For how long should vitamin D drops be continued in a newborn?

Duration of Vitamin D Supplementation in Newborns

Vitamin D supplementation at 400 IU daily should be continued throughout the entire breastfeeding period for breastfed infants, and for formula-fed infants until they consistently consume at least 28 ounces (840 mL) of vitamin D-fortified formula per day. 1, 2

Breastfed Infants

• Begin 400 IU daily at hospital discharge and continue throughout the entire duration of breastfeeding, regardless of whether breastfeeding is exclusive or partial. 1, 2, 3
• There is no specified upper age limit for discontinuation—the key determinant is continuation of breastfeeding, not the infant's age. 1
• This recommendation applies because breast milk contains insufficient vitamin D to meet infant requirements. 1, 4

Formula-Fed Infants

• Continue 400 IU daily supplementation until the infant reliably consumes at least 28 ounces of vitamin D-fortified formula per day. 2, 3
• Most infants reach this threshold within the first 2 months of life if consuming routine cow milk-based formula. 4
• Once the 28-ounce threshold is consistently met, supplementation can be discontinued as the formula provides adequate vitamin D. 2

Mixed-Fed Infants

• Continue 400 IU daily until the infant consistently consumes at least 28 ounces of formula daily. 2
• Do not assume partial formula feeding provides adequate vitamin D—supplementation is required until the 28-ounce threshold is reliably met. 1, 2

Special Populations Requiring Extended Supplementation

Preterm Infants

• Require 200-1,000 IU/day (or 80-400 IU/kg/day) along with multivitamin preparations. 5, 1
• Continue supplementation until consuming a completely mixed diet with normalized growth and hematologic status. 1
• This often extends well beyond the first year of life. 1

Infants on Long-Term Parenteral Nutrition

• Require periodic monitoring for vitamin D deficiency (target 25(OH)D >50 nmol/L or 20 ng/mL). 5, 1
• Additional supplementation needed if levels fall below target. 5, 1

Alternative Strategy: Maternal Supplementation

• Lactating mothers can take 6,400 IU daily instead of direct infant supplementation. 1, 2, 3
• This approach provides adequate vitamin D through breast milk and should continue throughout the breastfeeding period. 1, 6
• Consider this when direct infant compliance is challenging or exclusive breastfeeding is planned for ≥6 months. 1

Common Pitfalls to Avoid

• Do not discontinue supplementation at an arbitrary age (such as 6 months or 1 year)—base the decision on feeding method and volume. 1, 2
• Do not assume that introducing solid foods at 6 months eliminates the need for supplementation in breastfed infants. 1
• Do not delay initiation until the first outpatient visit—begin at hospital discharge. 2, 3
• Ensure adherence throughout the recommended period, as inconsistent supplementation is a common cause of treatment failure. 2, 7