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Ask Dr. Sears: Vitamin Overdose

Q  Do you recommend vitamin supplements? If yes, which vitamins should my baby get? Is there any chance that a baby can overdose on vitamins if she also drinks formula and eats vitamin-fortified cereals?

A It's important that your baby get the right amount of vitamins, since your baby needs adequate amounts of these nutrients for optimal growth. It is wise not to give your baby more than the recommended daily allowance—the RDA, also called daily value or DV. Yet, giving your baby an excess of most vitamins will cause no harm. Your baby will only excrete the excess in her urine. (Very high excess doses of vitamin A can be harmful, but only at approximately ten times the RDA.) The label on formula cans and food labels, such as some cereal boxes, list the RDA's of essential nutrients.

Here's a rundown of the eleven most common vitamins, and their health benefits:

  • Vitamin A promotes healthy vision, skin, and teeth, and also boosts the immune system.
  • The B vitamins (B-1, B-2, B-3, B-6, and B-12) are necessary for proper energy conversion at the cellular level and help boost the immune system and central nervous system.
  • Vitamin C promotes healthy blood vessels, immune system, and neurotransmitters in the brain.
  • Vitamin D promotes absorption of calcium and phosphorous for strong bones.
  • Vitamin E acts like an antioxidant protecting cell membranes from damage.
  • Vitamin F (folic acid) helps build healthy red blood cells and is important in the formation of normal spinal bones, especially in the preborn baby.
  • Vitamin K helps promote proper blood clotting.

Concerning the formula issue, all commercially available infant formulas contain the recommended amount of vitamins. If your baby gets 32 ounces of formula a day, then she is getting enough vitamins. If, however, she takes less than 32 ounces, a multi-vitamin supplement is recommended. When you start adding solid foods, she will also be getting vitamins from solids. You don't need to worry about her getting too much, as it's nearly impossible for baby to "overdose" on too much vitamins from foods.

Breastfed babies generally do not need vitamin supplements. There is some new evidence that suggests some breastfeeding babies or their mothers, especially if they are African-American, may need vitamin D supplements during the winter months if they are not exposed to at least ten minutes of sunlight a day. Also infants with nutritional needs for catch-up growth, such as premature infants, usually need vitamin, mineral, and iron supplements for at least the first year.

Besides vitamins, it's important that babies get enough minerals in their diet, which is why you will notice that some supplements are listed as a "multi-vitamin/multi-mineral" preparation. And one of the most important minerals to be sure your baby gets enough of is iron, especially after six months of age. At this point, babies begin to use up all their extra iron stores from the mothers blood at birth. This is why it's important to always use an iron-fortified formula, and not a "low iron" formula. Iron is necessary for your baby to make enough red blood cells. Your doctor will routinely measure your infant's iron levels in her hemoglobin around the nine-month well-baby checkup. Infant cereals are also fortified with vitamins and minerals. So, if your baby is taking 32 ounces of formula plus eating solid foods, you can be reassured that she has a vitamin-sufficient diet.

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