Additions to breast milk Full term baby
Vitamins. Breast milk contains all the nutrients necessary for growth. And while the baby is having breast milk only, and the mother has a well-balanced diet, no additions are necessary.
Vitamin A: Large quantities are available in a fat soluble base in breast milk. No supplement is needed as an overdose can be harmful.
Vitamin C is stored before birth and the full term baby should have sufficient to supply her needs in the first months. Breast milk contains four times as much vitamin C as cow’s milk and is not exposed to destruction by heat or light. So, although small, the amount of vitamin C in breast milk should be adequate for the baby’s needs provided the mother’s diet is not deficient.
If the mother does not eat food that contains vitamin C such as citrus fruits, guavas, potatoes, tomatoes and broccoli she should take vitamin C and calcium supplements (between 50 and 60 mg is required daily ” any excess is excreted harmlessly).
At around eight weeks additional vitamin C in the form of vitamin drops (or fruit juice) can be given to the infant, but are not absolutely necessary. Guava has the highest content (more than three times as much as orange juice), but apricot, youngberry and apple juice also contain vitamin C. These juices are well tolerated by infants and far less likely to cause rashes, wind, vomiting and colic than orange juice which should not be given to babies under six months. Diluted pure, unsweetened fruit juice (40 ml juice to 100 ml cooled boiled water) may be given to a baby between feeds from 6 months if she is awake, especially in hot weather. There is no need to wake her or insist if she does not like it.
Sweetened fruit juices or baby syrups rot the teeth rapidly (and may even have an effect even before the teeth appear) so should not be used. Fresh fruit juice which is sold in airtight packs that do not allow light to penetrate, maintain their vitamin C content. See-through plastic containers that allow light or air to penetrate are not as effective in protecting the vitamin C content which is reduced by heat, light and air. Once the teeth come through even unsweetened fruit juice can be harmful to the tooth enamel especially if sucked through a teat.
Vitamin D is needed for normal bone development and the prevention of rickets. Water-soluble vitamin D is available in breast milk and is also manufactured by the body in sunlight. Excessive vitamin D can be harmful and there is no need to give any if you are breast feeding, as long as the mother’s diet provides 200 IU daily, either from natural sources in the food she eats or’in the form of a vitamin supplement.
Vitamin E is needed to ensure that iron is absorbed efficiently and is available in far larger quantities in breast milk than in cow’s milk. There is no need to supplement. Strictly speaking, the baby who is completely breast fed is unlikely to need any extra vitamins if the mother eats a well-balanced diet.
Iron: Do not give supplementary iron to your healthy full term breast fed baby before six months as it reduces the antibacterial properties of breast milk. The small amount of iron present in breast milk is well absorbed, and should be sufficient for the first six months. By this time she should be starting solids and these should supply the extra iron needed (125 for iron-rich foods).
Fluoride: Fluoride should be given to your baby from birth – 0,25 mg daily -even if she is breast fed, since the concentration in breast milk is low even if you live in an area where the water has adequate fluoride. It is available in liquid form and you simply squirt the required dose under the baby’s tongue. Later on, when she is on solids, the tiny fluoride tablets can be crushed and mixed into her food. Too much fluoride can cause brown spots on the teeth so if you live in a high fluoride area you should not continue to supplement once your child is no longer breast fed.
Water. The breast fed baby does not need water in normal circumstances because the foremilk quenches the thirst. However, in hot weather she may need extra water and you can give her plain cooled boiled water. She will take it if she is thirsty – do not worry or add sugar if she does not want it.
Solids. The breast fed baby does not need to have solids for at least four to six months (119 for the introduction of solids).