Do breast-feeding babies need supplements

Do Breastfeeding Babies Need Supplements?

We are so excited to introduce a new column to our website, “Ask Amanda,” a virtual Q and A forum brought to you by Feed to Succeed’s expert Northshore dietitian Amanda Gordon. Amanda is also a certified lactation consultant, and she explains in this week’s first column whether breastfeeding infants need vitamin supplements.

Q: Hi Amanda, I am breastfeeding my 3-month-old. This is the first time I am breastfeeding, and it is going well. Every once in a while, she gets a bottle of formula. My pediatrician told me that formula-fed babies don’t need extra vitamins, but my sister-in-law is a nurse and she told me differently. What should I be doing?


A: Exclusively and partially breastfed babies need to take a vitamin D supplement. The American Academy of Pediatrics recommends exclusively and partially breastfed babies take 400 International Units (IUs) of vitamin D each day. Even breastfed babies who take some formula should take 400 IUs of vitamin D each day (unless they are taking more than 32 ounces of formula every day).

Even once they transition to whole milk, which is not recommended until one year of age, most children still don’t get quite the recommended amount of vitamin D daily and supplementation is often continued into toddler and childhood.

Breastfed babies usually need iron supplementation after three months old as well. The American Academy of Pediatrics recommends giving breastfed infants 1 mg/kg/day of a liquid iron supplement. If your baby is partially breastfed and partially formula fed, the iron recommendations are the same. Formula fed infants and partially breastfed infants who get at least half of all of their feedings from formula should get an iron-fortified formula and likely do not need iron supplementation.  Babies born prematurely, even if they are formula fed, often need more iron supplementation.  Check with your child’s pediatrician about iron supplementation for babies born prematurely.

There are over-the-counter vitamins that contain the recommended daily amounts of iron and vitamin D, which can make supplementation easier.  Side note: liquid iron stains, so I recommend giving it in the bath!

Aside from iron and vitamin D, the best way to ensure that your breastfed baby is getting enough of the vitamin and minerals she needs is for Mom to eat a balanced diet and ensure that she is getting enough calcium and vitamin D (it’s not just kids who need to drink milk!), protein and iron.

Please submit your questions about infant and toddler nutrition to our Facebook page or on our website contact us form. Each week we will pick a question to answer and post to our Facebook page and website.

Introducing New Foods to Kids

Introducing New Foods to Kids With special guests Alyssa and Nate

Meet Betsy’s kids, Alyssa and Nate! Betsy and her kids talk about the importance of eating a variety of different foods and food allergy management at their schools. Alyssa shares her experience with breakfast skipping. Nate discusses kids and milk drinking at his school. Great, short episode for other kids to tune in with their parents, spark some family discussion and join the Feed to Succeed community!

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Milk, water and all those beverage options!

Starbucks, energy drinks, sodas, juices…what’s a parent to do? Betsy and Jen return to the scene with their lively banter, focused on what and how much kids should be drinking. Is juice really that bad? When are sports drinks relevant? Listen in to see who drinks more water between our hosts; and whose kids are better fluid drinkers?

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Routines are essential to healthy eating habits

Why do kids benefit from meal schedules and routines?

New guest, nurse practitioner Karen Gentile of Kids First Pediatric Partners in Skokie, IL, joins Betsy and Jen to discuss the benefits and tips for establishing eating routines and schedules for kids of all ages, from toddlers to teens. Highlights of this episode include the importance of the disappearing breakfast routine, and do’s and don’ts of snacking – do kids really need them?

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Probiotics for Colic in Breastfed Infants By Gia Diakakis

After a few months of dealing with a colicky baby, I am so excited to be back from my second maternity leave! My first maternity leave was nowhere near long enough. I swear, I feel this time around, it was too long.

My first baby was a breeze. Great sleeper, great eater, and most importantly, I could put him down in his bassinet, or boppy newborn lounger and get my “stuff” done. I was able to shower, work out, cook, clean, organize my house and have a social life. This time around could not be any more different. I cannot put my baby down without hearing an instant shriek. She is in my arms from the moment she wakes up, to the moment she goes to sleep for the night.

Around the time she turned two months old, I began frantically searching the Internet for ways to soothe her so I would be able to put her down without crying. Luckily, we at Feed To Succeed, have an amazing group of dietitians that have turned into a wonderful group of friends. So while I was searching these soothing techniques, I received a group text about a study that was released showing that probiotics supplementation in breastfed infants help with colicky behaviors. I was so excited about this, that I drove to the office at 10PM on New Year’s Eve to pick up probiotic samples.

It has been six weeks of routinely using probiotic samples, and it has been great! It’s as if someone reprogramed my baby to reduce fussiness and increase happiness. Having such a great experience made me curious, so I began reading the research that the other dietitians and Feed To Succeed told me about. Was this just a coincidence?

After reading through a research article and a meta analysis of probiotic supplementation in colicky infants, it became clear this was not just a coincidence or placebo effect. The meta analysis looked at studies out of Italy, Poland, Australia and Canada. They looked at average minutes of crying and/or fussiness per day with each infant. In their analysis, they concluded that Probiotics are “…effective and can be recommended for breastfed infants with colic.” This conclusion was drawn after combing through four individual studies (in the countries outlined above) and seeing the average minutes of crying and/or fussiness significantly decreasing with probiotic supplementation.

I then read through a journal article that studied probiotic supplementation in colicky infants in the U.S. This study looked at the number of stools and consistency of stools per day. They concluded that probiotic supplementation lead to fewer and better-formed stools in breastfed infants.

There is still a lot unknown about colicky infants, but probiotic supplementation can help. There are so many different probiotic supplementations out there, and it can be very confusing. The two specific strains that were included in these studies are Lctobacillus reutri 1, and Bifidobacterium longum infantitis 2. Other strains may also help, but these are the two strains backed by research.

From one tired “powered by coffee” mama to another, it might be time to give probiotics a shot! Your baby may just need for healthy bacteria in their gastrointestinal tract and they might just be the thing your looking for.

This article is based on the following studies: 

1. Sung, Valerie, et al. “Lactobacillus reuteri to treat infant colic: a meta-analysis.” Pediatrics (2017): e20171811.

2. Smilowitz, Jennifer T., et al. “Safety and tolerability of Bifidobacterium longum subspecies infantis EVC001 supplementation in healthy term breastfed infants: a phase I clinical trial.” BMC pediatrics 17.1 (2017): 133.

How Many Tries Until My Kids Will Eat That?

Smita Joshi, guest expert in feeding difficulties, joins Betsy and Jen for an in-depth and helpful discussion about strategies for getting kids to eat things they don’t want to eat. Engaging and informative talk. One of the best yet!

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