How to give vitamin D supplement to babies?

(Content revised 10/2024)

How much vitamin D does a baby need?

Vitamin D is essential for bone health. Vitamin D helps calcium absorption in the gut, and maintains normal levels of calcium and phosphate in blood, keeping bones strong. In infants and children, persistently low vitamin D levels may cause rickets, resulting in soft bones, deformed bones, bone fractures, poor growth, and low calcium level in blood which may lead to convulsion. Infants need 400 IU (10 microgram) of vitamin D daily.

Infants under 12 months of age who are being breastfed are recommended to take a vitamin D supplement of 400 IU daily.

Why infants who are being breastfed need vitamin D supplement?

  • Breastmilk has many benefits and is the ideal food for babies. However, like other foods, it does not contain much vitamin D and is not sufficient to meet the requirement.
  • Vitamin D is obtained through sunlight exposure. However, current scientific research is still not sure the amount of sunlight one needs to get enough vitamin D. In addition, your baby's skin is thinner and more susceptible to sunburn. Taking supplements can help babies get enough vitamin D stably.

How do I give my baby vitamin D supplement?

  • The vitamin D supplement is usually in the form of vitamin D drops. Follow the instruction of healthcare professionals when you give your baby the vitamin D supplement.
  • If you purchase the product, check the product label for instructions to give your baby 400 IU of vitamin D.
  • You can give the vitamin D supplement in one of the following ways:
    1. Give the supplement directly into your baby's mouth; or
    2. Mix the supplement with a small amount of breastmilk, formula milk, or puree foods (for babies after 6 months of age) in a spoon and offer the mixture to your baby; or
    3. Put the supplement onto the surrounding area of nipple or areola of the breast and let your baby suckles for 30 seconds
  • Precaution : Babies only need 400 IU of vitamin D daily. Although taking vitamin D supplement is generally safe, you should not give your baby more than this level unless your doctor advise you to do so.

When should I open a new bottle of vitamin D supplements?

  • Please read instructions provided by the dispensary or on product label as to when to change to a new bottle.

Do babies taking both breastmilk and infant formula need a vitamin D supplement?

  • Infant formulae are added with vitamin D. According to overseas guideline, for babies taking both breastmilk and infant formula, if majority of their intake is not from infant formula (for example less than 500ml a day), they need a vitamin D supplement1.

What should I do if I have forgotten to give my baby vitamin D supplement for a few days?

  • Give the dose of today (400 IU of vitamin D) to your baby. Then continue to give it daily.
  • Here are some suggestions to help you remember to give the supplement to your baby:
    • Place a reminder near the place you nurse your baby;
    • Use an alarm or a daily reminder in your calendar on your mobile phone.

My 6-month old takes puree or solid foods, should she continue taking the supplement?

  • Your baby should continue to take vitamin D supplements until 12 months of age because the amount of vitamin D in solid foods is limited. You can provide oily fish (salmon, halibut, etc.) and eggs more often to help your baby getting more vitamin D from diet.

When should my baby stop the Vitamin D supplement?

  • Infants are advised to continue the vitamin D supplement in the first 12 months of life.
  • After 12 months of age, they are active and mobile, and can have more outdoor activities. They can obtain vitamin D while they are playing outdoors. In addition, they should also eat vitamin D rich food or drink such as oily fish, eggs, vitamin D fortified cow's milk or soy milk added with calcium regularly.
  • Children who have risk factors of vitamin D deficiency such as having dark skin, always staying indoors, having the clothes covering the arms and legs when being outdoors, having difficulty to have sun exposure or inadequate dietary intake, etc., may consult their family doctors, dietitians, pharmacists about the need of vitamin D supplements.

Reference:

  1. UNICEF United Kingdom. (2017). UNICEF UK Baby Friendly Initiative Infosheet Statement on Vitamin D supplementation for breastfed babies.