Which supplements are best for kids?

Andrea posted: “I have two children, ages 4 yrs. and 15 months. Both are very picky eaters. The youngest is quite difficult – he spits out all meats and most fruits/vegetables. I know that a balanced diet is the best answer and that is my goal, but for now I am very interested in supplements. What do you recommend for toddlers? One year olds? And how do you determine the appropriate dosage for each child? I recently read about the benefits of fish oils – do you recommend this supplement? Are there any resources that you recommend where I can learn more about dietary supplements?”

Fortunately, most of the food in the developed world is fortified with multiple vitamins and minerals. With very few exceptions (we’ll talk about those later), vitamin deficiencies are just about unheard of in the United States, at least among children who have ready access to food. On the other hand, an ordinary multivitamin with safe doses of vitamins is going to be harmless, and may put your mind at ease.

If you’d like to start your children on a multivitamin, I suggest an inexpensive one that tastes good. Any store-brand generic chewable multivitamin for children is absolutely fine and will cover what you need. There are also “Gummi” forms that some kids like*. Note that these are usually packaged for dosing in children age 4 years and up. For your 15 month old, ½ of the 4 year dose is probably fine, but check with your own doctor. At 15 months, you should “pre-crush” a ½ chewable tablet and give it mixed into some food. The multivitamins packaged for 15 month olds are liquids that taste terrible. I don’t know if giving the liquid is worth the fight, but you can try!

Remember that vitamins are medicines, and need to be kept out of reach of children. They’re in cute shapes that kids find attractive. An overdose of a vitamin should be immediately reported to a poison center (in the United States, call 800-222-1222.)

I do not recommend that any parent buy expensive, name-brand, or specialty-packaged vitamins. They are just not necessary. A chemical is a chemical, and a vitamin is a vitamin. Some are sold aggressively through shady multilevel marketing schemes—steer well away from those. You’ve got far more important things to spend your money on!

What are the vitamin deficiencies that do still occur in the United States?

Iron deficiency—this is especially common among children in lower socioeconomic groups, but can affect anyone. Good iron sources are fortified breakfast cereal, red meat, beans, peanut butter, and eggs. If your child doesn’t regularly consume these, either ask your pediatrician to screen him for iron deficiency or get him on a multivitamin with iron.

Calcium deficiency—calcium is best obtained from dairy sources. If your child isn’t big on milk, cheese, or yogurt, you’re going to have a tough time getting enough calcium in. Consider calcium-fortified juice, or a chocolate-like tasty calcium supplement.

Vitamin D—if your child doesn’t spend much time in the sunshine, or has dark skin, she’s at risk for vitamin D deficiency. All dairy is vitamin-D fortified, which helps; but you may wish to discuss your exact situation with your physician. Vitamin D deficiency is more common than many people realize.

Fish oil is a rich source of omega-3 fatty acids, which are essential to brain and eye health. In adults, omega-3 supplements may prevent heart attacks and stroke, and may slow down the cognitive decline that often occurs as people age. Fish oil supplements are safe in children, as long as they aren’t taking blood-thinning medications or have other bleeding problems. We don’t really know exactly how much a child needs. For adults, a usual dose is one 1000 mg fish oil capsule three times a day. Though children may balk at swallowing a huge fish oil capsule (which really isn’t very pleasant when chewed!), you can buy “Gummi” type chewables that are a good source of omega-3s from non-fish sources. Flaxseed oil is also a good source of omega-3s.

Though vitamin deficiencies are rare, a few individual kinds of vitamins and minerals are sometimes easy to miss for certain kids. You do not have to pay a lot to get a good vitamin supplement. Since there is little risk and little expense of giving a supplement to your children, it’s a good idea.

Additional resources:

FDA info on supplements: http://www.cfsan.fda.gov/~dms/supplmnt.html

US Dept Agriculture food and dietary info: http://fnic.nal.usda.gov/nal_display/index.php?info_center=4&tax_level=1

Info on individual vitamins and what they’re for: http://www.kidshealth.org/kid/stay_healthy/food/vitamin.html

Poisonings: http://www.poison.org/

* I don’t have any financial relationships with the makers of Gummis or any other over-the-counter or prescription supplement, medicine, or medical device.

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Tags: calcium, iron, minerals, multivitamin, supplement, vitamin, vitamin D

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