Who needs vitamins?

The Pediatric Insider

© 2011 Roy Benaroch, MD

For November, I’m concentrating my writing chops on National Novel Writing Month. Fun! So I’m re-running revised versions of some classic posts. And by classic, I mean “old.” This one was originally from June, 2008. Enjoy!

“Should I give my kids multivitamins?”

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 decent food. On the other hand, an ordinary multivitamin with safe doses of vitamins is probably 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. 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—stay 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 may have a tough time finding calcium sources. 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. Milk 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.

So: 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/

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5 Comments on “Who needs vitamins?”

  1. las artes Says:

    Experts disagree on whether multivitamins are necessary for children. Many young children are picky eaters, but that doesn’t necessarily mean that they have nutritional deficiencies. Many common foods — including breakfast cereal, milk and orange juice — are fortified with important nutrients, such as vitamin D and calcium. And children don’t need large amounts of vitamins and minerals. So your child may be getting more vitamins and minerals than you think.

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  2. mercadee Says:

    When they need a vitamin, most kids can take a daily children’s multivitamin, which should have the recommended daily allowance of all of the vitamins and minerals they might need, including vitamins A, C, D, and K, the B vitamins, iron, and calcium.

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  3. Alison Says:

    As a doctor who routinely tests for kids nutrient deficiencies they are common. Foods are not as nutritious as they use to be because our soil isn’t as good. That’s why Organic foods will generally taste better – the soil is healthier. Foods are fortified because in the manufacturing they strip the nutrients from it then add it back in. That’s why processed isn’t as healthy as whole foods even if kind of the same thing.

    Kids are routinely iron deficient, iodine deficient and vitamin D deficient. You can get more from the diet – start eating organ meats and lots of fish! Yeah, that’s what I thought. Give the kid a multi with extra vitamin D. Sorry to disagree doc, but in reading your blog, I don’t think nutrition is your thing.

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  4. Dr. Roy Says:

    Organic foods are not more nutritious than conventional foods, that’s a myth. In fact some nutrients may be a little bit better in conventional foods (though others are a little better in organic foods– it’s pretty much even, and the the differences aren’t significant.) True potential advantages of organic food is less exposure to insecticides, and less impact on the environment.

    Iodine deficiency is almost non-existent in the US, because almost all salt is fortified with iodine. Vitamin D and iron deficiency are both common, as I’ve discussed elsewhere.

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  5. Lester Janey Says:

    The best thing is of course to know which vitamins you are difficient from and supplement those but people would usually take multivitamins because it is easier..

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    http://www.melatoninfaq.com/

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