Breast milk really is best! and the way to go through the first year of life. As the number of mothers who want to breast feed their newborns continues to increase in our experience, we’ve decided to address the issue of Vitamin supplementation for exclusively breastfed and formula supplemented newborns in this post. The recommendations addressed here apply to full-term healthy newborns between birth and 12-months of life only. Additional considerations would apply for newborns who do not fit into this category. The element, Iron and Vitamin D will be discussed.

Iron is a key element in body cells and for biochemical processes. It’s many benefits and need to maintain adequacy of intake are protean and will not be discussed in great detail here.

Term, healthy newborns have sufficient iron in the blood cells and in storage forms in the body for at least the first 4 months of life.  Breast milk contains iron that despite it’s low quantity has been shown to be more efficiently available for absorption by the body. This goes a long way in offsetting the impact of its relatively low quantity. Recognition of the effects of insufficient iron for use by the body on blood formation, a condition called anemia which may be evident on a blood test. The body could also be dealing with insufficient iron levels without any abnormalities evident on a blood test. Their is evidence that developing nervous system is also affected by insufficient iron which can manifest as poor cognitive abilities in later life.

Newborns who are exclusively breastfed are at an increased risk of having insufficient iron available for use in the body after 4 months of life. Therefore, at 4 months of life exclusively breastfed infants should be supplemented with oral iron at this age until appropriate iron-containing complementary foods (including iron-fortified cereals) are introduced into their diet. For partially breastfed infants, the same risk above is often applicable once intake of the formula ingested in less than 500ml in a day. Therefore, beginning at 4 months of age, partially breastfed infants (more than half of their daily feedings as human milk) who are not receiving iron containing complementary foods should also receive supplemental iron at a dose determined by your physician.

Vitamin D is essential for good bone health and insufficient levels have been linked to a condition called rickets in infants and children. Bone maturation and formation does not progress as expected in children with Vitamin D deficiency.  Scientific research has in addition found an expanded role for Vitamin D in the body and conditions like type 1 diabetes mellitus as well as inflammatory diseases are being more readily identified in individuals with Vitamin D deficiency. There are limited natural sources of vitamin D in a typical diet. Nature makes up for this lapse with sunlight converting some chemicals in the skin into Vitamin D forms. Clothing and lifestyle choices in the outdoors and ethnic skin pigmentation and geographic location are some of the factors that do not easily allow for clear recommendations on what amount of sunshine is adequate for a given mother who is breastfeeding her newborn exclusively. Mother’s with insufficient Vitamin D levels will not have adequate Vitamin D in breast milk as well and will therefore, put their exclusively breast fed infant at risk for Vitamin D deficiency.

Current recommendations to ensure adequate vitamin D status have been revised to cover all infants, including those who are exclusively breastfed. These infants need to have a supplemental dose of 400 IU of Vitamin D orally daily.

There are many formulations for administering recommended doses of vitamins in eligible infants, discuss vitamin supplementation options with you doctor before administration.