A 1-month-old, full-term African-American boy is brought to the office for a routine check-up. He is exclusively breastfed. The boy does not have any medical problems, and his hospital stay after birth was unremarkable. His mother consumes a well-balanced diet, takes no medications, and does not drink alcohol. The boy is at the 50th percentile for weight and the 60th percentile for height. His physical examination is normal.

At this time, supplementation with which of the following should be recommended for this infant?

A. Folic acid
B. Iron
C. Riboflavin
D. Thiamine
E. Vitamin A
F. Vitamin D

For a healthy, exclusively breastfed 1-month-old infant, supplementation with vitamin D is recommended due to breast milk's insufficiency in providing the recommended daily dose for infants.

Explanation:

The question pertains to the recommended supplementation for a 1-month-old, full-term exclusively breastfed infant, who is healthy with normal growth parameters. While breast milk provides numerous nutritional benefits, it lacks sufficient amounts of certain nutrients, most notably vitamin D. Vitamin D is essential for calcium absorption and bone growth, and breast milk provides less than 20% of the recommended dose for infants. Given that deficiency of vitamin D can lead to rickets and other bone problems, and that sunlight exposure which helps in vitamin D synthesis, might be limited in certain geographical areas, many pediatricians recommend vitamin D supplementation for breastfed infants.