At what age should multivitamins (multiple vitamins) be started for a healthy, full-term infant?

Multivitamin Supplementation for Healthy Full-Term Infants

Healthy full-term infants do not routinely need multivitamin supplementation unless they have specific risk factors, but should receive vitamin D supplementation of 400 IU/day from birth. 1, 2

Vitamin Supplementation Guidelines by Age and Feeding Type

Birth to 6 Months

• Breastfed infants:

  • Vitamin D: 400 IU/day from birth 1, 2, 3
  • Vitamin K: 0.5-1 mg single dose within first hour after birth 1

• Formula-fed infants:

  • Vitamin D: Not required if consuming adequate vitamin D-fortified formula 2
  • Vitamin K: 0.5-1 mg single dose within first hour after birth 1

6-12 Months

• Continue vitamin D supplementation (400 IU/day) for breastfed infants 1, 3
• No routine multivitamin supplementation needed if diet includes:
  • Vitamin D-fortified milk/formula
  • Adequate vitamin C sources
  • Iron-fortified cereals or formula 2

Special Considerations for Supplementation

High-Risk Situations Requiring Supplementation

• Maternal factors:

  • Mother took medications interfering with vitamin K metabolism (anticoagulants, anticonvulsants, barbiturates) 1
  • Maternal anemia during pregnancy (increases risk of infant iron deficiency) 4

• Infant factors:

  • Premature birth
  • Low birth weight (<1500g): Consider multivitamin supplementation until reaching 2000g 5
  • Exclusively breastfed infants may need additional iron after 4-6 months 2, 6
  • Limited sun exposure 3
  • Restricted diet or feeding difficulties

Common Pitfalls in Infant Vitamin Supplementation

1. Overestimation of requirements: Research suggests that Recommended Dietary Allowances (RDAs) for most vitamins and minerals are likely overestimated for infants 6

2. Unnecessary supplementation: Despite recommendations that healthy infants don't need supplements if consuming appropriate foods, approximately one-third to one-half of 6-12 month old infants in the US receive nutrient supplements 2

3. Inadequate vitamin D: The most common legitimate supplementation need is vitamin D, particularly for exclusively breastfed infants 2, 3

4. Overlooking iron status: Iron deficiency remains a concern, especially for infants of mothers who were anemic during pregnancy 4

Monitoring

• Routine monitoring of vitamin concentrations (except vitamin D) is not generally recommended for healthy infants 7
• For infants on long-term parenteral nutrition, monitoring may be needed based on clinical indications 7

In summary, while multivitamin supplementation is not routinely needed for healthy full-term infants with adequate diets, vitamin D supplementation is recommended from birth for breastfed infants, and specific vitamins may be needed in certain high-risk situations.