Vitamins and Other Nutritional Supplements

Vitamins and Other Nutritional Supplements for Baby

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 (apart from vitamin D). 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 read our post on vitamin D

Iron THE WOMANLY ART OF BREASTFEEDING explains that you “might be told that your baby needs extra iron, but that’s because formula-fed babies need extra iron. There isn’t a lot of iron in your milk but there isn’t supposed to be.” The iron in human milk is better absorbed by your baby than is the iron in cow’s milk or iron-fortified formula,  the quantity of iron in human milk is appropriate for baby instead of the larger quantity in cow’s milk: in fact if your baby gets too much iron it will end up feeding the wrong bacteria in his intestines. 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 and 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 your baby’s iron levels, your healthcare provider can perform a simple haemoglobin test. 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. You might find our post on solids useful.

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 2005 policy statement1 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). Flouride supplements are not offered at all in many countries.

Vitamin B12 According to Nutrition During Lactation (Hamosh 1991, p. 157-58), a full-term infant of a well-nourished mother will be born with a store of vitamin B12 sufficient to meet his needs for about 8 months. If the mother is not vitamin B12 deficient herself, then her milk is an excellent source of vitamin B12 and is more than sufficient for her baby’s needs through the first year. There is evidence that babies born to vitamin B12 deficient mothers have low stores of vitamin B12 at birth. Studies have shown that mothers who are vitamin B12 deficient have low levels of vitamin B12 in their milk.

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.

1 http://pediatrics.aappublications.org/content/pediatrics/115/2/496.full.pdf