Mineral and vitamin supplements aren’t needed for a healthy, breastfed baby for the first 6 months.
While breast milk is the best source of nutrients for babies, sometimes it doesn’t provide enough vitamins and nutrients for the proper growth and health of the child. This often depends on the mother’s intake of sufficient vitamins and nutrients, which are transmitted to the baby in the form of breast milk.
Vitamin A deficiency in breastfed babies is rare as breast milk is an excellent source for this type of vitamin. Therefore, it’s best to continue breastfeeding to protect the child from this deficiency.
Vitamin B1 (Thiamine)
Breastfed babies by mothers, who have enough thiamine in their body, will never need to take an extra dose of vitamin B1. But if the mother is thiamine-deficient, then she should start by adding vitamin B1 to her diet, essentially to increase the vitamin supplementation to her child.
Vitamin B2 (Riboflavin)
Same as Vitamin B1, this type of vitamin deficiency is rare in breastfed babies.
When a mother’s diet contains sufficient Vitamin B6, her baby, if exclusively breastfed, will never need additional supplements. But if the mother is not getting enough vitamin B6, then additional vitamin B6 needs to be added to her diet to make it wholesome.
Only in cases of an obvious disease called scurvy (Vitamin C deficiency), breastfed babies will require a vitamin C supplement and mothers that exclusively breastfeed, need at least 120 mg per day. Supplements will increase the level of vitamin C in the milk of a mother with vitamin C deficiency.
Vitamin E supplements aren’t needed for mothers and their breastfed babies are rarely deficient.
Currently, there is no evidence pointing to fluoride supplements for breastfed babies to improve their dental health. Evidence supports that there is adequate fluoride in human milk.
Fluoride supplements should only be given after 6 months, and only to children whose primary water source is deficient in fluoride. If the child is given well water or bottled water, it’s unlikely that fluoride has been added to this water. Fluoride occurs naturally in most water, so one really needs to know how much fluoride is in the water before deciding whether to supplement or not after consulting the child’s physician.
Folic Acid (Folate)
Deficiency of folic acid hasn’t been reported in breastfed infants and supplements are not recommended.
Vitamin K is very low at birth. It is needed for blood clotting, and if there is a deficiency, it can lead to Vitamin K deficiency bleeding (VKDB) syndrome. Increasing the intake of vitamin K in the mother’s diet will help curb the problem.
An intramuscular injection of vitamin K at a dose of 0.5 to 1.0 mg should be routinely given to all infants on the first day to reduce the risk of newborn hemorrhagic diseases. An oral dose of vitamin K should not be taken because it is variably absorbed.
Additional zinc supplementation for healthy breastfed babies is usually not needed. Less appetite, low activity, no gain in weight and low immune system are signs of a zinc deficiency. Premature infants are at a higher risk of deficiency.
Breastfed babies do not need additional calcium over what they get from their mother’s breast milk and (during the second 6 months) from complementary foods.
No evidence shows that exceeding the amount of calcium in exclusively breastfed babies will be beneficial to achieving a long-term increase in bone mineralization.
Calcium is an important supplement that is responsible for building the bones of the baby. It keeps the nerves and muscles working, and the heart healthy. Children, who get enough calcium early in life have the strongest bones, and its best to start from infancy.
Calcium and vitamin D are needed by growing babies to prevent a disease called rickets that causes bow legs, stunted growth, and weak muscles.
We have listed some of the richest natural sources of calcium. These include:
- Hard cheeses like cheddar.
- Green leafy vegetables and cruciferous vegetables.
- Almonds and sesame seeds.
- White and red beans.
- Orange, guava, figs and prunes.
- Coloured Pepper (capsicum).
Calcium is measured in milligrams (mg). The best thing we can do for our children is to feed them a calcium-rich diet. If that’s not possible, then ask the doctor to suggest a supplement. The right amount of calcium intake is as follows:
- 200 mg of calcium a day is needed for babies younger than 6 months.
- 260 mg of calcium a day is needed for babies between 6-12 months.
We discussed the importance of calcium for children to have stronger bones. Likewise, babies and kids need vitamin D to help their body to absorb calcium and phosphorus. A deficiency in vitamin D can cause rickets, a softening and weakening of bones.
A breastfed baby’s risk factors for a deficiency in Vitamin D (Rickets) are:
- Little exposure to sunlight; if the baby is always covered and kept out of the sun or is always inside during the day.
- If both the mother and baby have dark skin and require more sun exposure to generate an adequate amount of vitamin D. The darker the skin pigmentation, the greater should be the amount of sun exposure.
- If the mother is deficient in vitamin D, then the amount of vitamin D in breast milk will be deficient; she will need a vitamin D supplement.
The best way to get vitamin D is from sun exposure. The primary source of vitamin D for babies, other than sunlight, is prior to birth. It is important for pregnant women to ensure they get enough vitamin D, particularly during the first 2-3 months.
As the baby becomes 6 months old and solid foods are introduced to the baby’s diet, the daily vitamin D requirement can be met by giving a vitamin D rich diet like cheese and egg yolks. Since Vitamin D isn’t found in many foods that children can eat, it’s best to seek a health care provider’s advice on a supplement, and give it to the baby.
Adding a vitamin D supplement to the mother’s diet and exposure to the sun will increase the amount of vitamin D in her breast milk. Supplementing the mother with 2000-4000 IU vitamin D per day safely increased the mother and the breastfed baby’s vitamin D status.
In 2011, a clinical study evaluated Vitamin D deficiency in healthy breastfed term infants at 3 months and their mothers in India. They concluded that the prevalence of its deficiency was found to be high in breastfed infants and their mothers, with radiological rickets in a third of infants within this study.
Babies who only have breast milk may need a vitamin D supplement. Baby formula has vitamin D added, so babies who drink more than 32 ounces of formula a day most probably won’t need extra vitamin D, but the mother has to check with the child’s doctor first.
When giving the baby liquid vitamin D, make sure the recommended amount is not exceeded. Carefully follow the physician’s instructions and use the dropper.
There are a lot of researches stressing on the importance of improving the mother’s nutrition and supplementing her diet with multivitamins. This will be as effective as giving her baby vitamin supplements. Healthy, breastfed babies with mothers on a nutritious diet will show little risk for vitamin deficiencies with a lower need for vitamin supplementation. But before deciding on starting the baby on supplements, it’s best to speak to the doctor and seek his advice. Don’t they say – it’s better to be safe than sorry!