Do babies need vitamin and mineral supplements?

Nutrients are actually an umbrella term for carbohydrates, fats, proteins, vitamins and minerals, and it’s not uncommon for parents to wonder if their child is really getting everything they need, especially during those periods when the only thing they seem to want to open their mouth for is pasta. But malnutrition is uncommon in children in the Western world and as long as you provide a varied diet, you don’t really need to worry too much about which food provides what. Your child will often get what they need from food – with one exception: vitamin D. If you want or need to exclude foods such as fish or eggs from your child’s diet, there are some additional nutrients that you need to keep an eye on.
Here’s a simple course on nutrition for babies, covering what vitamins and minerals babies need, which foods contain which nutrients, and what to consider regarding supplements and multivitamins for babies.

Vitamin K for newborns

Vitamin K is needed for blood clotting. Newborn babies in Sweden receive a vitamin K shot, and after that no further vitamin K is needed.

Vitamin D for babies from the second week of life

Vitamin D is needed to form bones and teeth, but it is also a vitamin that remains important throughout life to avoid osteoporosis. Adults get vitamin D in two main ways: by spending time in the sun and by eating foods containing vitamin D. The main food source of vitamin D is oily fish, but eggs and meat also contain some. Some foods are also enriched with vitamin D, such as many dairy products.

However, children do not get the amount of vitamin D they need – for one thing, sunshine hours are a bit sparse in many countries, and for another, their skin does not cope well with the sun, and they don’t eat enough food to cover their vitamin needs. For this reason, D-drops need to be given from the age of 1 week to 2 years, whether the baby is breast fed or formula fed. The latter does contain added vitamin D, but the Swedish Food Agency advises giving D-drops even to babies who only drink formula because otherwise there is a high risk of forgetting them when the baby starts eating other foods. Some children need to continue their D-drops for longer, such as those who do not eat oily fish or who wear clothes that cover their face, arms and legs. The Swedish Food Agency has a good list of who may need to take D-drops for an extended period of time, but as usual, your healthcare provider can also help you decide what is right for you.

Iron-rich food for babies

As we all know, babies grow an awful lot and therefore have almost the same iron needs as adults. Iron-rich foods include black pudding and liver, but iron can also be found in meat, eggs, shellfish, beans, peas, lentils and wholemeal products. But even if you have a little one who loves black pudding, it can be difficult to get enough iron. This is because babies are not able to eat very large portions to meet their iron requirements, so they need foods enriched with iron too.

Lots of baby food products are enriched with iron, especially baby porridge – check the packaging to be sure. If you prefer to make your own, you can mix an iron-rich food into your waffles or home-made porridge to increase the iron content. It’s good to know that iron is more easily absorbed with vitamin C (ascorbic acid) so it’s good to add something rich in vitamin C to your baby’s diet, such as fruit purée or some berries. Citrus fruits in particular are particularly rich in vitamin C.

Supplements or multivitamins for babies with poor or low nutrition?

Apart from vitamin D, babies almost never need supplements. Food supplements such as multivitamin tablets, calcium tablets or vitamin C tablets are often not adapted for babies, which can make it difficult to know for sure what dose to give the baby – and high doses can be dangerous in some cases. In very rare cases, individual babies may need a multivitamin supplement or occasional boosting of a particular nutrient. This could be, for example, if you notice that your baby is not gaining weight as it should, but this is not something you should experiment with on your own; it should be done in consultation with your baby’s doctor or a dietician.

But generally speaking, giving as varied a diet as you can (giving a wide variety of foods is also generally good for gut flora and the immune system) combined with fortified foods where necessary is all that’s needed. If your baby is very selective about food, don’t give up! It is more common than you think and it takes time to learn new flavours. But in the meantime, try to find creative ways to introduce protein, carbohydrates, fruit and vegetables in a way that your child actually accepts. Kiwis may not be popular, but maybe clementines and berries are eaten with pleasure. Maybe your child refuses to even touch legumes, but is happy to eat pancakes that have cooked and blended red lentils in the batter. Avocado might be accepted if it comes in the form of a smoothie. Perhaps your child is OK with eating soft-boiled carrot sticks for a snack but not with having grated carrots on their plate. These might all be the solution for a while – combined with setting out some new flavours to try. Then suddenly something changes and your baby tries something new! We have put together more tips about food refusal for those of you who need more help.

Which food provides which nutrients?

The more foods you exclude, for example because of an allergy or a vegetarian diet, the more important it is to know and keep track of what needs to be compensated – and how. Rather than talking about dietary supplements in the form of capsules, powders, bars and tablets, we’re talking about fortified foods, combined with replacing the foods that are omitted with something else. We have listed six key nutrients below that you need to keep an eye on if you want – or need – to exclude foods from your child’s diet.

1. Vitamin B12 for children who do not eat animal products
   Vitamin B12 is mainly found in meat, liver, fish, shellfish, eggs, milk and cheese. If your child eats several of these foods, you don’t need to worry about it. However, if you have a child who eats very little animal products, or is even vegan, you need to give them vitamin B12. This is because it is needed for the body to form blood cells and is necessary for the nervous system to function; a lack of B12 can lead to damage that cannot be repaired afterwards. If you have a child who does not eat animal products, you will need to supplement with, for example, oat or soya milk or plant-based yoghurts enriched with B12. If breast milk is a large part of the baby’s diet, your baby can also get its B12 from it, but in that case the breastfeeding mum will of course need to consume vitamin B12.
2. Zinc is needed for development and growth
   The most common sources of zinc are meat, dairy and wholemeal products. If you have a baby who doesn’t eat meat or drink milk, they need to get zinc from other sources, as a lack of it can interfere with their development and growth. However, finding other alternatives is usually not a problem, as wholemeal products are full of zinc. Nuts are also high in zinc and are a good supplement for young (and old) plant-based eaters. Fortified porridge is also a good source of zinc.
3. Babies’ bones and teeth need calcium
   Calcium, together with vitamin D, is needed for the formation of new bones and teeth. But growth can also be stunted if there is a long-term lack of calcium. Calcium is mainly found in dairy products and nuts, but there is also some in green leafy vegetables
4. (which should not be given in large quantities to babies under one year old). One good thing to know about calcium is that cheese actually contains quite little, unlike milk which has a much higher concentration of the mineral. Therefore, children who do not eat dairy products need to be given food with added calcium, such as fortified porridge, soya milk or oat milk.
5. Iodine is important for hormone balance
   Iodine is mainly found in fish, milk and eggs. If your baby eats a completely plant-based diet, any tiny bit of salt you add to the food needs to be enriched with iodine. Iodine deficiency can affect the functioning of the thyroid gland and lead to hormonal imbalances.
6. Omega-3 (DHA and EPA)
   Omega-3 fats are important for a child’s physical, motor and cognitive development. The body cannot produce polyunsaturated fats on its own, so we need to get them from food. Oily fish such as salmon, mackerel and herring are high in omega-3, so it’s good for babies who eat a lot of plant-based foods to supplement their diet with oily fish. If you can’t or don’t want to give your child fish, the energy-rich omega-3 fats can also be found in rapeseed oil, walnuts and flaxseed oil. Lots of vegetarians and vegans also use seaweed oil as an omega-3 supplement, but before giving it to a child, read up on the correct dosage – as giving too much algae oil to babies can be harmful.
7. Selenium
   Selenium is found in many foods, but the amount of the mineral varies. Animal products such as fish, offal, milk, eggs and cheese are high in selenium. If you don’t want to eat these, you can replace them with other foods that are also rich in selenium, such as nuts or seeds. Selenium deficiency is rare but can have serious consequences such as heart muscle changes.

Please note that all information above is based on Swedish recommendations.