The need for external supplementation of nutrients to newborns and infants depends on a multitude of factors. Some of those factors are the type of feed (whether fully breastfed or not), the term (full-term or pre-term), and the overall health of the baby and the mother.
The general recommendation is that vitamin and mineral supplements (with the exception of vitamin-D) are not necessary for healthy, full-term breastfed babies during the first year. Studies have shown that most vitamins, water, juice, and solid foods are not beneficial to healthy breastfed babies during the first six months, and can sometimes even be harmful.
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
1. 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.
2. 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
1. 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.
2. 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 and other nutrients.
As per WHO, more than 20 million infants are born prematurely 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 the birth weight of 1.5 kg are especially vulnerable to the 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 and 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.
3. Poor maternal nutrition status
The mother’s nutritional status throughout pregnancy and lactation is very critical in deciding the nutritional status of the infant. It is important that pregnant mothers take the right nutrients for the growing fetus. Folic acid, iron, calcium, vitamins B6 and B12 along with a protein-rich diet are essential nutrients for the mother during various stages of pregnancy and lactation that directly impact the health of the baby
1. Calcium helps to build strong bones and teeth.
2. Iron helps the red blood cells to deliver oxygen.
3. Folic acid is important in the production of blood and protein; it also reduces the risk of birth defects of the brain and spinal cord.
4. Vitamin B12 helps to form red blood cells and maintains the nervous system.
5. Vitamin B6 also helps form red blood cells and helps the body use protein, fat, and carbohydrates.
It is important that the specific nutrition needs of infants are addressed. Always seek the advice of your physician before choosing the right nutrition supplements for the mother and the infant.