Vitamin D Drops: Does My Baby Still Need Vitamin D Drops After Starting Solid Foods?

Katie Ferraro (31s):

So for Babies who are making the transition from exclusive breastfeeding, right? You were in a situation where you were providing 400 international units, or I use a Vitamin D per day for your exclusively breast fed baby. Maybe you're transitioning onto formula so you can stop the Vitamin D Drops generally after your baby is drinking one liter of formula, or when you get to the one year mark and you transition so your baby is now consuming fortified whole milk every day. They're generally going to be getting enough Vitamin D without the Drops at that time. Hey there. I'm Katie Ferraro, registered dietitian, college nutrition professor and mom of seven specializing in baby led weaning. Here on the baby-led weaning made easy podcast I help you strip out all of the noise and nonsense about feeding, leaving you with the confidence and knowledge you need to give your baby a safe start to solid foods using baby-led weaning.

Katie Ferraro (1m 29s):

For many families, especially those with exclusively breastfed babies, vitamin D is something that you're familiar with because you've probably been giving your baby Vitamin D Drops since the first few days of life. And in this episode, I wanna explore Vitamin D Drops, and whether or not your baby still needs to be taking Vitamin D Drops after starting Solid Foods. So let's start first by looking at what Vitamin D is. Okay? So Vitamin D is a fat soluble Vitamin, which means that it's found, and you're gonna be surprised not in very many foods, but if you have fat in your diet. The fat in those foods will help your body absorb the Vitamin D.

Katie Ferraro (2m 11s):

Now, what does Vitamin D do in our baby's bodies and our bodies? Well, calcium, as you know, is important for bone health and bone growth. But all the calcium in the world does nothing if you don't have Vitamin D to help your body absorb that calcium. So Vitamin D helps the body absorb calcium, helps the body use calcium to form and strengthen bones. So what happens if babies don't have enough Vitamin D? Well, the condition is known as rickets. It's a softening of the bones. It happens in growing babies and growing children when they learn to walk, the weight of their growing bodies puts pressure on their soft legs. And you particularly see the Boeing out of the legs, which is kind of the trademark of rickets. So soft bones can also result in fractures and frequency of fractures that are higher than normal in other injuries.

Katie Ferraro (2m 57s):

And then Vitamin D is also important cause it does play a role in your baby's brain development. And it's an essential nutrient, meaning that our bodies can't make enough of it, so it has to come from outside. So sometimes parents will say like, well, what's the deal with Vitamin D Drops? Like, you know, generations ago there wasn't a lot of rickets and babies didn't have Vitamin, D Drops. Well, there actually was for a while, a very high incidence of rickets. And that was, and during the industrial era when people started moving indoors, work and labor moved from outside on farms to inside in factories, children increasingly spending more time inside. And because of what we know about UV light exposure, dermatologists recommend against direct UV light exposure for babies.

Katie Ferraro (3m 41s):

So I know for me, when I was a Peace Corps volunteer, I lived in Nepal, for example. It was routine for parents to take their babies outside. They would oil the babies up, they would give them oil and like sun baths, and they were spending a lot of time hanging out outside, okay, higher levels of Vitamin D of course, when you come into contact with sunlight, we're also concerned on the flip side about the potential for UV light exposure, skin cancer, ect. So since we have this combination of indoor lifestyle and less exposure to sunshine, right? Vitamin D is sometimes called the sunshine Vitamin. We need to be supplementing with Vitamin D. Now who needs Vitamin D supplements? If, you are exclusively breastfeeding. The recommendation from your pediatrician is to start Vitamin D Drops.

Katie Ferraro (4m 25s):

You probably have gotten the recommendation that the American Academy of Pediatrics recommends that a daily intake level of 400 IUs or international units for Babies and most of the Vitamin D supplements that you can buy just at your regular store, drug store, grocery store, whatever, they're gonna contain this amount in one dose. But there are certainly brands where it's a little bit different. So you do need to read closely. And then you should always use the dropper that's provided with the actual brand. So again, we're looking to 400 IUs per day for exclusively breast fed babies. For formula fed babies, the formula is going to be fortified with Vitamin D, meaning that it is added into the formula.

Katie Ferraro (5m 7s):

So you don't have to worry about the Vitamin D Drops. Back to the exclusively breastfed infants. It's important when you're doing the Vitamin D Drops, okay, you can mix the Vitamin D Drops in with your baby's breast milk. If you're feeding it from a bottle, you can put the drop directly on your nipple if you're breastfeeding. That works for the brands that if there's only just one drop that you need, some parents will put the dose directly in the baby's mouth. Like they find that a period when the baby's relax, like during bath time or holding them is more efficient and also kind of aiming for the side of the cheek and not necessarily the back of the throat. Cause of course we don't wanna stimulate the gag reflex, have the baby gag to the point where they vomit and then throw up the Vitamin D supplement.

Katie Ferraro (11m 55s):

Hey, we're gonna take a quick break, but I'll be right back. Sometimes parents will say, well, what if I give too much Vitamin D? And we do know that there is an upper limit for Vitamin D IU. So the upper limit is the limit that's established that we know if you regularly dose above that amount that there could be potentially negative side effects. For babies 6 to 12 months of age, the upper limit is 1500 IUs per day. So like close to four times the recommended amount of the supplement. You're never going to overdose on Vitamin D from food sources. It's always gonna come from supplemental sources. So where does Vitamin D come from? We talked about supplements for exclusively breastfed babies, we talked about in formula fed babies, it's fortified into the formula. But when your baby starts solid foods, this is when we start getting questions like, well, if my baby's eating a variety of foods, do I need to continue the frops? Now, Vitamin D is found in a variety of dairy foods. So in the United States and many other countries, there are mandatory laws about fortification of dairy products with Vitamin D. So things like low sodium cheese that you're offering to your baby or whole milk that you might be utilizing as an ingredient, right? We never substitute fluid, whole cows milk in place of infant milk. That's breast milk or formula until after baby is one year old. But we can definitely use cows milk protein foods as ingredients starting at six months of life. And when we start solid foods, we want to do that, right? Introducing cow's milk protein helps reduce the risk of your baby having cow's milk protein allergy. So you will be incorporating some Vitamin D Foods, if you are offering dairy foods. Now we run into families where maybe the baby has a diagnosed cow's milk protein allergy, so they can't have any of those Vitamin D containing dairy foods. Or if the family is vegan and they abstain from animal foods, there might not be Vitamin D coming from the foods. But of course there's other fortified food stuff. A lot of vegetarian foods, milk alternatives can be fortified with Vitamin D. Things like breakfast cereal and orange juice, which to be honest, we're not normally feeding to babies in the six to 12 month bracket because we don't do juice for Babies and ready to eat breakfast cereals are too high in sodium and oftentimes too high in sugar for babies. So then what's left? Where else does Vitamin D come from in the diet? Well, different protein foods, in particular seafood. So those fatty fish like salmon and tuna and mackerel, very good sources of Vitamin D, beef liver and egg yolks. They also have smaller amounts of Vitamin D. So if you're not sure about how to feed your baby some of these different foods, I do have podcast episodes on how to do Liver, how to do Eggs, how to do fish. And I'll be sure to link to those in the description where you're listening to this episode. And then I'll also put them in the show notes if you wanna go and learn more. Maybe you wanna start offering these foods as a source of Vitamin D. But where most children get Vitamin D in the diet is from cow's milk products. And in the United States, there are laws, as I mentioned about fortifying the dairy products with Vitamin D. So in the US, Vitamin D fortified milk has to contain at least 100 IUs and up to a max of one 50 IUs per cup. So that's an eight ounce serving. So 6 to 12 month old Babies need about 400 IUs per the AAP recommendations. You're gonna be getting that from the drops. It is untenable that a you know, eight month old baby is having four full adult servings of dairy, right? You're starting these foods, which is important, but we want to continue the supplement if, you are breastfeeding. If you're formula feeding, you don't really have to worry about any of this, although I would still encourage you to be offering those Vitamin D containing foods for lots of other reasons, right? Because the foods, like the fatty fish and the Liver and the egg yolks, there's lots of other nutrients in there besides Vitamin D, but Vitamin D is a weird one cause it's just not naturally present in most of the foods that we eat. Historically, humans have obtained adequate levels of Vitamin D to promote optimal bone health from the sunlight. Well, we don't go in the sun anymore, right? As a person sitting inside on a computer talking to you guys who are probably inside listening to it somewhere. Although I hope maybe you're outside getting your Vitamin D fix. Regardless, your baby shouldn't be in the sun without sun protection. So we gotta get that Vitamin D from an external source. Now, generally at around the one year mark, when you stop commercial infant formula, those kiddos, toddlers, we really need to make sure that they're getting Vitamin D from their food sources. But again, most children are not gonna be getting the four full cups of dairy. I don't want your one-year-old drinking four cups of whole milk a day. So this is one of those areas where we sometimes kind of run into conflict. Well, if I were really gonna be feeding all the dairy foods to get the maximum amount of Vitamin D that would actually way surpass the amount of milk that you should be offering a toddler And If, you've been listening to the podcast for any length of time, you know that two of the biggest saboteurs of the toddler diet I always talk about are milk and snacks. Most toddlers, age one and older drink too much milk. Hey, we're gonna take a quick break, but I'll be right back.

Katie Ferraro (12m 37s):

AAP recommends between 16 and 24 ounces of cows milk per day, so I don't want you to go over that. But then 24 ounces is only three cups of milk and that's only gonna be 300 IUs. So where can you make up that gap? If, you want to stop the supplements. Most parents would recommend stopping Vitamin, D Drops at one year of age and making sure that your baby is getting, or your toddler rather at one year is getting a little bit of cow's milk protein, but not too much from cow's milk. And then you can also incorporate other dairy foods. We still wanna stick to the low sodium one, so lower sodium, softer cheeses, whole milk, full fat yogurt, okay? We offer whole milk dairy products for children up until age two.

Katie Ferraro (13m 17s):

They need that fat for, their still developing brain. Hopefully you're incorporating some fish if your family does eat fish products and those fatty fish are great sources. And then another one, it always makes me think of grandmas, but If, you ever look up like the list of the highest Vitamin, D Foods, cod, Liver oil comes out tops. I personally don't know anybody who can tolerate cod Liver oil. It's also very expensive, but it is a way that you could get Vitamin D into your child. If, you were so inclined. I think a mix of dairy foods and then also of fish foods. Also other protein foods have smaller amounts of Vitamin D in there. But If, you don't eat any of those foods, particularly for our vegan families. You can find Vitamin D in fortified foods.

Katie Ferraro (13m 58s):

You really need to read your labels. But thankfully, Vitamin D is now a mandated micronutrient on the newer version of the food label. So you can find out that info that you want. And If, you don't eat any of those foods, so no fortified foods and no animal foods. Then you could still want to continue with Vitamin D supplementation after age one. But for everybody else, If, you have dairy foods, if you have some animal foods in the diet, you can stop the Vitamin D Drops for the most part around one year of age. You always want to make sure to check with your own primary healthcare provider because your particular baby or family members may be at increased risk for certain underlying disease states that would require additional supplemental Vitamin D. But we never want you to go and supplement willy-nilly, right? You need to be taking supplements if and only If you have a diagnosed micronutrient deficiency.

Katie Ferraro (14m 44s):

Or if it's a standard recommendation, like 400 IUs of those Vitamin D Drops for your exclusively breast fed infants. Another suggestion if you're making the transition from breast milk to formula is that the general rule of thumb is that once your baby is drinking one liter of formula or having fortified whole milk every day, then they're probably getting enough Vitamin D without the Drops. But make sure that you're continuing to offer a variety of food cause those protein Foods, especially those fish foods do contain Vitamin D in there. I hope you guys learned a little bit about Vitamin D Drops. A link to all of the references that I mentioned today in the Show notes for this episode, which you can find at BLW podcast.com/333.

Katie Ferraro (15m 26s):

Thank you to our partners at AirWave Media. If you guys like a podcast that feature food and science, and using your brain. Check out some of the podcast offerings from AirWave or online at BLW podcast.com. Take care, And, I'll see you next time.