Vitamin D and Vitamin K for Newborns and Breastfed Babies: Official Advice and Safety
What the NHS, Health Canada and the Canadian Paediatric Society say about vitamin D drops and the newborn vitamin K injection, how overdoses happen, and who to call.
Content last updated . This page has not been medically reviewed.
If a baby may have had too much
If the baby has collapsed, had a seizure, has trouble breathing or cannot be woken, call 911 (US) now. [1] Otherwise call Poison Help at 1-800-222-1222 (US). [1] Have the bottle and its label ready. For other countries see Poison Help by country, and for general child-safety points see vitamin overdose in children.The short answer
Official bodies in the UK and Canada advise a daily vitamin D supplement from birth for breastfed babies, and say formula-fed babies usually do not need one because formula already contains vitamin D. [2][3] For vitamin K, the Canadian Paediatric Society and the College of Family Physicians of Canada recommend one injection for every newborn. [4] This page is information only. Your midwife, health visitor or pediatrician decides what is right for your baby.Vitamin D: what official bodies say
The table gives each body's published figure for a stated group. Evidence label: established nutritional role (vitamin D prevents rickets, which the NHS describes as a bone deformity). [5] One microgram (mcg) equals 40 IU, so 10 mcg is 400 IU. [5]| Body (country) | Group | Published advice | Source, year |
|---|---|---|---|
| NHS (UK) | Breastfed babies, birth to 1 year | Daily supplement containing 8.5 to 10 mcg of vitamin D, whether the baby is partly or fully breastfed and whether or not the mother takes a supplement [2] | NHS Best Start in Life, as read 2026 |
| NHS (UK) | Formula-fed babies | No supplement needed if the baby has about 500 ml (a pint) of formula a day, because formula is fortified [2] | NHS Best Start in Life, as read 2026 |
| Health Canada | Exclusively and partly breastfed infants | 10 mcg (400 IU) daily from birth; partly breastfed infants get this whatever their formula intake [3] | Health Canada, infant nutrition, as read 2026 |
| Health Canada | Infants not breastfed | No vitamin D supplement needed because infant formula contains vitamin D [3] | Health Canada, as read 2026 |
| US (MedlinePlus, citing US National Academies) | Infants 0 to 12 months | Adequate Intake 400 IU (10 mcg) per day [6] | MedlinePlus, as read 2026 |
An Adequate Intake is a planning level for groups of healthy people, not a prescription for one baby. See RDA, AI, DV and UL explained. The American Academy of Pediatrics page could not be read for this guide, so the US row is the national reference intake rather than pediatric advice.
Upper limits for babies differ by body
An upper limit is the most a body considers unlikely to cause harm from all sources combined, including formula. [7][3]| Body (country) | Age | Upper limit for vitamin D | Source, year |
|---|---|---|---|
| NHS (UK) | Under 12 months | 25 mcg (1,000 IU) a day [5] | NHS, page last reviewed 2020 |
| Health Canada | Under 6 months | 25 mcg (1,000 IU) a day [3] | Health Canada, as read 2026 |
| MedlinePlus (US) | 0 to 6 months; 7 to 12 months | 1,000 IU (25 mcg); 1,500 IU (38 mcg) a day [6] | MedlinePlus, as read 2026 |
| EFSA (EU) | 4 to 6 months; 7 to 11 months | 25 mcg; 35 mcg a day [7] | EFSA, 2024 summary report |
Do not mix these figures: each applies in its own country or region. For the adult and child picture see vitamin D toxicity and upper limits.
Drops and how overdoses happen
- The NHS says not to give two supplements at once. It gives cod liver oil plus vitamin drops as an example, because cod liver oil also contains vitamins A and D. [8]
- The NHS says having too much of some vitamins can be harmful, and to keep to the dose on the label. [8]
- Health Canada recommends a single vitamin D3 liquid (drops) without other vitamins for infants, and does not suggest vitamin D2 or multivitamins for this purpose. [3]
- A case report describes a 4-month-old, exclusively breastfed baby given a liquid D3 product that held three times the vitamin D printed on its label. The baby received about 50,000 IU a day for two months and developed severe hypercalcemia (too much calcium in the blood), hypercalciuria and nephrocalcinosis (calcium deposits in the kidneys). [9] This is one case, so it shows what can go wrong, not how often.
- MedlinePlus lists overdose symptoms such as loss of appetite, nausea, vomiting, constipation and weakness, and says many containers are not child-resistant. [1]
Strengths and dropper sizes differ between products, so ask a pharmacist or health visitor to show you how a particular label's measure works. [8] See liquid vitamins and drops and quality testing and certifications.
Can a breastfeeding parent take the vitamin D instead?
The NHS says a breastfed baby should have the supplement whether or not the mother takes one herself. [2] Health Canada says the vitamin D in a usual multivitamin (about 5 to 20 mcg, or 200 to 800 IU) is considered unlikely to raise breast milk vitamin D enough for an infant, and that studies of high maternal amounts need more research before practice changes. [3]One US randomized trial (evidence label: promising but limited) tested larger maternal amounts. Exclusively breastfeeding women received 400, 2,400 or 6,400 IU of D3 a day for six months, and babies in the two higher groups received no drops. The 2,400 IU group was stopped in 2009 because more of the infants were deficient. The authors concluded that 6,400 IU a day in mothers safely gave milk enough vitamin D for the baby. [10] These are study amounts under monitoring, not advice. They do not change the NHS and Health Canada recommendations above. See also vitamins while breastfeeding.
Vitamin K at birth
Newborns can bleed because they start life with low vitamin K stores and breast milk is low in it. Vitamin K deficiency bleeding (VKDB) has three timings: early (first 24 hours), classic (days 2 to 7) and late (2 to 12 weeks, up to 6 months). [4] Early bleeding is often linked to the mother's medicines that block vitamin K, such as antiepileptics, so tell your care team about all medicines. [4] Any unexplained bleeding in a baby needs urgent medical care.| Question | What the 2018 Canadian joint statement found | Strength |
|---|---|---|
| Does one injection prevent VKDB? | A systematic review suggests a single intramuscular dose at birth effectively prevents it; the societies recommend 0.5 to 1.0 mg for all newborns [4] | Established; recommendation by two Canadian professional bodies |
| Is oral vitamin K as good? | Oral doses, single or repeated, are less effective; a 2.0 mg oral course at birth, 2 to 4 weeks and 6 to 8 weeks is for babies whose parents decline the injection, who then have higher VKDB risk [4] | Evidence of less effect |
| Does the injection cause childhood cancer? | The statement says a 1993 American Academy of Pediatrics review dispelled leukemia concerns [4] | Reported by the statement |
| Any harm from injections? | No significant complications were reported after 420,000 newborn injections in one cited report; the effects of the pain on infants are unknown [4] | Limited |
| Premature babies in intensive care | Evidence is insufficient to recommend routine intravenous vitamin K [4] | Insufficient evidence |
Read more on vitamin K deficiency bleeding and vitamin K. Whether and how to give vitamin K to your baby is a decision with your midwife or pediatrician. Never stop or change a mother's prescribed medicine on your own.
What this page cannot tell you
- The NHS page on newborn vitamin K and the American Academy of Pediatrics pages could not be read, so this page cites the Canadian statement, not UK or US pediatric statements.
- Proper evidence not found here for how many drops of a given product equal a given amount. Sources searched were the NHS, Health Canada, MedlinePlus and PubMed. Product labels vary.
- Health Canada pages were read through a web-fetch summary tool, so wording is as that tool returned it.
Frequently asked questions
Do formula-fed babies need vitamin D drops?
The NHS says no if the baby has about 500 ml (a pint) of formula a day. [2] Health Canada says non-breastfed infants do not need a supplement because formula contains vitamin D. [3] The NHS vitamin D page says babies having less than 500 ml of formula should take a supplement. [5]
Can I give my baby a multivitamin instead of vitamin D drops?
Health Canada does not suggest multivitamins for this, and prefers a single vitamin D3 liquid. [3] The UK government recommends vitamin drops with A, C and D for children aged 6 months to 5 years, but not for babies having more than 500 ml of formula a day. [8] Ask a pharmacist which product fits your baby and country.
Does the vitamin K injection cause leukemia?
The Canadian statement says a 1993 American Academy of Pediatrics review dispelled concerns that the injection is linked to childhood cancers such as leukemia. [4] Ask your care team if you want to see the evidence.
What if I decline the vitamin K injection?
The Canadian statement gives an oral course (2.0 mg at birth, then at 2 to 4 and 6 to 8 weeks) for babies whose parents decline, and says those babies are at increased risk of VKDB. [4]
What if my baby had too much vitamin D?
Call Poison Help at 1-800-222-1222 (US), or 911 if the baby has collapsed, had a seizure, has trouble breathing or cannot be woken. [1] Other countries: see Poison Help by country.
References
- MedlinePlus, Cholecalciferol (Vitamin D3) drug information. Read 2026-10-23.
- NHS Best Start in Life (UK), Vitamins for babies (page undated as read). Read 2026-10-23.
- Health Canada, Nutrition for Healthy Term Infants: Recommendations from Birth to Six Months. Read 2026-10-23 (through the web-fetch summary tool; wording as that tool returned it).
- Ng E, Loewy AD. Guidelines for vitamin K prophylaxis in newborns: joint statement of the Canadian Paediatric Society and the College of Family Physicians of Canada. Can Fam Physician 2018;64:736-739. Read 2026-10-23.
- NHS (UK), Vitamin D, page last reviewed 3 August 2020 (as read). Read 2026-10-23.
- MedlinePlus, Vitamin D (encyclopedia). Read 2026-10-23.
- EFSA, Overview on Tolerable Upper Intake Levels as derived by the Scientific Committee on Food and the EFSA NDA Panel (summary report, May 2024). Read 2026-10-23; table cell order as extracted from the PDF.
- NHS (UK), Vitamins for children, page last reviewed 30 May 2024. Read 2026-10-23.
- Ketha H et al. Iatrogenic vitamin D toxicity in an infant: a case report and review of literature. J Steroid Biochem Mol Biol 2015 (PMID 25636720). Read 2026-10-23.
- Wagner CL et al. Maternal versus infant vitamin D supplementation during lactation: a randomized controlled trial. Pediatrics 2015 (PMID 26416936). Read 2026-10-23.