Does my baby need vitamin D drops?

The short answer

Yes, for most babies. The American Academy of Pediatrics recommends that all infants get at least 400 IU of vitamin D a day, starting soon after birth. CDC says breastfed babies, including those who get some formula, need a 400 IU supplement every day. Use drops made for infants, and give exactly the dose on the label, no more.

Needing drops isn't a sign that anything is wrong with breast milk. Breast milk is a wonderful food, and the AAP's advice covers all infants, whatever they're fed. The drops simply make sure one nutrient is covered while your baby's main food is milk. If you're not sure whether your baby needs them, it's a quick question for your pediatrician at the next visit.

Who needs drops: a quick guide

Here's the part many parents miss: formula-fed babies are not automatically covered. Formula has vitamin D added, but CDC says a supplement is only unnecessary once a baby drinks 32 oz or more of formula a day. Many young babies drink less than that, especially in the first days, when newborns usually take 1 to 2 oz (30 to 60 mL) at a time. If you formula-feed, ask your pediatrician whether your baby needs drops for now.

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Why babies need vitamin D

Vitamin D helps a baby build bones, and researchers think it plays a part in brain development too. The AAP's recommendation comes from its statement on preventing rickets and vitamin D deficiency in infants and children.

You might wonder about sunshine. For babies under 6 months, the AAP's sun-safety advice is to keep them out of direct sun: shade from a tree, an umbrella or the stroller canopy, clothes that cover arms and legs, and a brimmed hat. Sunscreen goes only on small areas like the face, and only if shade and clothing aren't available. So sunlight isn't a plan for a young baby's vitamin D, and the kind of sunlight that makes vitamin D doesn't pass through glass anyway, so a sunny window won't help. Outdoor time is still great for your baby's senses; keep it shaded, and let the drops handle the vitamin D.

How to give vitamin D drops

• Use drops made for infants.
• Give exactly the dose on the label, no more. Read the label again whenever you buy a new bottle.
• Tie it to a routine, such as the first morning feed or the diaper change after it, so it becomes automatic.
• Keep the bottle out of reach, like any medicine or supplement.
• Keep going until your pediatrician tells you your baby no longer needs them.

A self-check worth keeping: "My baby gets 400 IU of vitamin D daily, or I've checked they don't need it."

More isn't better

With vitamins, enough is the goal. Give the label dose and no extra. Research in pregnancy makes the same point: in a Danish trial, COPSAC2010, 623 pregnant women took either 2,800 IU or 400 IU a day, and when their children were followed to age 6, there was no difference in milestones, thinking, language or behavior.

The same goes for other drops. Don't give iron drops on your own; if you're breastfeeding, ask your pediatrician whether your baby needs iron before 6 months. And don't salt your baby's food to add iodine. Around 6 months, iron-rich solids take over much of that job (see the best first foods for brain development).

What about the breastfeeding parent?

What a breastfeeding mother eats shapes some nutrients in her milk, especially DHA and iodine. The American Thyroid Association and the AAP both recommend a daily supplement with 150 mcg of iodine for breastfeeding women, and the FDA and EPA advise 8 to 12 oz of lower-mercury fish a week while breastfeeding. Needs for iodine are higher while breastfeeding (the US RDA is 290 mcg a day), and choline needs peak at 550 mg a day. Keep taking your prenatal if your doctor agrees, and ask whether it covers what you need. Read more on diet while breastfeeding.

Your own vitamin D is worth asking about too. In pregnancy, the US recommended amount is 600 IU a day, with a safe upper limit of 4,000 IU. Salmon or trout, UV-exposed mushrooms, fortified milk and egg yolks are good food sources. Your baby still needs their own drops. If you're still pregnant or planning, see vitamin D before pregnancy.

Questions to ask your pediatrician

1. "Which vitamin D drops do you recommend, and how much should I give?"
2. "My baby gets some formula. Do they still need drops?"
3. "When can we stop the drops?"
4. "Does my baby need iron drops before solids start?"

Outside the US, follow your own health authority's advice and ask your doctor. For more on feeding choices, see breastfeeding and the baby brain.

Go deeper

Grow a Genius

In the book: Chapter 17: Feeding the Growing Brain

Chapter 17 puts vitamin D in the full first-year feeding plan, from breast and bottle to iron-first solids, and the Prenatal Label Decoder guide shows every brain nutrient's official daily amount on one table.

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