Do infants who are formula-fed (formula feeding) require vitamin D supplementation?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: May 23, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

Formula-fed babies typically do not need vitamin D supplements, but they may require supplementation if they consume less than 28 ounces of formula per day, in which case a daily supplement of 400 IU is recommended. Most infant formulas are already fortified with vitamin D at levels that meet or exceed the recommended daily intake of 400 IU (10 micrograms) per day for infants, as suggested by 1. This fortification is designed to prevent vitamin D deficiency, which can lead to rickets, a condition causing weak bones. However, the amount of formula consumed is crucial in determining the need for supplementation. Some key points to consider include:

  • The recommended daily intake of vitamin D for infants is 400 IU per day, as stated in 1.
  • Infant formulas are typically fortified with vitamin D, but the amount may vary depending on the brand and type of formula.
  • If a formula-fed baby consumes less than 28 ounces of formula per day, they may not be getting enough vitamin D, and a supplement could be necessary, as recommended in 1.
  • Vitamin D is essential for calcium absorption and bone development in growing infants, and its deficiency can lead to serious health issues, as discussed in 1. It's always best to discuss your baby's specific nutritional needs with their pediatrician, who can provide personalized recommendations based on your baby's growth, formula intake, and other health factors, taking into account the latest guidelines and research, such as those presented in 1.

From the Research

Vitamin D Supplementation for Formula-Fed Babies

  • The American Academy of Pediatrics (AAP) recommends a daily intake of 400 IU/day of vitamin D for infants and children 2.
  • A study found that among infants who consumed formula but no breast milk, 81% to 98% met the 2003 recommendation, but only 20% to 37% would have met the 2008 recommendation 2.
  • Another study compared bone mineralization in healthy full-term breastfed infants with and without supplemental vitamin D, and found that formula-fed infants had better bone mineralization than breastfed infants without supplemental vitamin D 3.
  • The US Institute of Medicine recommends a daily intake of 400 IU of vitamin D for children younger than 1 year of age 4.
  • The US Endocrine Society suggests that 400-1000 IU per day may be needed for children aged less than 1 year to maintain optimal vitamin D levels 4.
  • A review of vitamin D insufficiency found that severe vitamin D deficiency can be prevented by 400 IU of vitamin D per day and serum 25OHD concentrations above 30 nmol/l (12 ng/ml) 5.
  • A recent review of vitamin D deficiency found that a 25(OH)D level of >50 nmol/L or 20 ng/ml is the primary treatment goal, and that severe vitamin D deficiency should be avoided whenever possible 6.

Key Findings

  • Formula-fed babies may not need supplemental vitamin D if they are consuming enough formula, as most formulas are fortified with vitamin D 2, 3.
  • However, the AAP recommends that all infants, including those who are formula-fed, receive a daily supplement of 400 IU of vitamin D 2.
  • The optimal dose and status of vitamin D is still a subject of debate, and more research is needed to determine the best approach to vitamin D supplementation 4, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.