My Baby Refuses Vitamin D Drops
The short answer
The AAP recommends 400 IU of vitamin D daily for all breastfed and partially breastfed babies starting from the first few days of life. If your baby refuses the drops, try putting them on your nipple before nursing, mixing into a small amount of expressed milk, or trying a different brand as flavors vary. Most formulas contain vitamin D, so formula-fed babies may not need additional supplementation.
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By Age
What to expect by age
Start vitamin D drops within the first few days of life for breastfed babies. Place the drop on your nipple or on a pacifier. A single drop is very small and most babies tolerate it well. If baby fusses, try giving it at the start of a feeding when they are calm and hungry.
Continue daily vitamin D drops. If baby has been refusing, try a different brand as taste varies. Some brands have a neutral oil taste while others have added flavors. You can place the drop on a finger and let baby suck it off.
Once baby starts solids, you can mix the vitamin D drop into a small spoonful of food. Make sure baby eats the entire spoonful. Do not mix into a full bottle as baby may not finish it.
Continue vitamin D supplementation unless baby is drinking at least 32 ounces of formula per day. Mixing drops into a small amount of food remains an effective strategy.
The recommended vitamin D intake increases to 600 IU daily at 12 months. Vitamin D-fortified milk provides 100 IU per 8 ounces. If your toddler drinks 16-20 ounces of milk and eats some vitamin D-containing foods, they may still need supplementation. Discuss with your pediatrician.
What Should You Do?
When to take action
- Baby makes a face at the drops but still swallows them
- Baby accepts the drops when given on a nipple or in a small amount of food
- Baby prefers one brand of drops over another
- Baby consistently refuses all vitamin D drops and you cannot find a way to give them
- You are unsure if your baby needs vitamin D supplementation based on their formula intake
- Baby has risk factors for vitamin D deficiency such as darker skin or limited sun exposure
- Baby shows signs of vitamin D deficiency such as soft skull bones, bowed legs, or poor growth
- Baby has had a seizure which can very rarely be related to severe vitamin D deficiency
Sources
Related Resources
Trust your instincts. If something feels wrong, reach out to your pediatrician.
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Related Feeding Concerns
Does My Baby Need a Multivitamin?
Most babies who are breastfed need vitamin D supplementation, and those who are formula-fed typically get adequate vitamins through fortified formula. A full multivitamin is generally not necessary for babies eating a varied diet. Your pediatrician can help determine if your specific baby needs any supplements based on their diet, health, and risk factors.
My Baby Refuses Iron Supplements
Iron supplements can have a strong metallic taste that many babies dislike. Mixing the supplement with a small amount of vitamin C-rich juice or fruit puree can improve the taste and enhance iron absorption. Using a syringe to place drops at the back of the cheek can help bypass the taste buds. Iron supplements may stain teeth, so brush or wipe gums after giving them.
How Can My Baby Get Enough Calcium Without Dairy?
If your baby cannot have dairy due to allergy or intolerance, there are many other calcium sources. These include calcium-fortified foods, broccoli, kale, tofu made with calcium sulfate, beans, calcium-fortified plant milks (after 12 months), and sardines. Breast milk and formula provide adequate calcium before 12 months. If dairy-free after 12 months, planning is important.
When to Introduce Allergens to Baby
Current guidelines recommend introducing common allergens (peanut, egg, cow's milk products, tree nuts, wheat, soy, fish, shellfish, sesame) starting around 4-6 months when your baby is developmentally ready for solids. The landmark LEAP study showed that early introduction of peanuts (by 4-6 months) reduced peanut allergy risk by 80% in high-risk infants. Do not delay allergens - the old advice to wait until 1-3 years has been reversed because early exposure actually prevents allergies.
I'm Worried My Baby Is Aspirating During Feeds
Aspiration means liquid or food enters the airway instead of the stomach. Occasional coughing during feeds is common and does not usually indicate aspiration. True aspiration is less common and may present as recurrent respiratory infections, a wet or gurgly voice after feeds, or chronic cough. If you are concerned, a swallow study can provide a definitive answer.
Could My Baby Be Aspirating During Feeding?
Aspiration occurs when food or liquid enters the airway instead of the esophagus. Signs include coughing or choking during every feed, a wet or gurgly voice after eating, recurrent chest infections, and breathing changes during meals. Silent aspiration can occur without obvious coughing. If you suspect aspiration, contact your pediatrician as a swallowing study can diagnose it.