A 6-month-old exclusively breastfed infant is being introduced to complementary foods but the mother is concerned about vitamin D. Current guidance commonly recommends a daily vitamin D supplement for many breastfed infants. Which evaluative statement is most appropriate for counseling the mother?

• A. Suggest delaying any introduction of complementary foods until the infant can safely take fortified sports drinks that contain vitamin D, since these are more convenient.
• B. Advise no supplementation because breast milk always contains sufficient vitamin D for infants regardless of maternal status or sunlight exposure.
• C. Recommend immediate high-dose adult vitamin D capsules (several times pediatric dose) given to the infant to rapidly build stores without clinician oversight, as more is always better for infants.
• D. Recommend a vitamin D supplement (e.g., 400 IU/day) for exclusively or partially breastfed infants, because breast milk alone may not provide sufficient vitamin D and infants are at risk of deficiency; discuss dosing with the pediatrician.

Answer: (D)