Breast milk is the “perfect” food containing all the vitamins and nutrients that the infant needs, with the exception of two crucial nutrients: Vitamin-D & Iron.
- The growing infant requires vitamin-D to boost immunity, prevent chronic diseases and for skeletal strength. Vitamin-D is synthesized when the body is exposed to the sun. But due to reduced sunlight exposure, infants may not get adequate vitamin-D.Hence,the American Academy of Pediatrics (AAP) recommends 400 IU of vitamin-D supplementation per day from day one.
- Although breast milk does not contain adequate levels of iron, babies are born with iron stores. Thus, these stores along with the amount of iron in breast milk may be adequate until the baby starts eating solid food. However, there may be situations, for example where the mother is anemic, when iron supplementation is recommended for infants.
Other Vitamin Requirements
- The AAP has routinely recommended vitamin-K injections at birth to reduce the risk of hemorrhagic disease.The rationale is that infants may not have sufficient levels of vitamin K as it does not cross the placental wall.
- As per World Health Organization (WHO),vitamin-A deficiency (VAD) is one of the important factors for childhood vision impairment and night blindness, especially in developing countries. So,vitamin-A supplementation may be recommended where required in infants and children.
Apart from the above, there are situations where infants do need additional supplementation of vitamins, minerals, amino acids & other nutrients.
1. Premature infants
As per WHO, more than 20 million infants are born premature every year,around 96% of them in developing countries. These infants are at increased risk of early growth retardation, infectious diseases, developmental delay and death during infancy and childhood. Infants below birth weight of 1.5 kg are especially vulnerable to above mentioned conditions.
For premature babies WHO recommends
- Vitamin D supplementation at a dose ranging from 400 IU to 1000 IU per day from birth until 6 months of age.
- Daily calcium (120–140 mg/kg per day) and phosphorus (60–90 mg/kg per day) supplementation during the first months of life.
- Iron supplementation of 2–4 mg/kg per day starting at 2 weeks until 6 months of age.
2. Recovery after infection
Infection leads to nitrogen loss which results in weight loss & poor immunity. Here, vitamins supplementation along with amino acids is recommended to help compensate the nitrogen loss, boost immunity and prevent weight-loss. This is normally recommended for 30 - 60 days duration.