Should My Breastfed Baby Be Receiving Vitamin or Fluoride Supplements?

Advertisements, family members and even health professionals often urge mothers to add "something" to baby's perfect diet of mother's milk. According to the our comprehensive guidebook, THE WOMANLY ART OF BREASTFEEDING, if a breastfeeding mother is getting an adequate supply of vitamins in her diet, her milk will contain adequate nutrients in the perfect balance for her baby. If your baby is healthy and doing well, there is no need for vitamins, iron, or other supplements in the early months. Furthermore, many mothers have found that vitamin or fluoride supplements may cause fussiness or colic in their infants. By treating each mother and baby as a unique pair, unnecessary supplementation can often be avoided.

Concerns are sometimes raised about the breastfed baby's need for these specific nutrients:

Vitamin D Exclusively breastfed healthy, full-term infants from birth to six months who have adequate exposure to sunlight are not at risk for developing vitamin D deficiency or rickets. Rickets occurs because of a deficiency in sunlight exposure, not because of a deficiency in human milk.

La Leche League International's THE BREASTFEEDING ANSWER BOOK, 3rd Edition, lists the following risk factors for vitamin D deficiency:

Dark skin
Consistent coverage of skin with clothing or sunscreen when outdoors
Live in areas where there is little sunlight for parts of the year or do not go outdoors
Live in areas of heavy air pollution, which blocks sunlight
Mother is vitamin D deficient

Other risk factors include:

increased birth order
exposure to lead
the replacement of human milk with foods low in calcium or foods that reduce calcium absorption

For more information, please refer to the following articles:

Sunlight Deficiency: Helping Breastfeeding Mothers Find the Facts, LEAVEN August-September 2003
Sunlight Deficiency, "Vitamin D," and Breastfeeding, LEAVEN June-July 2003
SUNLIGHT DEFICIENCY AND BREASTFEEDING, BREASTFEEDING ABSTRACTS November 2002

Iron According to THE BREASTFEEDING ANSWER BOOK, published by LLLI, the iron in human milk is better absorbed by your baby than is the iron in cow's milk or iron-fortified formula. This means that the quantity of iron in human milk is appropriate for baby instead of the larger quantity in cow's milk. The full-term healthy baby usually has no need of additional iron until about the middle of his first year, around the time he starts taking solids. The high lactose ad vitamin C levels in human milk aid the absorption of iron, and breastfed babies do not lose iron through their bowels.

If there is concern about the baby's iron levels, a simple hemoglobin test can be done in the doctor's office. If necessary, it is easy to offer the baby foods which are naturally rich in iron. However, iron drops and iron-fortified foods sometimes cause digestive upsets when given to babies and can actually reduce the efficiency of iron absorption.

Women are often advised to continue to take prenatal vitamins as long as they are breastfeeding and these vitamins often include a large dose of iron. The iron levels in a mother's milk are not affected by the amount of iron in her diet or by iron supplements she may take.

Fluoride The American Academy of Pediatrics recommended in its 1997 policy statement that babies younger than six months should NOT receive fluoride supplements and that babies older than six months receive supplements only if they live in an area where the drinking water contains less than 0.3 ppm of fluoride. Fluoride supplements tend to contribute to excess intestinal gas (wind).

Vitamin B12 Vitamin B12 supplements are strongly recommended for mothers who adhere to vegetarian diets that include no animal products, such as vegan and macrobiotic diets. Such diets can lead to a vitamin B12 deficiency in mother and/or baby because this vitamin is primarily available from animal protein. Symptoms of Vitamin B12 deficiency may include loss of appetite, regression in motor development, lethargy, muscle atrophy, vomiting, blood abnormalities and neurological problems. If caught early enough, treatment with vitamin supplements can completely resolve these symptoms.

If you have additional concerns about these or other nutrients, please contact your local LLL Leader. To find a Group near you, call 1-800-LALECHE, look at our LLL Web Page Index or follow the hints in our page on finding a local LLL Leader. If you are unable to find a local Group, you may consider attending one of our on-line LLL meetings.

Available from the LLLI Online Store: MY CHILD WON'T EAT! by Carlos González, MD Parents everywhere worry when their baby or toddler doesn't seem to eat as much as they think he should. Carlos González, a pediatrician and father, sets those fears to rest as he explores the reasons why a child refuses food, the pitfalls of growth charts, and the ways that growth and activity affect a child's caloric needs. He reassures parents that children know how much they need to eat and it's the parents' job to provide healthful food choices. Forcing a child to eat more than what he needs can only lead to tears, tantrums, and eventually, obesity. (Softcover, 183 pages. No. 1716-12)

For additional information on the components of human milk you may want to purchase our comprehensive guidebook, THE WOMANLY ART OF BREASTFEEDING. It is offered for sale by most LLL Groups and from the LLLI Online Store.

Our FAQs present information from La Leche League International on topics of interest to parents of breastfed children. Not all of the information may be pertinent to your family's lifestyle. This information is general in nature and not intended to be advice, medical or otherwise. If you have a serious breastfeeding problem or concern, you are strongly encouraged to talk directly to a La Leche League Leader. Please consult health care professionals on any medical issue, as La Leche League Leaders are not medical practitioners.

Last updated Friday, September 15, 2006 by njb.

Page last edited Sun Oct 14 09:31:04 UTC 2007.