Does my baby need a vitamin supplement?

Generally, most healthy people do not need to take a vitamin supplement if they are getting a varied and balanced diet. The exception to this is vitamin D, which is very difficult to get enough of from food alone.

But for babies, it depends on the age of your baby and whether they are fed breastmilk or formula milk.

Birth to 6 months

The UK DH recommend that all exclusively breastfed babies are given a daily vitamin D supplement from birth. Look for a supplement that contains between 8.5-10µg/ micrograms (340-400 IU/ International Units).

Babies that are exclusively formula fed do not need a vitamin D supplement as formula milks contain added vitamin D. The level of vitamin D within formula milk is stipulated by regulations, so you do not need to compare the levels across brands - no one brand is better than any other.

If your baby is combination fed (both breastmilk and formula milk), you will need to supplement with vitamin D if your baby is consuming less than 500ml formula per day.

6 to 12 months

From 6 months, it’s recommended that breast-fed babies are given a daily supplement containing vitamins A, C and 10µg vitamin D. This is because these nutrients are the ones are harder to get enough of if your child is not eating a varied diet - in fact for vitamin D it is incredibly hard to get enough from food alone.

Babies that are exclusively formula fed do not need a supplement, as formula milks contain added vitamins A, C and D. The levels of all of these vitamins are stipulated by regulations, so again you do not need to compare the levels across brands.

Whether your baby is solely fed formula milk or combination fed, once they are having less than 500ml formula per day, they should be given a daily supplement containing vitamins A, C and 10µg vitamin D.

Some parents may be eligible for the Healthy Start scheme, which will provide free vitamins. You can check if you’re eligible on the website or by speaking to your midwife / health visitor. The Healthy Start vitamins contain:

233µg vitamin A, in the form of beta-carotene

20mg vitamin C

10µg vitamin D

Over 12 months

The DH recommend that all children aged 1-4 years take a daily vitamin supplement containing vitamins A, C and 10µg vitamin D. Again, this is due to it being more difficult to get some nutrients in from diet alone, particularly if your child is a fussy eater and going through a period of development.

Choosing a vitamin supplement

A short report in 2018 looked at vitamin supplements in 9 major UK retailers and found that only 1/4 to 1/3 of the 67 multivitamins available for purchase contained the recommended daily dose of vitamin D (10µg). This highlights that there is a huge choice of supplements available to buy, but it is important to take note of the dosage instructions and levels provided so that children are receiving the right amount. It is also worth noting that under EU regulations for food supplements, the actual amount contained in the supplement can be 20% lower or 50% higher than what is stated on the packet.

A recent report into complementary feeding suggested that most children eating a balanced and varied diet are getting enough vitamin A, and so would not need a supplement. This is likely to be the case for vitamin C as well. They recommend that the government review their guidelines, but as yet this has not happened.

When shopping online, as many of us do, there are lots more supplements available to choose from. Different countries do have different recommendations about vitamin supplements, and so the amounts and range of vitamins provided in these could vary hugely. Some key points to consider when choosing a supplement:

• Is it sugar free? some contain fructose, sucrose or flavourings

• Is it allergen free? some contain peanut oil or soya

• Does it contain only the vitamins that you really need? With a varied diet it is not necessary to over-supplement a baby ‘just in case’, as you could risk causing harm

• Is it easy to dose and give to your baby? It will be harder to disguise the taste if you need to give a whole spoonful compared to a small drop

References and additional reading

https://www.nhs.uk/start4life/baby/baby-vitamins/

https://www.nhs.uk/conditions/pregnancy-and-baby/vitamins-for-children/

https://www.healthystart.nhs.uk

Moon, R.J. et al. (2018) Vitamin D supplementation: are multivitamins sufficient? Archives of Disease in Childhood Published Online First: 25 February 2019

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/725530/SACN_report_on_Feeding_in_the_First_Year_of_Life.pdf