Which nutrient does the American Academy of Pediatrics now recommend be given as a supplement to breast fed infants starting in the second month?

Which nutrient does the American Academy of Pediatrics now recommend be given as a supplement to breast fed infants starting in the second month?
Which nutrient does the American Academy of Pediatrics now recommend be given as a supplement to breast fed infants starting in the second month?

The American Academy of Pediatrics (AAP) recommends infants be fed breast milk (also known as human milk) exclusively for the first 6 months after birth. Human milk contains a natural balance of vitamins, especially C, E and the B vitamins. So, if you and your baby are both healthy, and you are well nourished, your child may not require any supplements of these vitamins. However, breastfed infants need supplemental vitamin D.

Why do babies need vitamin D supplements?

Our bodies need sunlight to produce vitamin D, which is why exposure to sunlight is good in moderation. However, children should wear sunscreen, hats, and protective clothing when outdoors for extended periods of time to prevent sunburn and reduce the risk of skin cancer later in life. For this reason, the AAP recommends that all infants receive a vitamin D supplement (unless they are consuming more than 27 ounces per day of commercial formula that has the vitamin D supplement added.

How much vitamin D do babies need?

Vitamin D supplements of 400 IU (10 mcg) per day are recommended for babies up until age one year, with 600 IU (15 mcg) per day for children over one year. Talk to your pediatrician about supplemental vitamin D drops.

Do babies need iron supplements?

For the first four months, your breastfed baby needs no additional iron. The iron in their body at birth was enough for their initial growth. But now the reserves will be low and as their growth increases, so will their need for iron. At four months of age infants who are partially or completely breastfeeding should be supplemented with 1 mg/kg per day of oral iron until appropriate iron-containing complementary foods (including iron-fortified cereals) are introduced in their diet.

Universal screening for iron deficiency

The AAP recommends that all babies be screened at 12 months of age for iron deficiency and iron deficiency anemia. See Anemia and Your Child: Parent FAQs for more information.

If there were pregnancy or birth complications such as diabetes, low birth weight, or prematurity, or if your baby was small for gestational age and is taking breast milk, iron supplementation may start in the first month after birth. Fortunately, once you start your baby on solid foods, they’ll also receive iron from meats, iron-fortified cereals and green vegetables.

More information

  • Vitamin D Deficiency and Rickets

  • Where We Stand: Vitamins

  • Tips to Reduce Arsenic in Your Baby's Diet

  • Dietary Supplements for Toddlers

Last Updated 5/24/2022SourceAdapted from Caring for Your Baby and Young Child: Birth to Age 5 7th Edition (Copyright © 2019 American Academy of Pediatrics)

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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

Consider these guidelines from the American Academy of Pediatrics for vitamin D for babies:

  • Breastfed or partially breastfed babies need 400 international units (IU) of liquid vitamin D a day — starting soon after birth. Babies should continue to receive this amount of vitamin D until weaned or until they drink 32 ounces (about 1 liter) a day of vitamin D-fortified formula or, after age 12 months, whole milk.
  • Babies getting less than 32 ounces (about 1 liter) a day of vitamin D-fortified formula need 400 IU of liquid vitamin D a day — starting in the first few days after birth. Babies should continue receiving the vitamin D supplement until they drink at least 32 ounces (about 1 liter) of vitamin D-fortified formula a day.

When giving your baby liquid vitamin D, make sure not to give more than the recommended amount. Read the instructions that come with the supplement and use only the dropper that's provided.

While breast milk is the best source of nutrients for babies, it likely won't provide enough vitamin D. Babies need 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, supplements are the best way to prevent vitamin D deficiency.

As your baby gets older and you add solid foods to your baby's diet, you can help meet the daily vitamin D requirement by providing foods that contain vitamin D — such as salmon, egg yolks and fortified foods.

If you have questions about your baby's need for vitamin D supplements, talk to your baby's health care provider.

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June 07, 2022

  1. Vitamin D. Office of Dietary Supplements. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Accessed Feb. 17, 2022.
  2. 2020-2025 Dietary Guidelines for Americans. U.S. Department of Health and Human Services and U.S. Department of Agriculture. https://www.dietaryguidelines.gov. Accessed Feb. 17, 2022.
  3. Pazirandeh S, et al. Overview of vitamin D. https://www.uptodate.com/contents/search. Accessed Feb. 17, 2022.
  4. Tan ML, et al. Vitamin D supplementation for term breastfed infants to prevent vitamin D deficiency and improve bone health. Cochrane Database of Systematic Reviews. 2020; doi:10.1002/14651858.CD013046.pub2.

See more Expert Answers

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Which nutrient should be supplemented for breastfed infants?

To avoid developing a vitamin D deficiency, the Dietary Guidelines for Americans and American Academy of Pediatrics recommend breastfed and partially breastfed infants be supplemented with 400 IU per day of vitamin D beginning in the first few days of life.

What are the American Academy of Pediatrics AAP recommendations regarding breastfeeding and nutrition for the first 6 months?

The AAP recommends: Exclusive breastfeeding for the first 6 months. There is no need to introduce infant formula or other sources of nutrition for most infants. Beyond 6 months, breastfeeding should be maintained along with nutritious complementary foods.

What nutrients do infants need?

5 Nutrients Your Baby Needs.
Iron. Iron is an essential nutrient for life. ... .
Omega 3 fatty acids. Boost your baby's brain and eye development, as well as immunity with omega 3 fatty acids. ... .
Protein. Protein packs a lot of punch in terms of your baby's growth and development. ... .
Vitamin D. ... .

Do breast fed babies need iron supplements?

By age 6 months, however, infants require an external source of iron apart from breast milk. Breast milk contains little iron; therefore, parents of infants receiving only breast milk should talk to their infant's health care provider about whether their infant needs iron supplements before 6 months of age.