Are Vitamins and Supplements Safe for Kids

How much and which ones should they take?

A daily multivitamin is a healthy basic for adults and kids alike, right? Maybe not. Late last year, 
the Annals of Internal Medicine deemed multivitamin and mineral supplements massive money drains that don’t deliver promised health benefits.

Though the American supplement industry is robust — taking in nearly $27 billion annually — doctors and researchers aren’t sold on the value of vitamins. Per a 2009 University of California, Davis, study, most kids and teens who pop a daily pill probably don’t need one because they get adequate nutrition from their diet. The same study found that kids with nutritional deficiencies are the least likely to take a supplement.

This leaves confused parents holding the bag — or, in this case, the bottle of brightly colored chewables. Read on to discover if nutritional help makes sense for your child.

The diet defense

As it turns out, deciding whether kids need a daily pill isn’t simple. If your child eats a varied diet that includes a few servings of fruits, vegetables, dairy, meat and plenty of whole grains (see “A Well-Rounded Diet” chart below), a multivitamin probably isn’t necessary. “We encourage parents to help kids meet their nutritional requirements through food, because the nutrients in food are better absorbed than those in supplements,” says dietitian Kristi King, MPH, RD, LD.

A well-rounded diet: If your kiddo downs most of the following foods on most days, a multivitamin might not be necessary. Check with your pediatrician to be safe.

Ages 2-3 4-8 9-13 14-18
Whole grains* 3 oz. 4-5 oz. 5-6 oz. 6-7 oz.
Fruits 1 cup 1-1½ cups 1-1½ cups 1½-2 cups
Vegetables 1 cup 1½ cups 2-2½ cups 2½-3 cups
Dairy 2 cups 2 cups 3 cups 3 cups
Meat & beans 2 oz. 3-4 oz. 5 oz. 5-6 oz.

*At least half the grains children consume should be whole grains, such as oatmeal or whole wheat.
Source: US Department of Agriculture

In fact, for kids already downing vitamin-rich foods such as leafy greens, milk, meat and fish on a daily basis, a pill could be overkill, she notes. That’s because certain fat-soluble vitamins (A, D, E and K) are toxic in very high doses.

Then there’s the challenge of finding a kids’ vitamin that’s not full of unwanted additives or worse: A 2008 US Food and Drug Administration study reported that a significant number of popular children’s vitamins were contaminated with lead. Other questionable ingredients include added sugar and artificial dyes, linked to behavior problems in children since the 1970s. And kids’ supplements may not contain the vitamins or doses promised — ConsumerLab has found labeling errors in 40 percent of vitamins  analyzed in consumer testing. 

Next page: Is it safe to skip vitamins? Get supplement-savvy.

 

Is it safe to skip vitamins?

With all the questions surrounding supplements, some parents choose to bypass them altogether. But that may be a mistake, too. Picky eaters, exceptionally slow growers, chronically ill children or those who avoid certain food groups due to allergies or preferences may need added vitamins: “It can be very hard on a restrictive diet to get everything kids need for growth,” King says.

In these cases, King recommends a multivitamin and mineral supplement as opposed to single-vitamin supplementation (with the exception of vitamin D — see below), because vitamins and minerals must be balanced appropriately to be effective. Too much of a single nutrient can be problematic: An excess of iron may cause abdominal pain, while too much magnesium may lead to diarrhea.

For some kids, a multivitamin might not be enough. Multivitamin supplements are designed to complement a typical varied diet, so kids who avoid entire food groups — say, dairy or animal products — may need a multivitamin plus other supplementation.

For example, dairy avoiders may need additional calcium and vitamin D for healthy bones and teeth, while vegans can benefit from supplemental B-12, a vitamin found mainly in animal foods that’s important for nerve function. Those who avoid gluten might miss out on the magnesium or vitamin E found in whole grains.

Research shows that most Americans are deficient in vitamin D, so the American Academy of Pediatrics recommends 400 IU (international units) per day for babies and children via a nutritional supplement. Vitamin D isn’t readily available in food, so even an immaculate diet won’t provide enough, King says.

Get supplement-savvy

So what’s a parent to do about a child who won’t drink milk or gets stuck in an “I hate veggies!” phase? A few simple blood tests that check levels of iron and vitamins such as D and B12 can put you on a path of customizing a supplement regimen. 

But knowing which supplements you need is only half the battle; now you have to pick one. All vitamins aren’t created equal, and some manufacturers use cheaper ingredients that don’t absorb well, says nutritionist and mom Haylie Pomroy, author of The Fast Metabolism Diet. Go for one with folate (labeled as “5-methyltetrahydrofolate” or “L-methylfolate”) instead of synthetic folic acid (“methylcobalamin,” B12’s bioactive form) and “cholecalciferol” (vitamin D’s most active form). If a vitamin contains these superstars, Pomroy says, it’s likely high quality.

What about buzzy supplements such as probiotics and fish oil? While research is still emerging, says King, probiotics have been linked to reduced colic in breastfed babies, and fish oil may improve cognitive function. But because recommended dosages haven’t been established for children, be sure to check with your pediatrician before supplementing.

Malia Jacobson is a nationally published parenting journalist. Her most recent book is Sleep Tight, Every Night.