An Expert's Guide to Supplementing Breastfed Babies - November 2024

Breast milk has been scientifically proven to be a complete nutrient for newborns: it's all the food they need during their first few years of life. But in some cases they may need a little bit of help in the nutrition department. This is where supplementing comes in. We sat down with Pharmacist Nazatul Amira Hamzah from Primabumi Sdn Bhd to help nursing mums learn how and why they may need to supplement their newborn's nutrient intake. Nazatul Amira Hamzah, Pharmacist at Primabumi Sdn Bhd Nazatul is a qualified pharmacist with 10 years of experience in pharmacy practice involving both hospital and community settings. She currently holds the position of Pharmacist and Key Account Manager at a renowned pharmaceutical company in Kuala Lumpur. Thinking of supplementing your breastfed baby, mummies? Here is a pharmacist's guide on doing so. What are the common reasons for supplementing breastfed babies? Although breast milk stands as the best source of nutrition for babies, there are some circumstances in which additional supplementation may be required, including: Preterm babies: Because they were born prematurely, they did not have enough time to build iron reserves before birth. Iron is essential in the production of haemoglobin, which carries oxygen throughout the body via red blood cells. Iron also plays a critical role in supporting proper growth and development. Lack of exposure to sunlight: Vitamin D supports healthy development of the bones, teeth, and immune system. Humans rely on our exposure to sunlight to produce vitamin D, as we can’t produce it on our own. Babies, whose delicate skin requires protection from the sun, are susceptible to vitamin D deficiency. Babies who lack vitamin D could suffer from weakened bones and skeletal deformities. How do parents determine if their breastfed baby needs additional supplements beyond breast milk? Parents should consult a paediatrician to determine if additional supplements are necessary. This can be based on several factors such as the baby’s diet, growth patterns, medical history, and potential deficiencies detected through blood tests. At what age is it appropriate to start giving health supplements to breastfed babies? The American Academy of Pediatrics (AAP) recommends iron supplementation should begin at 4 months of age for exclusively breastfed newborns. This should continue until they start consuming complementary iron-rich meals. On the other hand, vitamin D supplementation should start right after birth because breast milk alone does not provide enough vitamin D. Are there any risks or side effects to giving iron and vitamin D supplements to babies? Too much iron may cause diarrhoea and, subsequenty, the loss of fluids and other nutrients from the baby’s body. If this happens frequently or over a prolonged period, iron supplementation will negatively affect the baby’s growth rather than promote it. Excessive vitamin D levels lead to hypercalcaemia, a condition where the blood contains too much calcium. Hypercalcaemia can result in serious complications, including: digestive disorders such as feeding intolerance, vomiting, nausea, constipation, diarrhoea and stomach pain tiredness, irritability, dizziness and confusion failure to thrive dehydration frequent urination (polyuria) increased risk of kidney failure Therefore, it is crucial that any supplementation, in any case, always be prescribed by a healthcare professional. How should parents choose health supplements for their breastfed babies? Parents should select infant-specific supplements from reputable manufacturers. They must follow the dosing recommendations stated on the product packaging unless otherwise advised by a healthcare professional. How can parents safely administer health supplements to their breastfed babies? To ensure the safe administration of supplements, parents should use the dropper or syringe that comes with the product. Measure out the precise amounts, and, if necessary, mix the supplement with breast milk or formula. They should always follow the instructions on the supplement packaging and consult their healthcare provider if they have any questions or concerns. What are the recommendations for iron and vitamin D supplementation in breastfed babies? The table below summarises the recommended dosage for iron and vitamin D supplementation for breastfed babies according to the American Academy of Pediatrics (AAP): Requirement for Iron Requirement for Vitamin D Preterm infants aged 4 to 12 months 2 mg per kg per day Infants aged 0 to 12 months 400 IU per day Full term infants aged 4 to 6 months 1 mg per kg per day Children above 12 months 600 IU per day Full term infants aged 6 to 12 months 11 mg per day Babies and toddlers aged up to 3 years 7 mg per day *IU stands for international units. **Please take note that the above dosing recommendations serve only as general guidance. Seek expert advice on the most appropriate dosage for your baby. Are there natural alternatives to commercial health supplements for breastfed babies? Once your baby starts eating solid foods, you can replace commercial health supplements with suitable foods fortified with iron and vitamin D. How can parents monitor the effectiveness and safety of health supplements given to their breastfed babies? Parents can monitor the efficacy and safety of their baby's supplementation by: bringing their babies for regular checkups with a healthcare professional carefully observing any changes in health or behaviour documenting any possible signs of side effects If necessary, blood tests may be performed in order to determine the amounts of certain nutrients. Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner. For more insightful stories and fun recipes, stay tuned to Motherhood Story!

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