Vitamins and supplements for infants, toddlers, and older children

Why do babies and infants need vitamins?

Babies get most of their nutrition from breast milk and/or formula. But depending on their individual needs and how much breast milk or infant formula they get, they may need vitamins as supplements.

Why do older infants, toddlers, and older children need vitamins?

Children who are already eating solids get nutrients from what they drink and eat. Eating a wide variety of foods is the best way to ensure your child gets the nutrients they need, but there are many reasons why your child’s diet may not be as varied. 

A pediatrician may recommend supplementing with vitamins or minerals to make up for any nutrient deficiencies your child may have.

Supplements for newborns and infants 

Vitamin K

Vitamin K is necessary for healthy blood clotting after an injury, cut, or open wound. Babies do not have enough vitamin K immediately after birth, so the standard of care is to give newborns a vitamin K shot at birth.

This vitamin K shot is not a vaccine or immunization. Your baby may feel pain briefly, and rarely, some babies develop a rash near the shot site (usually the upper thigh). If your child gets a rash, it should resolve quickly. 

Vitamin D

Vitamin D plays an important role in healthy bone development, and a deficiency can increase the risk of conditions like:

• Rickets (soft, weakened bones)
• Broken and fractured bones 
• Depression
• Autoimmune disease
• Infections

The American Academy of Pediatrics (AAP) recommends that babies younger than 12 months old get 400 IU vitamin D daily. While Vitamin D is absorbed through the skin from exposure to direct sunlight, many factors limit how much vitamin D a person absorbs. For babies under 6 months, the AAP recommends limited exposure to direct sunlight, making it hard to get enough vitamin D from time outdoors.

Breastfed babies do not get enough vitamin D from breast milk. The AAP recommends that exclusively or partially breastfed babies receive a vitamin D supplement. If your baby drinks less than 32 ounces of infant formula, talk to your local pediatrician or text a Summer Health pediatrician about adding a vitamin D supplement.

Liquid Vitamin D drops are convenient. Consider choosing one that has no added sugars and that’s available in a concentrated formula where one drop equals one dose.  

Iron

Before 4 months old, babies usually have enough iron stored in their bodies to prevent iron deficiency. Babies born prematurely are the exception since they may not have spent enough time in the uterus to build their iron stores. 

Babies born preterm, with low birth weights, or with blood loss often have lower iron stores and use up their iron stores more quickly, putting them at greater risk for iron deficiency. If your baby falls into any of these categories, a pediatrician may recommend starting iron supplementation during their first month of life.

Supplements for older infants, toddlers, and older children

Vitamin D 

The American Academy of Pediatrics recommends toddlers and older children get 600 IU vitamin D daily. Whether your older child is getting enough vitamin D largely depends on their diet and the amount of vitamin D-fortified foods they are eating. Older babies still mostly relying on breast milk and/or formula for most of their nutrition should continue receiving a vitamin D supplement. 

Iron

After 4 months, babies’ iron stores begin to dwindle and they will require more iron to keep up with their growth and development. Iron deficiency is the most common cause of anemia in children and can lead to complications.

Your child should get most of their iron from iron-rich, solid foods like iron-fortified cereals, meats, fish, eggs, and green vegetables. If your child doesn't get enough iron-rich foods, a pediatrician may recommend or prescribe iron supplements or iron-fortified formulas.

Daily multivitamin

Most children eating a balanced and varied diet get all the nutrients they need. If you are concerned about whether your child may benefit from a daily multivitamin, discuss this with your local pediatrician or text a Summer Health pediatrician for guidance. 

Supplement safety

Many children’s vitamin supplements, especially daily multivitamins, are colorful and attractive to kids. They often come in the form of gummies or chewable tablets. While this can be helpful in getting your child excited to take their vitamin, it can also pose a safety risk. 

Never refer to any medications, including vitamin supplements, as candy, and look for options with low sugar content. Never offer supplements as a treat or reward.

It’s important to keep all medications — including vitamins and other supplements — out of children’s reach. Taking too much of certain vitamins can cause toxicities and side effects like nausea, rashes, etc. If you are ever concerned that your child has eaten too many vitamins, contact your local poison center at 800-222-1222.

‍