Vitamins and Minerals
The need for infant vitamins is a confusing topic. Babies do need vitamins to grow well and to be healthy. They need them for strong bones, healthy teeth, and to build up their blood and prevent anemia. The confusing part is that most infants get all of the vitamins and minerals they need through the foods that they eat and drink, including vitamin A, calcium, zinc, and the vitamins and minerals discussed in this section. So while they do need vitamins and minerals, they don't always need a supplement each day, unless they were born prematurely or have some other health problem.
Iron
Iron is one of the more important minerals your baby needs. The effects of a diet poor in iron, which can lead to iron deficiency anemia, are well known. These include learning problems, developmental delays, and behavioral problems.
However, your infant, unless she was born prematurely, should be able to get all of the iron she needs from breastmilk or an iron-fortified formula during her first four to six months. After that time she does need extra iron, but you can usually provide it in the baby foods that she is beginning to eat, such as an iron-fortified infant rice cereal, in addition to continuing to feed her breastmilk or formula.
Will iron cause my baby to have any medical problems?
No. Iron is essential for your baby's growth and development and it does not cause colic, constipation, or any other problems. Infants who drink a low-iron formula or plain cow's milk are likely to develop medical problems, though, including anemia.
If your baby is otherwise well, she probably won't develop an iron deficiency unless you switch her to cow's milk before her first birthday or you do not give extra iron after she is six months old. Remember that premature babies often need a vitamin supplement that has iron in it.
Fluoride
Newborns don't need fluoride, but once your infant is about six months old and begins getting teeth, she will need fluoride to keep them strong and growing well. The main source of this fluoride isn't an extra vitamin though. Instead you can provide it by offering your baby some fluoridated tap water each day.
Your baby may not be getting enough fluoride if she is drinking any of the following:
Well water
Tap water that is not fluoridated
Bottled water that does not have added fluoride
Water that is filtered of fluoride
Breastmilk exclusively
Ready-to-feed formula exclusively
You can start your baby on fluoride supplements, but getting too much fluoride can easily lead to fluorosis or staining of the teeth, so it is usually best to try to give your baby fluoridated water. If you are exclusively breastfeeding, offering some extra water with fluoride once your baby is six months old is the best way to avoid problems. Talk to your pediatrician to get a prescription for a fluoride supplement if your baby has no way of getting fluoride from the water she is drinking.
Vitamin D
Not getting enough vitamin D can cause a baby to get a bone disorder called rickets. Because infant formula is fortified with vitamin D, infants drinking at least seventeen ounces of formula each day do not need any extra vitamin D.
Rickets, caused by a deficiency of vitamin D, is a serious disorder that causes skeletal deformities and poor growth. Although not as common as it used to be, it does still affect some children, especially those who are very dark-skinned, don't get any or little sun exposure, and are exclusively breastfed.
Unlike formula, breastmilk does not contain enough vitamin D for babies, but that wasn't thought to be a problem because it was believed that exclusively breastfed infants got enough vitamin D from sunlight exposure. However, now that the effects of excessive sun exposure are known and sunscreen is being used more often, it is thought that exposure to the sun is not enough for breastfed babies. The AAP now recommends that breastfed babies receive a vitamin D supplement beginning in the first two months of life. The need for vitamin D supplements is a controversial topic though, especially for light-skinned infants in sunny climates, so you might talk to your pediatrician about whether this is necessary for your baby.
