I am sure as a parent you’ve all come across an article or two that addressed why vitamins supplements are not a must for kids or why you can probably skip it in your daily regimen. While many of these articles do share some valuable details, they’re some things that parents should keep in mind before tossing the supplements. To kick off our “Back to School Blog Series”, we wanted to share with you six essential nuggets that you should keep in mind the next time you come across an article that gives the side eye to giving your kids vitamin supplements.
Before we begin, let’s dive deeper into why some may suggest vitamin supplements aren’t essential.
According to the American Academy of Pediatrics, “healthy children receiving a normal, well-balanced diet do not need vitamin supplementation.” A child who eats a well-balanced diet including fish, milk, fruits, and vegetables is unlikely to need vitamin supplements. Most infant and toddler foods including milk and juices are fortified with vitamins and minerals. This is, however, easier said than done. Let’s take a look at the other side of the coin.
It is estimated that 10% of children eat a balanced diet consisting of 10 servings of fruits and vegetables every day, 2 to 4 cups of milk and two servings of fish a week.
Because humans cannot synthesize vitamins (except vitamin D), they need to be ingested in the diet to prevent disorders of metabolism. Besides, vitamins should be distinguished from minerals (such as calcium and iron), some of which are also essential micronutrients.
Gross vitamin deficiency with associated clinical diseases have become rare in Western societies, they occur mainly in special populations, including older adults; vegans; new immigrants; the very poor; patients with alcoholism, malabsorption, little sun exposure, history of gastric bypass surgery, extensive resection of the intestine, or inborn errors of metabolism; and those undergoing hemodialysis or receiving parenteral nutrition.
However, inadequate intake or low serum levels of some vitamins can be associated with biochemical abnormalities.
Now that we’ve briefly gone over the data on the value of vitamin supplements in a child’s daily regimen, let’s take a look at the six things parents should know about vitamin supplements and minerals.
1. BREASTFED INFANTS NEED VITAMINS OR SUPPLEMENTS BETWEEN FOUR AND SIX MONTHS
After six months of age, the volume of human milk ingested by exclusively breastfed infants generally becomes insufficient to meet the infant’s requirements for energy, protein, iron, zinc, and some fat-soluble vitamins. Complementary feeds should be introduced between the age of four and six months. In babies that remain exclusively breastfed, vitamin D and Iron supplementation are recommended. Your pediatrician should determine the dose.
2. WHAT KIND OF VITAMIN SHOULD I GIVE MY CHILD?
The type of vitamin will depend on whether the child has any underlying medical problem, special needs or if he or she is on medications. For example, a child who is a strict vegetarian will need a supplement that contains vitamins B12 and D, as well as riboflavin and calcium, which may be lacking in his diet.
Otherwise, healthy children will do well with a generic multivitamin (liquid or chewable), but parents should read the label carefully.
We recommend liquid vitamins for children younger than four years of age which will decrease the risk of choking on chewable multivitamins since many are unable to grind foods when they chew.
Many foods are fortified with vitamin D, such as milk, orange juice, and soy products, but unless they are ingested consistently, these foods aren’t enough on their own. Most children do not get enough Vitamin D.; As a result, the (American Association of Pediatrics) AAP recommends that children – from infancy to young adulthood – take a supplement with 400 IU of vitamin D.
3. SOME CONDITIONS MAY REQUIRE SPECIFIC VITAMIN SUPPLEMENTS
Children with measles, diarrhea, respiratory disease, or severe malnutrition – VITAMIN A
Institutionalized individuals either due to incarceration or special needs, patients being evaluated for or on medications that predispose to osteoporosis (e.g., some seizure medications) and patients with malabsorption (e.g., Crohn disease and celiac disease,) – VITAMIN D.
Children who don’t drink enough milk or eat other dairy products- VITAMIN D AND CALCIUM.
Children who drink too much milk and not enough of different foods – IRON
Vegan diet – may need VITAMINS B12 & D, RIBOFLAVIN, IRON, CALCIUM, AND ZINC.
Medical condition, such as short bowel syndrome, malabsorption, some liver diseases or cystic fibrosis that could lead to problems absorbing vitamins (especially fat-soluble vitamins) and minerals from the foods they eat – VITAMINS A, E. D & K and some minerals
4. ALL MULTIVITAMINS ARE NOT THE SAME IN QUALITY AND CONTENT
Production of multivitamins is not controlled as strictly as many other medications; therefore, the content, dosage, and intestinal absorption vary widely.
One national survey found that when young children who had diets low in certain nutrients were given vitamin supplements, some of the kids wound up getting more than the recommended upper limit of vitamin A, folic acid, and zinc.
Be aware of the fact that not all multivitamins contain the same number of vitamins and minerals. For example, Centrum Kids Chewable Multivitamin has 23 different vitamins and minerals; other multivitamins, especially gummy vitamins, only have nine.
5. VITAMIN ENHANCED DRINKS SHOULD NOT BE SUBSTITUTED FOR VITAMIN SUPPLEMENTS
Do not substitute a vitamin drink for a vitamin supplement. Often vitamin drinks (including sports or energy drinks) contain caffeine and added sugar.
6. TOO MANY VITAMINS CAN BE HARMFUL
Lastly, while we are advocating including vitamins in your kid’s daily regimen, too much of anything can be detrimental. Excessive vitamin intake or overdose can be harmful. Some vitamins can also interfere with the absorption of the effect of some prescribed medications.
- Bone loss (osteopenia) with an increased risk of fracture has been associated with excessive Vitamin A intake. Increased incidence of congenital disabilities and mothers who take preformed vitamin A in doses >10,000 international units in the first trimester of pregnancy.
- Vitamin E may impair the hematologic response to iron in children with iron-deficiency anemia. While not conclusive, scientific information suggests that high-dose vitamin E (≥400 units/day) might increase all-cause mortality and increase the risk of heart failure.
- Excessive ingestion of overdose and vitamins with minerals may result in significant damage due to adverse effects from iron.