Essential throughout life, vitamins are all the more important in a newborn’s first months because they will play a crucial role in their physical and immune development. While a majority of these vitamins are provided through milk and then solid food, others require supplementation to avoid the risk of deficiency. Small vitamin point!
Whether in adults, children or infants, vitamins are essential for the body. They ensure the development and functioning of the immune and nervous systems and help to absorb, assimilate and fix nutrients and other minerals essential for our metabolism such as iron or calcium. In babies, they will actively participate in its growth and must therefore be present in the amount necessary on a daily basis so that no deficiency disturbs it.
However, the majority of vitamins are not synthesized directly by the human body but come from external sources and more particularly from food. So, how are these vitamins administered to the newborn? How do you make sure you don't miss any? In which cases should I resort to supplementation? When should you be concerned about a possible deficiency?
Please note, vitamin supplements for babies and pregnant women must be approved by a health professional.
Vitamins in infants
Baby is born but its development and growth are only at the beginning of their adventure! From the bones to the brain, his entire system will continue to evolve which must be supported as best as possible in order to guarantee his health throughout his life. Vitamins, essential elements of this complex mechanism that is the human body, must therefore be present in sufficient doses in its diet because they are not produced naturally by the body.
While milk, whether breastfeeding or artificial, covers a large part of this need, certain vitamins need to be supplied by another means in order not to expose the child to a deficiency which could have serious repercussions and to long term on his health. This is where supplementation comes in and it mainly concerns 2 vitamins: vitamin D and the vitamin K.
Vitamin D supplementation: from newborns to teenagers
In adults, vitamin D is produced naturally in the skin (skin biosythesis), through exposure to the sun. This vitamin is involved in particular in the mineralization of bones and teeth by promoting the absorption of calcium and phosphorus. She is therefore the keeper of strong bones! It also strengthens the natural defenses. If 10 to 15 minutes a day in the sun are enough to synthesize this vitamin, this method is to be avoided for babies whose skin is extremely fragile and should not be exposed to ultraviolet rays.
To replace the effects of the sun and because milk is not enough to cover the daily intake of vitamin D, children should receive, from their birth and until their 18th birthday (ideally), a supplementation of which the dosage and the frequency vary according to their diet and age.
- From 0 to 18 months, the French Pediatric Society recommends vitamin D supplementation of 1,000-1,200 IU / d (International Unit / day) in case of breastfeeding or infant formula not enriched with vitamin D. If baby is fed milk enriched with vitamin D, the dosage is 600-800 IU / d.
- From 18 months to 5 years, supplementation will be done either by 2 loading doses of 80,000 – 100,000 IU administered at the beginning of the winter period (around November) and at the end of winter (February), or by a single dose of 200,000 IU given in November.
- In adolescents aged 10 to 18, the SFP recommends the same supplementation.
Why continue this supplementation after 24 months when children's skin can be exposed to UVB? Quite simply because in winter, not only the sun shines less strongly and less often, not allowing a sufficient production of vitamin D, but we also wear much more covering clothes limiting the surface exposed to the rays allowing the synthesis. Children are thus vulnerable to deficiencies that are dangerous for their health. For this same reason, studies have shown that children living in areas far north, where there is less sunlight, are more prone to deficiency. Special care is also advised for children with dark skin because the pigmentation filters UVB rays and thus blocks biosynthesis.
Vitamin D supplementation most often takes the form of drops. These drops can be given directly orally to baby before feeding or bottle-feeding and do not taste repellent to the baby.
This vitamin D supplementation in the context of maternity does not only concern the child. Indeed, the mother transmitting, through her own diet, essential nutrients to the baby via the cord during pregnancy and then into breast milk when she chooses to breastfeed, it is increasingly common to administer a maternal supplementation called preventive, either by a single loading dose (80,000 IU or 100,000 IU) at the beginning of the 7th month of pregnancy, or throughout pregnancy by a daily dose of 400 IU. This method and its effectiveness have been proven through numerous studies.
Vitamin K supplementation: in the first month of life
Vitamin K is produced by bacteria in the gut and its role is crucial in blood clotting. But it does not cross the placenta, is transmitted only in very small amounts in breast milk and in newborns, its production is insufficient. Supplementation has therefore become systematic in order to avoid the risks of hemorrhagic syndrome in newborns and infants, which is rare but very serious.
According to the recommendations of the French Society of Neonatology, all babies born at term should receive orally or by injection 3 doses of vitamin K1 of 2 mg each:
- The first dose is given at birth
- The second between 72 and 96 hours of life or shortly before leaving the maternity ward
- The third dose is given at one month of the infant's life
A rhythm easy to remember thanks to a little trick of the SFN: vitamin K like "4 hours, 4 days and 4 weeks".
Please note, however, that the dosage and rate of administration are different in premature babies who benefit from specific recommendations.
Breast milk and infant milk, is there a difference in vitamin intake?
Vitamins, minerals, trace elements, sugars, fats, proteins … With the exception of vitamins D and K, breast milk contains all the nutrients essential for baby's development and health and therefore remains the most suitable food. It is for this reason that WHO recommends breast-feeding, when possible, for up to 6 months.
For several years now, infant formulas have improved to best reproduce the richness of breast milk, and even offer more benefits. Indeed, for these two vitamins, the supplementation recommendations are not the same depending on the method of breastfeeding chosen.
- In the case of vitamin D, if the milk formula is fortified, the daily dose can thus drop from 1000 IU to 600-800 IU. Be careful, even enriched with vitamin D, these milks do not provide the whistling dose and therefore do not protect babies from deficiencies.
- For vitamin K, the third recommended dose at 1 month of life is no longer mandatory in infants fed formula.
Have you chosen mixed breastfeeding by alternating bottles of artificial milk and breastfeeding or bottles of breast milk? Speak directly to your doctor and / or pediatrician who will be the best person to determine the most suitable dosage for your newborn baby. Never decide on a supplement alone as they are not harmless and can even be very dangerous for the health not only yours but also the baby's.
And when it comes to breast milk, never forget that it is a direct reflection of mother's diet. To ensure the contributions of all these vitamins to baby but also for his own health, it is necessary to have oneself a balanced and varied diet.
How to recognize a deficiency and what are the risks?
Vitamin D and K supplements respond to the most common deficiencies in the past and to the complications, sometimes serious, which are associated with them.
The vitamin D Allowing calcium absorption and bone mineralization, a deficiency can lead to rickets. This growth disease causes brittle bones that are not properly calcified, and in the long term, deformities. Since supplementation was introduced, rickets have all but disappeared. However, a distinction must be made between deficiency rickets and genetic rickets. The latter remains linked to a vitamin D deficiency but this is due to a transmitted disorder of the metabolism preventing the synthesis of the vitamin. It remains rare and affects only one in 2,000 children. It is normally identified upstream and allows the baby to be treated from birth.
Supplementation as well as the first days spent in maternity under medical supervision are enough to rule out the risk of deficiency. Regular visits to the pediatrician also make it possible to monitor the correct balance of vitamin intake, but if in doubt, it is preferable to consult. If a deficiency is suspected, a blood test and a urine test will measure the presence of vitamin D and, possibly, its insufficiency. X-rays can be used as a second step. Treatment usually involves adjustment of vitamin supplementation and should be followed regularly to avoid vitamin D poisoning and hypercalciuria.
The vitamin K deficiency is the most common deficiency in newborns. However, it is very dangerous. It can be the cause of a hemorrhagic syndrome of the newborn which occurs most often during the first days and more rarely in the first month and even after (it is said then late) and results in internal bleeding and / externalized, for lack of sufficient blood coagulation. In the most serious cases, this syndrome can cause irreversible damage to the brain, even death.
Fortunately, it remains extremely rare, and supplementation given at birth and in the first few days has reduced the number of affected infants to less than one in 100,000.
The most common symptoms of vitamin K deficiency newborn hemorrhage are blood in the infant's stool or urine, or bruises and bruises. When a hemorrhagic disease of the newborn is diagnosed, it can be treated therapeutically by giving a daily dose of vitamin K.
And after ? Vitamins in children
Gradually, food diversification will replace milk and take over in the daily intake of vitamins and minerals in children. This is why it is essential to ensure that you offer foods suitable for your age but above all sufficiently varied and as often as possible, fresh, to preserve the nutrients as much as possible.
For example, we will mainly find the vitamin A, essential for the immune system, in orange fruits and vegetables in the form of beta-carotene (carrots, apricot, pumpkin, but also spinach and cabbage) as well as in oily fish or eggs.
The vitamin B, or rather the B vitamins, because there are 8 different (we are talking about the B complex vitamins), have a very wide and crucial field of action for the whole body! They act in particular on the metabolism of carbohydrates, proteins and lipids, the synthesis of hormones and neurotransmitters, the production of red blood cells and the division of cells. Like their multiple roles, their food sources are very diverse.
Ascorbic acid, the famous vitamin C which is rightly associated with citrus fruits, is involved in the functioning of the immune system as well as in the absorption of iron, which is also essential. But it is not only found in oranges and clementines, it is also present in strawberries, peppers, broccoli …
About the vitamin D, in addition to exposure to the sun, it can be added in a smaller quantity and insufficient to cover daily needs thanks to fatty fish such as salmon, tuna and mackerel or even egg yolk.