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Does My
Child Need a Multivitamin?
Multivitamins for
children have graduated from the unappealing, cod-liver oil days
to taking up entire store shelves in a tantalizing array of
shapes, sizes, and colors. A pediatrician defines the difference
between multivitamins for children and dietary supplements, and
looks at the merits and risks of each.
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For some, the first thing
that comes to mind when thinking about supplements is more along the
lines of gingko biloba or ephedra than Flintstones vitamins. While
it is true that certain blockbuster dietary supplements for adults
have found their way into the public spotlight in recent years, the
majority of them–with the exception of multivitamins–are not
recommended for children.
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Supplements Defined
Before taking a look at the most common
form of dietary supplements given to children and discussing their
merits and/or risks, it’s worth taking a step back and first
defining what actually constitutes a supplement. In 1994, Congress
defined “dietary supplement” as a product taken by mouth that
contains an ingredient (such as vitamins, minerals, and herbs, to
name a few) intended to supplement the diet. Offered in a variety of
forms ranging from capsules, tablets, and pills to liquids, powders
and bars, all dietary supplements must not only be clearly labeled
as such, but must identify each of the product’s dietary ingredients
and refrain from making claims of treating or curing disease on the
label.
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Supplements for Children
It’s important to start out any discussion
of supplements for children by saying that most experts agree that
dietary supplements–with the exception of multivitamins–are not
really necessary for most children (at least under the age of
twelve). In fact, many question their effectiveness and voice
concerns over their use. While everything from herbal remedies to
sports bars tend to be included in the broader definition of
supplements, when it comes to children the discussion tends to be
focused on the more traditional definition of dietary supplements:
multivitamins.
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Multi-Faceted Multivitamins
Multivitamins for children have become big
business–taking up entire shelves at the stores. In contrast to the
unappealing cod-liver oil days of generations past, you’ve probably
noticed that twenty-first century multivitamin manufacturers have
not only increased in number, but they’ve gotten creative. When it
comes to good old-fashioned vitamins and minerals conveniently
packaged as multivitamins, children are now offered an array of
tantalizing shapes, sizes, and colors. Gummy bears and gumballs are
some of the latest innovations to hit the scene and seemingly gain
instant popularity. It’s no wonder that parents nowadays actually
find themselves faced not only with the decision of which vitamins
to buy (if any), but with children who all but beg for their daily
“allowance” of dietary supplements. A few general points to consider
include:
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 | Teach your children right from the start that vitamins are
medicine, not candy.
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| Just because the government doesn’t oversee the sale of
supplements in the same way they regulate medicines doesn’t mean
that you shouldn’t treat them both with equal caution. Always
store your vitamins alongside your medicines–safely out of reach
and in childproof containers.
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| Stick to recommended dosing. Vitamin dosing is generally very
straightforward, easily found on the package label, and based on
clearly defined recommended daily allowances (RDA) of each of
their supplemental ingredients.
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| When comparing different children’s multivitamins–such as
gummy bears to generic chewables–simply look at the labels,
determine which contain the vitamins and minerals your child
needs, and how much of each.
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| After you’ve found a supplemental multivitamin that suits your
child’s needs, consider cost, taste, and appeal (since the label
won’t mean anything if you can’t get your child to take them!).
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| Be aware that it is possible to get too much of a good thing.
Even seemingly harmless vitamins can cause serious problems: Too
much vitamin C is known to cause diarrhea, while too much vitamin
A can cause problems in organs such as the liver and brain, and an
iron overdose can even be fatal. |
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Are Multivitamins
Necessary?
You’re likely to find varying opinions
in books and from health professionals about whether or not
children need to take a daily multivitamin. The reason is that
while the body is unable to make its own vitamins and minerals,
most kids who eat a variety of foods get all the nutrients they
need (and more) from their diet.
Now I’m willing to bet that many of you would argue that your
kids are picky eaters. Believe me when I say that I agree, and
that as a parent, I too have experienced the “I want pizza every
day of the week and I don’t like anything that comes in any
shade of green” phenomenon. I’m sure I’m not alone in seeking
peace of mind by giving each of my children a multivitamin at
the end of the day as a convenient way to fill in any dietary
voids my picky eaters may have created.
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That said, there are
certainly many instances in which vitamins offer more than just
a back-up for picky-eaters. In some instances–such as with
cystic fibrosis or children who eat true vegetarian
diets–potentially serious vitamin deficiencies are both
predictable and preventable with supplementation. Some
deficiencies are isolated to single, common vitamins and
minerals. They include:
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Vitamin D: Vitamin D helps make strong bones and
teeth. Production of vitamin D in the body is not only
dependent on dietary intake, but sunlight as well. Recent
studies suggest that children may not be getting enough
vitamin D, and in April 2003, the American Academy of
Pediatrics came out with a statement that all children–from
infancy up through adolescence–need to get at least 200 IU of
this rickets-preventing vitamin. While formula-fed babies who
drink at least 17 ounces a day generally meet this requirement
without any additional supplementation, breastfed babies
generally need to be given vitamin drops containing vitamin D,
and older children may require over-the-counter tablets.
Iron: Iron is a key component in red blood cells.
For a variety of reasons, iron levels can become low in
infants and children, requiring supplementation.
Calcium: This is another important nutrient
necessary for healthy bones. While milk is often the major
source of calcium for many children, some don’t like it or
can’t have it and therefore require some form of
supplementation. Quite often, it’s possible to get the daily
recommended amount from calcium-rich foods such as yogurt,
cheese, tofu, sardines, broccoli and spinach, or
calcium-fortified juices or waffles. TUMS and other
supplemental forms of calcium are always an option but as with
other dietary supplements, you’ll first want to discuss this
option with your health care provider or a nutrition expert.
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