The Different Supplements Breastfed Babies May Need

Baby being medicated
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Breast milk is the ideal food for your baby. It's full of nutrition to help them grow, develop, and fight off illnesses. That said, you might be wondering if breast milk contains everything that your child needs and whether or not your breastfed baby should take vitamins. Here’s what you need to know about vitamin and mineral supplements for breastfed babies.

Vitamin and Mineral Supplements for Breastfed Babies

While most of your child’s nutrients come from your breast milk, there are a few vitamins and minerals that healthy breastfed newborns might not get enough of through breastfeeding alone. Here are the vitamin and mineral supplements that breastfed babies typically receive.

Vitamin K

There is only a small amount of vitamin K in breast milk, and all babies have low levels of vitamin K when they're born. Babies need vitamin K to clot the blood and control bleeding. Every child—whether breastfed or not—is given a shot of vitamin K immediately after birth. This injection helps your baby’s blood to clot and prevents a rare but dangerous newborn bleeding disorder.

After the initial newborn dose of vitamin K, a healthy child will not need any additional vitamin K supplements. 

Vitamin D

Your child's body needs vitamin D to absorb calcium and build strong bones and teeth. It also plays a role in the immune system and might help prevent infections. If a child does not have enough vitamin D, they can develop a condition called rickets.

Rickets

Rickets can lead to the softening of the bones and problems with a child's bone development. It can also cause slow growth, pain, and bone deformities such as bow legs.

While it is rare, a breastfed baby can develop rickets if there’s not enough vitamin D in breast milk.

While breast milk does contain vitamin D, the amount of vitamin D in breast milk will differ from one person to the next. Our body's main source of vitamin D is the sun. When you expose your skin to sunlight, it makes vitamin D. However, the amount of vitamin D you get from the sun depends on your skin color, the amount of time you spend in the sun, and your use of sunblock.

People who have darker skin tones need to spend more time in the sun than people with lighter skin tones to get the same amount of vitamin D. Of course, with the use of sunblock, people with all skin tones end up blocking their exposure to the sun and preventing vitamin D production. These factors affect how much vitamin D is in your body, which in turn affects how much vitamin D there is in your breast milk.

Your baby can also get vitamin D from the sun. However, putting infants in direct sunlight is not recommend. When they do spend time outdoors, infants and young children should stay covered and wear sunscreen (while necessarily, this protection from the sun prevents the production of vitamin D).

Recommendation for Vitamin D


  • Many people, including infants, do not get enough vitamin D from the sun. There is a risk of a vitamin D deficiency in children who are breastfeeding exclusively as well as those who are fed with a combination of breastfeeding and formula feeding. While more time in the sun would help, overexposure to the sun has its own risks, such as the development of skin cancer.
  • Studies show that people who are nursing and who supplement with 6400 IU/day can safely produce breast milk with enough vitamin D to satisfy their baby's requirement. This is a good alternative for people who do not want to supplement their babies directly.
  • To prevent vitamin D deficiency and bone problems, the American Academy of Pediatrics (AAP) recommends a supplement for all breastfed babies. Starting on the first day of life, vitamin D is given in liquid drops at the recommended dose is 400 IU a day.
  • Babies who are exclusively formula-fed with an infant formula that contains vitamin D (at least 400 IU/L) do not need additional vitamin D supplements.

Iron

Iron is an essential mineral for your baby's growth and development. It’s needed to make the red blood cells that carry oxygen throughout the body. If your child doesn’t get enough iron, it can lead to anemia. Iron deficiency anemia does not always have symptoms, but it can cause pale skin, a fast heartbeat, feeding difficulty, and weakness. Long-term iron deficiency can lead to problems with the development of the body and the brain. 

There is iron in breast milk. While it might only be a small amount, it’s enough for your child because babies absorb the iron in breast milk very well. In fact, they absorb the iron in breast milk better than they absorb the iron in infant formula.

Babies also store iron in their bodies toward the end of pregnancy. Around 6 months of age, a baby's iron stores begin to deplete. However, the timing coincides perfectly with the introduction of foods, during which time iron-rich foods should be the focus. Not all breastfed babies will need iron supplementation once they reach 6 months of age.

Recommendation for Iron

  • If you're breastfeeding exclusively, your child should not need an iron supplement for up to 6 months after birth. By 6 months of age, babies use up the iron that they have stored and the iron in breast milk will no longer be enough.
  • According to the AAP, after four months of exclusive breastfeeding, there is a greater risk of iron deficiency. Between four and six months of age, your baby's pediatrician will recommend the addition of an iron supplement.
  • Iron is given as a liquid in a dose of 1mg/kg/day until your child is getting enough iron through their diet. At 1 year old, your child's doctor will test them for iron deficiency and let you know if you need to continue giving them iron supplements.
  • If your child breastfeeds and drinks infant formula, they will need supplementation if you breastfeed or give breast milk more than half of the time. The supplement for partially breastfed infants is the same as for exclusively breastfed infants.
  • Children who receive infant formula do not need an extra iron supplement if they’re using an iron-fortified infant formula.

Fluoride

Fluoride is an essential mineral that strengthens the enamel on your child’s teeth and helps prevent cavities. Your breast milk contains fluoride, and your child does not need a supplement during the first six months of life. A supplement may or may not be necessary after the age of 6 months, depending on your child's diet and your water supply.

After six months, your child's pediatrician might recommend a fluoride supplement if:

  • Your Drinking Water Doesn’t Contain Enough Fluoride. In many places, fluoride is added to the local drinking water supply. If you use the public water supply in your home and it contains fluoride in an amount less than 0.3 parts per million, your child might need a supplement. You can call your water company to get information about the fluoridation of your water.
  • You Use Bottled Water. If your child uses bottled water, it might not have enough fluoride. However, check the label on the bottle, as some brands add fluoride to their water.
    You Use Well Water.
    If you have well water at home, test it for fluoride. Water usually contains some natural fluoride, but it might not be enough to address your child's needs.

It’s important to know how much fluoride is in your water supply. Your child's doctor will need this information to make recommendations about fluoride supplementation.

While your child needs fluoride for healthy teeth, too much fluoride can cause problems with tooth development and staining of the teeth.

Vitamin Supplements and Special Circumstances

These recommendations are for healthy full-term infants. Some babies are born early or with special health concerns and might need to start taking iron well before 4 months of age, or they may require other vitamin supplements.

Your child might need additional supplements if:

  • They were born prematurely. Preemies have different needs than babies born at full-term. Premature infants don't have the same iron stores as full-term infants, and they might need more vitamins and minerals than breast milk or formula can provide. The types and amounts of supplements that a preemie will need will depend on how early the child was born and their overall health.
  • They have special health concerns. Children born with certain health conditions or needs might need iron or other vitamins and minerals right from the start. Your child's unique health situation will determine whether (and which) supplements are needed.
  • You've had weight loss surgery. You can still breastfeed if you’ve had a gastric bypass you can still breastfeed, just make sure that your child's doctor is aware of your surgery. It's likely that you will have to take additional vitamins and supplements after gastric surgery and your child might need them as well. Your health care team will monitor your health and the health of your child to ensure you are both adequately nourished.
  • You are vegan. Meat and dairy products are the main sources of vitamin B12. If you follow a strict vegan diet, your breast milk might not have enough of this essential vitamin. Taking a B12 supplement during pregnancy and lactation might be enough, but your baby might need a supplement if your B12 levels are too low.

A Word From Verywell

Breast milk contains everything your baby needs, but you might need to give your child an extra boost of certain essential vitamins and minerals to ensure that they grow well. Vitamin supplements do not cause harm when they are given as directed, but a vitamin or mineral deficiency can present problems for infants and children. Supplementation is an easy way to make sure each child gets what he needs.

If you’re breastfeeding a healthy full-term newborn, your baby should start a vitamin D supplement right away. After four to six months, your child might need additional iron. After six months, a fluoride supplement might be recommended (depending on your water supply). Make sure to take your baby to the pediatrician regularly for well-baby visits. These appointments are a great way to stay informed about the recommendations, get your questions answered, and ensure your child is getting everything they need.

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Article Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Vitamin D. Updated April 20, 2020.

  2. American Academy of Pediatrics (AAP). Vitamin D: On the Double. Updated September 19, 2016.

Additional Reading
  • Baker RD, Greer FR. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0–3 years of age). Pediatrics. 2010 Nov 1;126(5):1040-50.
  • Clark MB, Slayton RL. Fluoride use in caries prevention in the primary care setting. Pediatrics. 2014 Sep 1;134(3):626-33.
  • Hale, Thomas W., and Rowe, Hilary E. Medications and Mothers' Milk: A Manual of Lactational Pharmacology Sixteenth Edition. Hale Publishing. 2014.
  • Kleinman RE. Introduction: Recommended Iron Levels for Nutritional Formulas for Infants. The Journal of pediatrics. 2015 Jan 10;167(4): S1-2.
  • Lawrence, Ruth A., MD, Lawrence, Robert M., MD.  Breastfeeding A Guide For The Medical Profession Eighth Edition. Elsevier Health Sciences. 2015.