The last time the AAP revised the guidelines on vitamin D drops and dropped the age at which drops should be introduced to right after birth, I combed the article to find any evidence to support that there was any difference in outcome between implementing that practice immediately or waiting until the baby is older -- say 2 weeks to a month of age.  There was virtually NO research on introduction of vitamin D drops so early.  So we really don't know if there is any additional benefit from shoving a dropper into the mouth of a 1, 2 or 3 day old infant that may warrant which might possibly contribute to oral aversions in some babies or cause some mothers to drop the vitamin D drops entirely because they don't like giving it to their babies.  I've seen enough moms to know that this is frequently the reason why they abandon using the vitamin D drops.

So it seems to me in the face of zero research to justify the earlier introduction of vitamin D drops, putting the drops on the mother's nipple in the early days when a baby is in the hospital until such time that using a dropper becomes less invasive once breastfeeding is firmly established is a very sensible idea.  

If you go to the AAP policy statements on vitamin D or iron supplementation -- you'll see that there is a neonatologist who questioned such early use of droppers -- but I'm not sure whether it was the iron or the D statement.

Best, Susan Burger

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