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Why do breastfed babies need vitamin D supplements?
Q: I am breastfeeding my 2-month-old baby. He’s been very healthy and growing well, and I intend to breastfeed him for at least one year. The pediatrician just told me there’s a new recommendation to give breastfed babies vitamins. Please tell me more about this.
A: Judi, it’s great that you’re able to give your baby all the health advantages of breastfeeding. You’re correct that the American Academy of Pediatrics just issued a new recommendation that breastfed babies should receive vitamin D supplements to prevent rickets, a condition that can weaken children’s bones.

The reason for the new recommendation is that doctors have been seeing more rickets in children. Previously, infants received enough vitamin D from the combination of two sources: from milk (either breastmilk or formula) and from the sun, which stimulates the body to produce vitamin D. But with the current recommendations to reduce babies’ exposure to sun to prevent skin cancer, many babies are not receiving enough vitamin D. The children most at risk for rickets are babies who are exclusively breastfed, older children who do not drink vitamin D-fortified formula or milk, children with dark skin, and those rarely exposed to sunlight.

The new recommendation is that breastfed infants should be given daily vitamin D supplements starting by 2 months of age and continuing until they drink at least 17 ounces of vitamin D-fortified formula or milk per day. The recommendation also applies to bottle-fed babies and older children who do not drink at least 17 ounces of milk each day, or get regular exposure to sunlight.

The vitamin D supplements should be given daily to infants as multivitamin drops containing 200-400 I.U. of vitamin D. With the addition of vitamin D in multivitamins, the American Academy of Pediatrics continues to recommend that breastfeeding is the healthiest way to feed your baby.

Karen Sokal-Gutierrez M.D., M.P.H. Pediatrician