ShePrep

Do babies need vitamin drops?

Written by Andy Hendrick
6 sources cited

Guidance differs by countryFollow the amount stated on the product label and your health visitor, public health nurse, paediatrician or GP. Do not give two supplements containing the same vitamin at once

It depends where you live. The UK recommends a daily vitamin D supplement from birth for breastfed babies, and vitamins A, C and D from 6 months to 5 years. The US and New Zealand recommend vitamin D for breastfed babies. Ireland recommends vitamin D from birth to 12 months. Formula-fed babies taking enough formula are usually excluded.

The verdict

Some babies need supplements and some do not, and which is which depends on your country, on how your baby is fed, and on their age. There is no single global answer, and anyone who gives you one is describing their own country's rule.

This page names which vitamin each country recommends and from what age. It does not give amounts. The number that matters is the one on the product you are holding, because concentrations differ between products, and getting it from the label rather than from a website is how you avoid doubling up.

The one thread that runs through all of them

Formula is fortified. That single fact explains most of the structure of every country's rule.

Infant formula has vitamin D, and in the UK vitamins A and C, added to it by law. A baby taking a full formula intake is therefore already receiving those vitamins, and adding drops on top risks too much rather than too little. Every authority builds an exclusion around this: the UK excludes babies having more than about a pint of formula a day, Ireland excludes babies taking more than a set daily formula volume, and the AAP excludes babies consuming more than a set volume of fortified formula.

Breast milk is superb at almost everything and poor at vitamin D. That is not a criticism of breastfeeding; it is a consequence of humans evolving to make vitamin D in skin exposed to sunlight, and of modern life plus sun safety advice meaning babies do not get that exposure. New Zealand's guidance states the position plainly: babies cannot safely get the vitamin D they need from the sun, because their skin is very sensitive and should not be exposed to direct sunlight.

Which vitamin, and from when

United Kingdom

Two separate recommendations run in parallel. Breastfed babies should have a daily vitamin D supplement from birth, whether or not the mother is supplementing herself. And all children aged 6 months to 5 years should have a daily supplement containing vitamins A, C and D.

The UK is the only one of these four that routinely recommends vitamins A and C as well, which surprises parents who have moved between countries. The Department of Health and Social Care recommends supplements containing only those three, and the NHS advises talking to a pharmacist if a product you have bought contains others.

Ireland

Vitamin D3 daily from birth to 12 months for babies who are breastfed or taking less than a set daily volume of formula. The HSE does not recommend routine A and C drops, and covers those nutrients through food, with particular attention to iron from around 6 months and vitamin C foods served alongside plant sources of iron to improve absorption.

United States

Vitamin D for all infants unless they are taking more than a set volume of fortified formula each day. The AAP then adds something the UK and Ireland handle differently: oral iron supplementation for partially or completely breastfed babies from four months, until iron-containing complementary foods are established, plus universal screening for iron deficiency at 12 months.

New Zealand

Vitamin D for all exclusively or partially breastfed babies, starting by 4 weeks and continuing until 1 year.

Why the safety instruction matters more than the amount

The NHS gives a warning that is easy to skim past: having too much of some vitamins can be harmful, keep to the dose recommended on the label, and be careful not to give your child two supplements at the same time. Its worked example is cod liver oil plus vitamin drops, since cod liver oil already contains vitamins A and D.

Vitamins A and D are fat-soluble and are stored in the body rather than excreted, which is why doubling up on them is a real risk and not a theoretical one. One product, at the amount on its own label, is enough.

This is also why this page does not quote figures. Products differ in concentration, so a number lifted from a website and applied to a different bottle is how errors happen. The label is the authority, and the health visitor, public health nurse, paediatrician or GP is who to ask if it is not clear.

Vitamin K is not this

Worth separating, because parents conflate them. Vitamin K is given at birth to prevent vitamin K deficiency bleeding, usually as a single injection, occasionally as an oral course. It is a newborn measure, it is not the same as ongoing vitamin drops, and if an oral course has been chosen it must be completed as scheduled.

Preterm and other special cases

Babies born preterm, babies who were small for gestational age, babies with malabsorption, and babies on restricted diets may need different supplementation, sometimes starting earlier and sometimes at different amounts. The AAP notes iron supplementation may start in the first month for some of these babies.

None of that is a decision to make from a website. If your baby was born early or has been under specialist care, follow the plan you were given at discharge and check it at each review.

Where guidance differs

On vitamin D for breastfed babies: everyone agrees, though the start point varies from birth in the UK and Ireland to by four weeks in New Zealand.

On vitamins A and C: the UK recommends them routinely from 6 months to 5 years. Ireland, the US and New Zealand do not.

On iron: the US recommends supplementation for breastfed babies from four months and universal screening at 12 months. The UK and Ireland address iron through weaning foods instead, with iron-rich first foods from around 6 months.

On cost: in the UK, families who qualify for Healthy Start can get vitamin drops free, and the NHS directs parents to their health visitor to find out where.

If you have missed some

Missing days does not undo anything. Vitamin D deficiency develops over months, not days. Start again and carry on.

If you think your baby may have had too much of a supplement, or has had two products containing the same vitamin, stop both and speak to a pharmacist, GP or NHS 111 equivalent, taking the packaging with you. Symptoms that would warrant same-day advice include repeated vomiting, unusual sleepiness, poor feeding or irritability.

Guidance by country

The UK recommends more than vitamin D. The NHS states that the government recommends all children aged 6 months to 5 years are given vitamin supplements containing vitamins A, C and D every day, and that babies who are being breastfed should be given a daily vitamin D supplement from birth, whether or not the mother is taking one herself. Babies having more than about a pint of infant formula a day should not be given vitamin supplements, because formula is fortified. It adds that having too much of some vitamins can be harmful, to keep to the dose recommended on the label, and not to give two supplements at the same time. Free vitamin drops are available to families who qualify for Healthy Start.

Showing guidance from NHSread the source.

Sources

  1. Vitamins for children NHS, accessed
  2. Vitamin D NHS, accessed
  3. Where We Stand: Vitamin D & Iron Supplements for Babies American Academy of Pediatrics, accessed
  4. Nutrients your baby needs during weaning HSE Ireland, accessed
  5. Vitamin D and your baby Health New Zealand | Te Whatu Ora, accessed
  6. Drinks for babies 0 to 12 months HSE Ireland, accessed