When are supplements appropriate in babies and children?

By Christina Hills, HCPC-Registered Paediatric Dietitian + Baby Nutritionist

Should I give my baby or child a nutritional supplement?

It’s a question I hear ALOT- and understandably so. I’m a big advocate for nourishing through food where we can. But there are common situations where relying on diet alone isn’t enough. And through my 10+ years experience working in the NHS and private practice I have seen many nutritional deficiencies in my time to know this is the case

So what is currently recommended in the UK around supplements in babies and children, and what do I recommend.

Vitamin D: For Pretty Much Everyone

Vitamin D is important for our bone health as it helps the body to absorb calcium. Our bodies were designed to naturally produce vitamin D when our skin is exposed to sunshine- but as expected that source of vitamin D production just isn’t reliable in the UK- we get limited sun, we spend more time indoors and often cover up outside for good reason. As a result, vitamin D deficiency is common, especially in children and teens in the UK.

UK Recommendations:

In the UK the following is currently recommended:

• Birth to 1 year (breastfed or formula under 500 ml/day): 8.5–10 µg/day of vitamin D is recommended year-round (NHS / DOH advice)

• 1 to 4 years: 10 µg/day throughout the year

• Formula-fed infants (>500 ml/day): Don’t need vitamin D supplementation because formula is fortified

• From 5 years onward and adults: At least 10 µg/day in autumn and winter, and year-round for those at higher risk (e.g. limited sun exposure/more time spent inside, darker skin)

Vitamins A, C, and D for Young Children (6 months–5 years)

The UK government also recommends daily supplements containing Vitamins A, C, and D for children aged 6 months to 5 years, especially in babies and young children with restricted diets

These nutrients cover key roles in the body:

• Vitamin A: super important for the eyes and vision development, immune function and skin health

• Vitamin C: plays a huge role in the immune support, it also helps the body absorb plant-based iron and helps with skin and wound healing

• Vitamin D: requirements as per the above

Now of course many babies and children will get vitamin A and C adequately from food, and if you are confident that your baby or child is eating a variety of foods from each of the different food groups then you may not require the additional vitamins A + C. If you are unsure, seek 1:1 advice.

When Restricted Diets or Clinical Conditions Call for Extras

Babies and children on restricted diets- may need more specific supplements- like for example children on plant-based diets may need B12, iodine and omega-3 - as well as vitamin D (with additional iron if required). Or if whole food groups are missing- like no fruit + veg, or no meat or fish then I might recommend an additional supplement in certain situations. Or perhaps if a child has a food allergy - such as a milk allergy - and isn’t consuming any form of milk over the age of 1 - then nutrients like calcium and iodine may need to be considered.

There are also specific conditions where single nutrients may provide some benefit such as targeted omega-3 supplements for regulating mood and symptoms of ADHD in some children.

However, I would always suggest getting 1:1 advice if giving anything outside of the standard public health recommendations listed above.

Why More Isn’t Always Better

Supplements can certainly be beneficial in some cases, but it’s not a free-for-all- and more isn’t always better, and some vitamins can be toxic in excess, especially fat-soluble vitamins and certain minerals like iron.

My Top Tips for Supplements for Parents

• Start with Food First: Prioritise a varied diet rich in a range of whole foods from all the different groups

• Follow Official Guidelines: Vitamin D as above, and A, C, D for children 6 months–5  years unless diet is sufficient

• Assess Diet Restrictions: Plant-based or following a limited diet? Consider additional more targeted supplements

• Avoid Megadoses: Stick to recommended doses. Don’t combine overlapping supplements (e.g. cod liver oil + vitamin drops may both contain high levels of vitamin A)

• Check Age-Appropriate Formats: Choose formulations made for the child’s age group

• Consult a Nutrition Professional: Especially in cases of medical conditions or highly restrictive diets like ARFID or plant-based diets.

I offer 1:1 consultations in my online clinic. You will get a 45 minute session, with full dietary assessment of your baby or child’s diet, followed by a written plan with practical advice and recommendations for any further tests e.g. blood tests or skin prick tests, followed by a supplement plan tailored to your individual situation. Check out the clinic here, or get in touch now if you have any questions, or if you are ready to go- book now!

References + Further Reading

NHS Weaning & Feeding – Vitamins for children (A, C & D): https://www.nhs.uk/baby/weaning-and-feeding/vitamins-for-children/

NHS Vitamin D guidance (birth to older ages, upper limits): https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/

SACN guidance on vitamin D: https://assets.publishing.service.gov.uk/media/5a804e36ed915d74e622dafa/SACN_Vitamin_D_and_Health_report.pdf