What are the instructions for administering vitamin D drops to newborns?

Vitamin D Supplementation Instructions for Newborns

Newborns should receive 400 IU of vitamin D daily as a standard supplementation dose. 1, 2

Dosing Recommendations by Age

• For term infants up to 12 months of age, the recommended daily vitamin D supplementation is 400 IU/day (or 40-150 IU/kg/day) 3
• For preterm infants, a higher dose of 200-1000 IU/day (or 80-400 IU/kg/day) is recommended 3
• The goal of supplementation is to achieve and maintain serum 25(OH)D levels above 50 nmol/L (20 ng/mL) 1

Administration Instructions

• Begin vitamin D supplementation within the first few days of life 2
• Administer vitamin D drops directly into the infant's mouth, ideally at the same time each day to establish routine 1
• Place drops on the back of the tongue or inside the cheek, not directly on the throat to avoid gagging 1
• For breastfed infants, administer drops after a feeding when the infant is calm 2, 4
• For formula-fed infants, supplementation is still needed until the infant consumes enough formula to provide 400 IU daily (typically around 1 liter of formula per day) 5

Duration of Supplementation

• Continue daily vitamin D supplementation throughout the first year of life 6
• Some guidelines recommend continuing supplementation until 6 years of age, particularly in regions with limited sun exposure 6
• For infants with dark skin, a higher dose of 600 IU/day may be considered 6

Monitoring

• Routine monitoring of vitamin D levels is not generally recommended for healthy term infants receiving appropriate supplementation 1
• For preterm infants or those at high risk of deficiency, monitoring may be considered at 3-6 months of age 1, 7
• Target serum 25(OH)D concentration should be >50 nmol/L (20 ng/mL) 1

Special Considerations

• Exclusively breastfed infants are at higher risk of vitamin D insufficiency as breast milk contains low levels of vitamin D 2, 4
• Formula-fed infants still require supplementation until consuming at least 1 liter of formula daily 5
• Infants with darker skin, limited sun exposure, or living at higher latitudes may require special attention to ensure adequate vitamin D status 6

Safety Considerations

• The recommended dose of 400 IU/day is well below the tolerable upper intake level for infants 1
• Avoid using highly concentrated vitamin D preparations to prevent accidental overdosing 2
• Vitamin D toxicity is rare but can occur with excessive supplementation 1