Feeding
Vitamins and supplements for babies
A small number are genuinely recommended, the specifics vary by country, and most of the rest are unnecessary.
Infant supplementation is one of the areas where national guidance genuinely differs, which makes generic advice unreliable and local guidance worth checking.
Vitamin K
Given at birth rather than as an ongoing supplement.
Newborns have low vitamin K stores, and deficiency can cause bleeding — including intracranial bleeding — which is rare, unpredictable and can be devastating.
A single intramuscular injection at birth prevents both early and late forms.
Oral courses are an alternative in some settings and require multiple doses over weeks, which are frequently missed, making them less reliable.
This is offered rather than mandatory, and declining it is a decision worth making with full information rather than on the basis of internet material.
Vitamin D
The main ongoing recommendation in many countries.
Breast milk contains little vitamin D, and infant formula is fortified.
Which is why guidance in many countries recommends a daily vitamin D supplement for breastfed and mixed-fed babies from birth or from a specified age, and for formula-fed babies once they are taking less than a specified volume of formula per day.
Amounts recommended vary by country.
Risk factors for deficiency include darker skin, limited sun exposure, covering clothing, higher latitudes and maternal deficiency in pregnancy.
Rickets still occurs and is entirely preventable, which is the reason for the recommendation.
Excess is possible and there have been cases of toxicity from high-dose products, so following the stated dose matters.
Iron
Where timing matters.
Babies are born with iron stores that deplete by around six months, which is one of the reasons solids are introduced then.
Iron-rich foods from the start of weaning are the main strategy: meat, fish, eggs, pulses and fortified cereals, with vitamin C-containing foods alongside to aid absorption.
Routine iron supplementation is not recommended for term babies in most guidance, and preterm and low birth weight babies frequently are prescribed it.
Iron deficiency is common in toddlers, particularly with high cow's milk intake and restricted diets, and is treated with supplementation after diagnosis rather than pre-emptively — excess iron is harmful and iron overdose in children is a serious poisoning.
Combined vitamin drops
Recommended in some countries and not others.
Where recommended, these typically contain vitamins A, C and D and are advised for young children from a specified age, sometimes free for eligible families.
The rationale is population-level insurance against deficiency in a group with variable intake.
Which is a public health measure rather than a treatment.
Vitamin B12
Relevant for specific situations.
Infants breastfed by mothers on vegan diets, or with untreated B12 deficiency, are at risk, and deficiency in infancy can cause serious neurological consequences.
Maternal supplementation during pregnancy and breastfeeding, and appropriate supplementation for the child once weaned, is important.
This is a situation warranting dietetic input rather than guesswork.
What is generally not needed
Where marketing outruns evidence.
Probiotics as a routine supplement, with the exception of specific strains for specific indications such as colic in breastfed infants, where there is some trial evidence.
Omega-3 supplements for typically developing infants.
Multivitamin products beyond those recommended nationally.
Teething remedies, gripe waters and herbal preparations, which are unregulated in many places and occasionally contaminated.
And anything marketed for immunity, sleep or brain development in infants, none of which has meaningful evidence.
Practical points
Follow the dose on the product for the age, and do not exceed it.
Do not combine multiple products containing the same vitamin, which is how excess occurs.
Keep all supplements out of reach, since iron in particular is a serious poisoning risk in children.
Check whether formula already contains what you are considering adding.
Tell any clinician what your child is taking, including anything bought over the counter.
And be sceptical of products bought from unregulated online sources, where content and labelling have repeatedly been found unreliable.
Where to check
National health services publish specific infant supplementation guidance, and it differs enough between countries that following advice from elsewhere can be wrong.
A health visitor, pharmacist or clinician can confirm what applies locally and to your child's particular circumstances, including prematurity and any dietary restriction.
General information only, not medical advice. Supplementation guidance varies by country — consult your health visitor, pharmacist or clinician, and keep supplements out of children's reach.
