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  • With Mayo Clinic emeritus consultant

    Jay L. Hoecker, M.D.

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Question

Vitamin D for babies: Are supplements needed?

Does my baby need a vitamin D supplement?

Answer

from Jay L. Hoecker, M.D.

It depends on whether you breast-feed your baby or how much vitamin D-fortified formula or cow's milk your baby is drinking.

Consider these general guidelines from the American Academy of Pediatrics and the Institute of Medicine for vitamin D for babies:

  • If you're breast-feeding or partially breast-feeding your baby, give your baby 400 international units (IU) of liquid vitamin D a day — starting in the first few days after birth. Continue giving your baby vitamin D until you wean your baby and he or she drinks 32 ounces (about 1 liter) a day of vitamin D-fortified formula.
  • If you're feeding your baby vitamin D-fortified formula, give your baby 400 IU of liquid vitamin D a day — starting in the first few days after birth — until your baby drinks at least 32 ounces (about 1 liter) a day.

While breast milk is the best source of nutrients for babies, it likely won't provide enough vitamin D. Your baby needs vitamin D to absorb calcium and phosphorus. Too little vitamin D can cause rickets, a softening and weakening of bones. Since sun exposure — an important source of vitamin D — isn't recommended for babies younger than 6 months, supplements are the best way to prevent vitamin D deficiency in infants.

As your baby gets older and you add solid foods to his or her diet, you can help your baby meet the daily vitamin D requirement by providing foods that contain vitamin D — such as oily fish, eggs and fortified foods. Keep in mind, however, that most babies won't consistently eat these foods during their first year.

When giving your baby liquid vitamin D, make sure you don't exceed the recommended amount. Carefully read the instructions that come with the supplement and use only the dropper that's provided.  Chewable and gummy vitamins that contain vitamin D are available for older children.

If you have questions about your baby's need for vitamin D supplements, consult your baby's doctor. You might also ask your baby's doctor about vitamin D recommendations for older children. Some guidelines suggest increasing vitamin D to 600 IU a day at age 1 and beyond.

Next question
Tummy time: How much does your baby need?
References
  1. Evaluation, treatment and prevention of vitamin D deficiency: An Endocrine Society clinical practice guideline. Chevy Chase, Md.: Endocrine Society. http://www.endo-society.org/guidelines/final/upload/FINAL-Standalone-Vitamin-D-Guideline.pdf. Accessed Aug. 30, 2011.
  2. Dietary Reference Intakes for calcium and vitamin D. Institute of Medicine. http://www.iom.edu/vitamind. Accessed June 29, 2011.
  3. Holt K, et al. Bright Futures Nutrition. 3rd ed. Elk Grove, Ill: American Academy of Pediatrics; 2011:27.
  4. Wagner CL, et al. Prevention of rickets and vitamin D deficiency in infants, children and adolescents. Pediatrics. 2008;122:1142.
  5. Perrine CG, et al. Adherence to vitamin D recommendations among US infants. Pediatrics. 2010;125:627.
  6. Casey CF, et al. Vitamin D supplementation in infants, children, and adolescents. American Family Physician. 2010;81;745.
  7. Infant overdose risk with liquid vitamin D. U.S. Food and Drug Administration. http://www.fda.gov/downloads/ForConsumers/ConsumerUpdates/UCM215586.pdf. Accessed June 29, 2011.
  8. Ward LM, et al. Vitamin D-deficiency rickets among children in Canada. Canadian Medical Association Journal. 2007;177:161.
AN02157 Sept. 27, 2011

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