Babies: Do breastfed babies need supplements?

On my playgroup message board a few moms said that their doctors had already checked the babies' iron levels, which surprised me. They are talking about beginning vitamins and/or iron. Are supplements really necessary for breastfed babies?

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Robert Steele

Robert W. Steele, MD, is a board certified pediatrician at St. John's Regional Health Center in Springfield, MO. He graduated from medical... Read more

In general, vitamin and iron supplements are not necessary for breastfed infants. Following are some specifics:

Vitamin D: Research has shown that breast milk contains adequate vitamin D for at least the first six months of your baby's life. Rickets have rarely been found in exclusively breastfed babies. Some infants who live in more northern climates, having darker pigmented skin and/or are not outside much do not get enough sun exposure (20 minutes exposure a day just to the cheeks) may not make sufficient vitamin D. If this is the case, discuss your concerns with your care provider.

Fluoride: In a 1997 policy statement, The American Academy of Pediatrics recommended that babies under six months of age should not receive fluoride supplements. Babiest babies older than six months should receive supplements only if they live in an area where the drinking water is severely deficient in fluoride, containing less than 0.3 ppm of fluoride.

Iron: The iron in breast milk is better absorbed by your baby than is the iron in cow?s milk or iron-fortified formula. The full-term healthy baby usually has no need of additional iron until about the middle of her first year of life. It is recommended that all infants have their blood checked between nine and twelve months of age to screen for anemia. Iron supplements should only be started if iron deficiency anemia is found at that time.

Vitamin B12: If you are following a strict vegetarian diet you may be deficient in Vitamin B12. If this is the case, you can give change your diet or take a suplement, rather than giving it directly to her baby.

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