Why do babies need extra vitamin D?

Children and adults can make vitamin D themselves when their skin is exposed to sunlight. But that ability takes a while to develop, so babies can't make enough of it yet. Babies also have very sensitive skin that needs to be protected from the sun, which makes it difficult for them to make vitamin D themselves.

Although breast milk is the best food a baby can get, there isn't much vitamin D in it. So breastfed babies don't get enough vitamin D. Likewise, most formulas have vitamin D added to them, but not enough to cover babies' needs.

How much vitamin D does a baby need and how can it be supplied?

According to estimates by the German Nutrition Society (DGE), babies need 10 micrograms (10µg) of vitamin D per day during their first year of life to prevent rickets.

Newborns can’t make that much themselves or get it from their food. So German pediatricians recommend giving all babies vitamin D supplements (as tablets or drops). For the prevention of rickets, 10 to 12.5µg per day is enough during the first year – starting from the end of the first week after birth. For babies born in winter, the recommendation is to carry on giving them vitamin D supplements during the winter months of their second year.

The dose is sometimes also described in International Units (IU): 10 to 12.5µg of vitamin D is the same as 400 to 500 IU of vitamin D.

At the “U2” check-up in Germany (for babies that are three to ten days old), the pediatrician explains why vitamin D is important for bone health and writes a prescription for the drops or tablets. They also explain why is important for the development of healthy teeth. Vitamin D and can be given together in one tablet. The U2 check-up is a good time to ask any questions you have about vitamin D.

Does vitamin D have any disadvantages?

Given at the right dose, vitamin D has no disadvantages for the child. It is important to stick to the dose of tablets or drops recommended by the doctor. Too much vitamin D can increase the levels in the blood too much, which can cause side effects like loss of appetite, vomiting, restlessness or lethargy. It can also lead to deposits in the kidneys, causing damage there.

Good to know:

The vitamin D supplements that pediatricians prescribe are especially for babies. Over-the-counter products might contain a higher dose and be harmful for babies.

How can you give tablets or drops to the baby?

It is best to give the drops or tablets to the baby when you feed them. Otherwise, their body can’t use the vitamin D.

You can place vitamin D tablets inside the baby’s cheek just before feeding. They will then dissolve in the breast milk or formula. Another possibility is to dissolve the tablet in some water or breast milk on a teaspoon and then carefully drip it into the baby’s mouth before feeding them. The water must be boiled beforehand to get rid of any germs and then cooled down to a safe temperature for the baby.

Vitamin D drops can be dripped onto the nipple or the bottle teat right before feeding the baby. If you put the drops inside the baby’s cheek, it’s important to make sure you don’t give them too much by mistake.

Chibuzor MT, Graham-Kalio D, Osaji JO et al. Vitamin D, calcium or a combination of vitamin D and calcium for the treatment of nutritional rickets in children. Cochrane Database Syst Rev 2020; (4): CD012581.

Committee to Review Dietary Reference Intakes for Vitamin D and Calcium, Food and Nutrition Board. Dietary Reference Intakes for Calcium and Vitamin D. Washington (DC): National Academies Press (US); 2011.

Day RE, Krishnarao R, Sahota P et al. We still don't know that our children need vitamin D daily: a study of parents' understanding of vitamin D requirements in children aged 0-2 years. BMC Public Health 2019; 19(1): 1119.

Deutsche Gesellschaft für Ernährung (DGE), Österreichische Gesellschaft für Ernährung (ÖGE), Schweizerische Gesellschaft für Ernährung (SGE). D-A-CH: Referenzwerte für die Nährstoffzufuhr. Bonn: DGE; 2021.

Ernährungskommission der Deutschen Gesellschaft für Kinder- und Jugendmedizin (DGKJ). Gesunde Ernährung für mein Baby. Monatsschr Kinderheilkd 2014; 162(6): 527-538.

Gemeinsamer Bundesausschuss (G-BA). Kinder-Richtlinie: Richtlinie zur Früherkennung von Krankheiten bei Kindern. 2023.

Institute for Quality and Efficiency in Health Care (IQWiG, Germany). Blutwerte. Profitieren ältere Personen von einer regelmäßigen Bestimmung der Vitamin-B12- und Vitamin-D-Werte im Blut? (HTA kompakt: Das Wichtigste verständlich erklärt; HT20-04). 2022.

Koletzko B, Bauer CP, Cierpka M et al. Ernährung und Bewegung von Säuglingen und stillenden Frauen. Aktualisierte Handlungsempfehlungen von „Gesund ins Leben – Netzwerk Junge Familie“, eine Initiative von IN FORM. Monatsschr Kinderheilk 2016; 9(164): 765-789.

Reinehr T, Schnabel D, Wabitsch M et al. Vitamin-D-Supplementierung jenseits des zweiten Lebensjahres. Monatsschr Kinderheilkd 2018; 166(9): 814-822.

Robert Koch-Institut (RKI). Antworten des Robert Koch-Instituts auf häufig gestellte Fragen zu Vitamin D. 2019.

Tan ML, Abrams SA, Osborn DA. Vitamin D supplementation for term breastfed infants to prevent vitamin D deficiency and improve bone health. Cochrane Database Syst Rev 2020; (12): CD013046.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

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Created on November 11, 2024

Next planned update: 2027

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Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

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