Does my Baby Need Vitamins or Supplements?

RachelMS, RD, LDN, CSSD, CBS

Read time: 5 minutes

What to know about whether your baby needs extra vitamins

  • Breastmilk or formula provides your baby with most of the vitamins and minerals they need.1

  • Depending on the situation, possible supplements infants need include Vitamin K, Vitamin D, Vitamin B12, and iron.

During the first 6 months of life, your baby should exclusively be fed breastmilk and/or formula. Healthy full-term babies will likely get most of the vitamins and minerals they need from that breastmilk or formula.2,3

As your baby begins eating solid foods, usually around 6 months, breastmilk and formula will continue to provide the majority of nutrients and calories.22,23 Adding a variety of fruits and vegetables, whole grains, and protein-dense foods will help your child get more of the nutrients they need. A multivitamin is usually not necessary for babies under 1 year old.1,3

Read more: Nutrient Needs and Feeding Tips for 6 to 12 Month Olds

When does my baby need extra vitamins?

Some babies may need additional vitamins, such as:

  • Premature infants, born weighing less than 3.3 pounds, will likely need extra vitamins and minerals added directly to breastmilk or formula.4

  • Babies who are exclusively as well as partially breastfed are recommended to be given vitamin D and potentially iron.5,6

  • Babies born to mothers who follow a strict vegan diet may need a B12 supplement.9

Be sure to chat with your child’s pediatrician before starting any supplements.

Which vitamin supplements could a baby need?

Vitamin K

What does vitamin K do? Vitamin K is necessary to help with blood clotting.2,7

Who may need vitamin K? The American Academy of Pediatrics (AAP) recommends that all babies receive a one-time vitamin K injection shortly after birth to reduce the risk of hemorrhagic disease.11

Vitamin D

What does vitamin D do? Vitamin D allows the body to absorb and retain calcium and phosphorus, both critical for building strong bones.27

What are symptoms of vitamin D deficiency? A vitamin D deficiency can lead to rickets, a bone-softening disease that still impacts children in the U.S., usually in the first two years of life.2,5

Who may need vitamin D? In many cases, breastmilk does not provide adequate vitamin D for baby.4,5 This is why the AAP and other health organizations recommend that all breastfed babies be supplemented with Vitamin D.6,8

Formula fed babies generally do not need additional vitamin D supplementation because formula has vitamin D already added. If your baby is drinking at least 32 ounces of formula per day, they are receiving adequate amounts of vitamin D.2,6

Read more: Why Vitamin D Matters for Babies, Tots and Mama

Vitamin B12

What does vitamin B12 do? Vitamin B12 keeps the body’s nerve and blood cells healthy and helps make DNA, the genetic material in all cells.9 Vitamin B12 deficiency can cause a type of anemia called megaloblastic anemia that makes people tired and weak.10

What are symptoms of vitamin B12 deficiency? Signs and symptoms of vitamin B12 deficiency in infants include vomiting, lethargy, anemia, failure to thrive, hypotonia (low muscle tone), and developmental delay/regression.4,12 Breastfed infants may develop clinical signs of vitamin B12 deficiency before their mothers do.4

Who may need vitamin B12? Breastfeeding people who may need vitamin B12 include: Vegans and some vegetarians, those who have had weight loss surgery, or people with malabsorption concerns.9 Taking B12 is often necessary for these groups to help make sure that both themselves and their babies are receiving adequate amounts.

Infant formulas must contain vitamin B12, so formula fed babies usually get enough of this nutrient.

If your family is vegan or there are other risk factors for low B12, discussing your family’s diet with a registered dietitian can help provide some insight on supplementation or food choices.13

Read more: Vegan Diet during Pregnancy, Breastfeeding, and for the Family

Iron

What does iron do? Iron plays an important role in the delivery of oxygen to tissues throughout the body.20 This mineral is also important for physical growth and brain development.20

What are symptoms of iron deficiency? There are several levels of iron deficiency before iron deficiency anemia is diagnosed.20 Even mild and moderate deficiencies in babies and toddlers can cause symptoms such as shortness of breath, irritability, weakness, fatigue, and headaches.21

Who may need iron? Breastmilk is low in iron but most babies are born with sufficient reserves of iron while in the womb to protect them from anemia, at least until the age of 4-6 months.4 If you had poorly controlled gestational diabetes, or your baby was premature or smaller than 6 pounds at birth, your baby may not have gotten enough iron during pregnancy.4,14 There is also some research showing that delayed cord clamping at birth can help boost baby’s iron reserves.5

Babies who are formula fed are recommended to be provided an iron-fortified formula to meet their needs.6

The AAP Committee on Nutrition recommends exclusively and partially breastfed infants receive 1 mg/kg/day of a liquid iron supplement starting at 4-6 months, continuing until iron-containing solid foods are introduced at about six months of age.6,16 However other major organizations, including the Academy of Breastfeeding Medicine as well as the United States Preventative Services Task Force, do not find the research on supplementing your baby compelling enough to recommend supplementation for breastfed babies.5,20

Speak with your baby’s doctor about iron supplementation and whether it’s right for you and your baby.18

Introduce iron-rich foods once your baby begins eating solids. When you begin to introduce your baby to solid food, choose foods that contain iron, like fortified cereals, meats, fish, beans, and vegetables every day.

Include vitamin C rich foods as well to help iron be absorbed better.25

If you are already supplementing your infant with iron when introducing iron-containing foods, chat with baby’s healthcare provider to see if the iron supplement should be stopped.4,5

Read more:
Why is Iron Important for my Baby and toddler?

What Should I Know about Iron Deficiency Anemia during Pregnancy?

If you have more questions about whether your baby could benefit from vitamins or other supplements, reach out to our team of registered dietitians and moms are available from Monday – Friday 8 am – 6 pm (ET) and Saturday – Sunday 8 am – 2 pm (ET). Chat now!

What to do to make sure baby is meeting their vitamin and mineral needs

If formula feeding, continue to feed your baby with iron-fortified formula through the first year

Your baby is receiving adequate iron and vitamin D in their formula therefore it’s important to continue feeding them infant formula through the first year of life.6

Talk with your baby’s healthcare provider if you are breastfeeding

If you are breastfeeding, chat with your infant’s healthcare provider about supplementing with iron and vitamin D. They’ll let you know if your little one needs a supplement, how much to give, and how long to supplement for.

Tip: One way to supplement your infant is to place the liquid supplement on your nipple before latching baby to feed. Chat with your child’s healthcare provider for more tips on how to give your baby the supplements they may need.

Understand that your preemie may have different needs

If your baby was born prematurely, they may need more iron than a term baby or need larger amounts of other nutrients.9 Speak with your baby’s doctor about your baby’s specific needs.

Do not introduce cow’s milk until after your baby’s first birthday

Babies who are fed cow’s milk (instead of breastmilk or iron-fortified formula) during the first year of life are more likely to develop iron-deficient anemia because the cow’s milk proteins can affect your child’s iron status.15,24

Note that while cups of cow’s milk are not recommended before a year, it is safe for your little one to have the small amounts of milk used in baking and cooking. And as long as your child does not have a cow’s milk protein allergy or lactose intolerance, it is also safe for them to eat cheese and yogurt in the texture they can handle.26

Let's Chat!

We know parenting often means sleepless nights, stressful days, and countless questions and confusion, and we want to support you in your feeding journey and beyond.

Our Happy Baby Experts are a team of lactation consultants and registered dietitians certified in infant and maternal nutrition – and they’re all moms, too, which means they’ve been there and seen that. They’re here to help on our free, live chat platform Monday - Friday 8am - 6pm (ET), and Saturday - Sunday 8am - 2pm (ET).Chat Now!

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For more on this topic, check out the following articles:

Meal Plan for 6 to 9 Month Old Baby

Why does Vitamin C Matter for Babies, Tots and Mama

Meeting Your Needs and Baby’s on a Vegetarian Diet

Does your Toddler need Vitamins or Supplements

Why does Vitamin B12 Matter for Babies, Tots, and Mama?