

Some very premature babies (weighing less than 1500 grams/3.3 pounds) may need extra vitamins and minerals, which can be added to their mother's milk earlier being given to the baby.

Following is more than specific information on babe's needs for certain vitamins and minerals.

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Vitamin A

Breastmilk is a natural, first-class source of vitamin A. Promoting breastfeeding is the all-time way to protect babies from Vitamin A deficiency. Vitamin A deficiency is rare in breastfed babies even in areas of the globe where vitamin A deficiency is widespread.

Breastmilk: A Critical Source of Vitamin A for Infants and Young Children (PDF format) from the LINKAGES Project. Also bachelor in English, French, Portuguese and Spanish.

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Vitamin B1 (thiamine)

If mom is getting enough thiamine, and then her milk has enough for baby and supplements are not needed. If mom is thiamine-deficient, then adding additional thiamine to mom's nutrition should increase the corporeality of thiamine in her milk (since this vitamin is water-soluble) to the necessary levels. Thiamine deficiency (beriberi) is rare in the Usa.

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Vitamin B2 (riboflavin)

Supplements are non recommended for breastfed babies, as riboflavin deficiency is rare in developed countries. The levels of riboflavin in homo milk are quite constant and are commonly afflicted but by big maternal supplements (3x the maternal RDA).

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Vitamin B6

If mom gets adequate amounts of vitamin B6, then additional supplements are not necessary for a salubrious baby. If mom is not getting plenty vitamin B6, then adding additional vitamin B6 to mom'southward diet will increment the levels in her milk to the required levels.

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Vitamin B12

Meet Does my infant demand vitamin B12 supplements?

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Vitamin C

Breastfed babies should non be routinely supplemented with vitamin C except in cases of obvious scurvy (vitamin C deficiency). FDA requirements for breastfeeding mothers for this vitamin are 120 mg per day (over 18 years) and 115 mg per day (under 18 years). If you smoke, add 35 mg per day to these amounts. Supplements of vitamin C for a mother practice not significantly alter the amounts in breastmilk, as they remain fairly constant no affair what mother's intake levels (bold the mother is not vitamin-C deficient).  For a female parent deficient in vitamin C, supplements volition increase milk levels.

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Calcium

Breastfed babies exercise non need boosted calcium over that which they get from breastmilk and (during the 2nd 6 months) complementary foods. According to the American Academy of Pediatrics Policy Statement on Calcium Requirements of Infants, Children, and Adolescents:

No available evidence shows that exceeding the amount of calcium retained by the exclusively breastfed term infant during the first six months of life or the amount retained by the human milk-fed infant supplemented with solid foods during the second 6 months of life is benign to achieving long-term increases in bone mineralization.

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Vitamin D

The American Academy of Pediatrics recommends that all babies receive routine vitamin D supplementation (400 IU per day) due to decreased sunlight exposure and an increase in rickets.

The babies who do demand these supplements need them due to a lack of sufficient sunlight. Factors that put your breastfed baby at risk for vitamin D deficiency (rickets) are:

• Infant has very little exposure to sunlight. For example: if you live in a far northern latitude, if you live in an urban surface area where alpine buildings and pollution block sunlight, if infant is always completely covered and kept out of the sun, if baby is always within during the day, or if you ever apply loftier-SPF sunscreen.
• Both mother and baby have darker skin and thus crave more dominicus exposure to generate an adequate amount of vitamin D. Again, this is a "not plenty sunlight" outcome – the darker your skin pigmentation, the greater the corporeality of sun exposure needed. There is not much data bachelor on howmuch more than sunlight is needed if y'all have medium or darker toned skin.
• Mother is deficient in vitamin D – there is increasing evidence in the final few years indicating that vitamin D deficiency is becoming more common in western countries. The corporeality of vitamin D in breastmilk depends upon mom's vitamin D status. If baby gets plenty sunlight, mom'south deficiency is unlikely to be a problem for infant. However, if baby is not producing enough vitamin D from sunlight exposure, then breastmilk will need to see a larger percentage of baby'southward vitamin D needs. If mom has minimal exposure to sunlight (encounter above examples)and is non consuming enough foods or supplements containing vitamin D, and then she may be vitamin D scarce.

The best way to get vitamin D, the fashion that our bodies were designed to go the vast majority of our vitamin D, is from sun exposure. Depending upon where you live and how dark your skin is, going exterior regularly may be all that is required for you or your babe to generate adequate amounts of vitamin D.  However, ane of the problems with getting your vitamin D with sun exposure is simply that it's hard to determine how much time outside is needed since it depends on and so many factors (pare tone, breadth, time of yr, how much peel is exposed, corporeality of air pollution, etc.) Keep in mind that there is also a concern of sunburn and increased hazard of skin cancer with too much sunday exposure.

The primary source of vitamin D for babies, other than sunlight, is the stores that were laid downward in baby's torso prior to birth. Because mom's vitamin D status during pregnancy directly affects babe's vitamin D stores at nascence and specially during the first ii-3 months, it is very helpful for pregnant women to make sure they are getting enough vitamin D.

Adding a vitamin D supplement to mom's diet and/or exposure to ultraviolet lite will increase the amount of vitamin D in her breastmilk. As long every bit mom is vitamin D sufficient, her breastmilk will have the "correct" amount of vitamin D. All the same, babies were "designed" to get simply part of their vitamin D from breastmilk and the remainder from lord's day exposure – what if infant does not become a minimum amount of sun? A 2015 study [Hollis et al 2015] concluded that "Maternal vitamin D supplementation with 6400 IU/solar day safely supplies chest milk with adequate vitamin D to satisfy her nursing infant's requirement and offers an alternate strategy to direct infant supplementation." Read more about this written report and vitamin D in our interview with Dr. Bruce Hollis. A 2004 study [Hollis & Wagner 2004] determined that supplementing the female parent with 2000-4000 IU vitamin D per day safely increased mother's and baby's vitamin D status: the 2000 IU/d dose resulted in a limited improvement, and "A maternal intake of 4000 IU/d could achieve substantial progress toward improving both maternal and neonatal nutritional vitamin D status." A Finnish written report [Ala-Houhala 1986] showed that supplementing the mother with 50 µg (2000 IU) vitamin D per day was as effective for maintaining infant'southward vitamin D levels every bit supplementing the infant with x µg (400 IU) per day.

See also: Vitamin D and Breastfeeding: An interview with Bruce Hollis, PhD

Papadimitriou DT. The Large Vitamin D Mistake. J Prev Med Public Health. 2017

Wagner CL,Greer FR and the Section on Breastfeeding and Commission on Nutrition Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents. Pediatrics. Nov 2008; 122;1142. doi: 10.1542/peds.2008-1862

Hollis BW, Wagner CL, et al. Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial. Pediatrics. 2015; 136;625. doi: 10.1542/peds.2015-1669

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Vitamin Eastward

No known deficiencies of vitamin East have been described in healthy term infants fed man milk. Vitamin E supplements for mothers and their breastfed babies are non indicated.

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Fluoride

Currently there is no evidence indicating that fluoride supplements in infancy improve a breastfed baby's dental health. Dr. Ruth Lawrence (in Breastfeeding: A Guide for the Medical Profession, 7th ed., p.932) states:

The supplementation of fluoride in the diet of a healthy breastfed infant is no longer recommended by the AAP. Evidence supports the contention that at that place is adequate fluoride in human milk, and fluorosis from excessive amounts is a concern.

The American Academy of Pediatrics recommends that fluoride supplements only be given after 6 months, and just to children whose primary water source is scarce in fluoride.

The American Academy of Pediatric Dentistry is slightly more conservative, suggesting that the caries run a risk to the individual child also be considered: "The AAPD endorses the supplementation of a child'due south diet with fluoride according to established guidelines1, when fluoride levels in customs h2o supplies are sub- optimal and after consideration of sources of dietary fluoride and the caries gamble of the kid."

Many city h2o systems add fluoride to the water. If you use well water or bottled water, it's unlikely that fluoride has been added to your water, merely it may still exist there. Fluoride occurs naturally in most water, and then yous really need to know how much fluoride is in your water before you determine whether to supplement.

How do you find out how much fluoride is in your drinking water?

• If you utilize city water, telephone call your local water department to find out.
• If yous employ bottled water, call the bottling company.
• If you apply well water, you tin ask your local h2o department about having your water tested for fluoride – fluoride analysis isn't very expensive.

Later yous know how much fluoride is already in your drinking water and make up one's mind whether your child is at high risk for developing cavities, you lot can determine whether fluoride supplementation might be benign.

More information:

Fluoride Supplements from AskDrSears.com

Fluoride Dietary Supplementation from the American Academy of Pediatrics

Rozier RG, Adair S, Graham F, et al. Evidence-based clinical recommendations on the prescription of dietary fluoride supplements for caries prevention: a report of the American Dental Association Council on Scientific Affairs. J Am Dent Assoc. 2010;141(12):1480-9.

Journal search on Fluoride and Human Milk

Over lxx Years of Customs Water Fluoridation from the CDC

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Folic acid (folate)

Folic acrid deficiency has not been reported in breastfed, total-term infants, and supplements are not recommended.

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Iron

Here's my information page on Is Atomic number 26 Supplementation Necessary?

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Vitamin M

Infant's vitamin M stores at nativity are very low. Vitamin K is needed for proper blood clotting, and a deficiency of this vitamin causes a syndrome called Vitamin K deficiency haemorrhage (VKDB). Increasing mom's vitamin K intake increases the corporeality of vitamin K in her milk. The American Academy of Pediatrics recommends:

Intramuscular vitamin Grand₁ (phytonadione) at a dose of 0.5 to 1.0 mg should routinely be administered to all infants on the outset day to reduce the risk of hemorrhagic illness of the newborn. A filibuster of administration until later the first feeding at the chest simply non later than 6 hours of historic period is recommended. A single oral dose of vitamin Chiliad should not be used, because the oral dose is variably absorbed and does non provide acceptable concentrations or stores for the breastfed infant.

Additional information:

Evidence on: The Vitamin One thousand Shot in Newborns past Nicole Churchin

Vitamin K1 Prophylaxis from the British Columbia Reproductive Intendance Program

Niacin

Niacin deficiency in breastfed infants in developed countries is extremely rare, and no supplementation is recommended.

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Zinc

Salubrious full-term breastfed babies do not need boosted zinc by what they get from breastmilk and (subsequently vi-8 months) from complementary foods. Good sources of zinc include meat (especially red meat) and yogurt. Signs of a mild zinc deficiency include: lessened appetite, lowered immune function, limited action, growth faltering. Low nativity weight, small for gestational age and premature infants are at gamble for zinc deficiency.

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If you're worried that your baby will demand vitamins because your diet is non ideal

Studies have shown that when a mother is deficient in a certain food, improving the female parent's nutrition and/or supplementing her diet (multivitamins, etc.) may be as constructive or more than effective than giving her baby vitamin supplements.

More data @

• How does mom'south diet affect her milk?
• Vitamins for nursing moms

Additional information

FAQ on Vitamin and Fluoride Supplements for the Breastfed Baby from La Leche League.

The Science of Feeding Your Children by Jay Gordon, Doc

Vitamin & Iron Supplements from the American Academy of Pediatrics

Food Information from the the American Society for Nutritional Sciences includes electric current data on food sources, diet recommendations, deficiencies, toxicity, clinical uses, recent research and references for further information for many micro- and macronutrients.

USDA Food Composition Data

Nutrition Assay Tool (NAT) from the Food Science and Human Diet Department at the Academy of Illinois

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References

American Academy of Pediatrics, Committee on Nutrition. Fluoride supplementation for children: interim policy recommendations. Pediatrics. 1995;95(5):777

American Academy of Pediatrics, Work Group on Breastfeeding. Breastfeeding and the Use of Human Milk. Pediatrics. 1997;100(6):1035

Baker SS, Cochran WJ, Flores CA, Georgieff MK, Jacobson MS, Jaksic T, Krebs NF. American Academy of Pediatrics. Commission on Nutrition. Calcium Requirements of Infants, Children, and Adolescents. Pediatrics 1999 Nov;104(5 Pt 1):1152-seven.

Milner JD, Stein DM, McCarter R, Moon RY. Early on Infant Multivitamin Supplementation Is Associated With Increased Risk for Food Allergy and Asthma. Pediatrics. 2004 Jul;114(one):27-32.

Greer, FR. Do breastfed infants need supplemental vitamins? Pediatr Clin North Am (U.s.), April 2001, 48(two) p 415-23

In conclusion, in healthy, breastfed infants of well-nourished mothers, there is piddling risk for vitamin deficiencies and the need for vitamin supplementation is rare. The exceptions to this are a need for vitamin One thousand in the immediate newborn menses and vitamin D in breastfed infants with night skin or inadequate sunlight exposure.

Krebs NF, Westcott J. Zinc and breastfed infants: if and when is there a risk of deficiency? Adv Exp Med Biol. 2002; 503: 69-75.

Krebs NF. Dietary zinc and fe sources, physical growth and cognitive development of breastfed infants. J Nutr 2000 February;130(2S Suppl):358S-360S.

Mohrbacher, N. and Stock, J. BREASTFEEDING Respond BOOK. Schaumburg, Illinois, USA; LLLI 1997.

Hamosh M, Dewey, Garza C, et al: Nutrition During Lactation. Plant of Medicine, Washington, DC; National Academy Press 1991, pp. 133-140.

Butte NF, Lopez-Alarcon MG, Garza C. Nutrient adequacy of sectional breastfeeding for the term infant during the get-go vi months of life. Geneva, Switzerland; Earth Health Organisation 2002, pp. 26-thirty.

Dietary Reference Intakes (DRI) and Recommended Dietary Allowances (RDA) from the US Department of Agronomics's Food and Nutrition Information Center

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Source: https://kellymom.com/nutrition/vitamins/vitamins/

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