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Does Your Child Need Vitamins?

Most parents want to do what’s best for their children. In many cases, that includes giving them a vitamin and mineral combination to ensure good nutrition. Nearly half of American three-year-olds take multivitamins.

Do children even need multivitamin and mineral (MVM) supplements? Are MVMs helpful? Useless? Possibly harmful? With so many children taking MVMs, it’s surprising that very little solid clinical research exists to weigh the benefits and possible side effects of MVM use among children.

Start with good food
“Food is always the best way for people to get all the vitamins and minerals they need,” says Dale Ames Kline, Registered Dietician. “The less processed the food, the more nutritious it is. Whole foods also contain other substances that keep us healthy.” Foods are the best source of nutrients. Regular meals and snacks can provide all the nutrients most young children need.

The American Academy of Pediatrics does not recommend MVMs for healthy children over one year old and adolescents who eat a healthy and varied diet. Many children are picky eaters, but that doesn’t necessarily mean they have nutritional deficiencies.

Many common foods, such as cereals, milk, and orange juice, are fortified with nutrients including B vitamins, vitamin D, calcium, and iron. Fortifying foods means adding vitamins and minerals which were not originally in the product. Breads are commonly enriched, which is the process of returning vitamins lost in refining flour to the final product. Your children may be getting more vitamins and minerals than you realize.

A study by UC Davis Children’s Hospital analyzed data from 11,000 children between two and seventeen years old. The data showed that most healthy children who take daily MVMs probably don’t need them because they get adequate nutrition from their food. On the other hand, the study also found that children (uninsured, low socioeconomic group, and those in poor health) who could benefit most from MVM use were less likely to be taking them.

A group of doctors writing in 2013 for the Annuals of Internal Medicine titled their editorial, “Enough is enough. Stop wasting money on vitamin and mineral supplements.” The researchers concluded there is now enough evidence to advise against routinely giving MVMs, their use is not justified, and they should be avoided.

Not without risk
A study published in the Journal of Pediatrics found that children who take MVMs are at greater risk than nonusers of getting too much iron, zinc, copper, selenium, folic acid, and vitamins A and C. Large doses of certain vitamins and minerals can be toxic to children. B vitamins and vitamin C are water soluble so that excessive amounts readily leave the body in urine.

However, vitamins A, D, E and K, are fat soluble, meaning that excess amounts over what the body needs concentrate in the body’s fat. Vitamins stored in fat stay in the body for a long time. Each additional dose of that fat-soluble vitamin increases the risk of complications such as dizziness, vision and blood clotting problems. Eating a normal balanced diet is unlikely to cause toxic levels of fat-soluble vitamins.

Know that certain MVMs may interact with prescription medications your child takes. If you do give your children MVMs, remember to treat them like prescription medications. Keep them out of reach, and be sure your child realizes that vitamins, even yummy gummy bears, are not candy. A young child who takes a large number of MVMs may experience anything from nausea and vomiting to kidney damage.

Who can benefit?
Certain children need MVMs because their nutritional needs cannot be met by food alone. According to Dr. Jay Hoecker of the Mayo Clinic, MVMs may be indicated for children with: failure to thrive; food allergies; certain chronic diseases; and restrictive diets (such as a vegan diet). A child with milk allergies may need calcium tablets. A child on a vegan diet is likely to need a vitamin B-12 supplement because B-12 is found exclusively in animal products.

MVMs may be indicated for children who refuse to eat a varied diet. Some children have low levels of vitamins D and E, and calcium, according to the American Academy of Pediatrics. Kline says, “There are times when extra vitamins and minerals are used to treat specific health conditions. The use of these supplemental nutrients should be based on medical need.” So think about checking with your pediatrician before giving daily MVMs to your child. They could help. They could be useless. And they could even be potentially harmful.


Resources: American Academy of Pediatrics site for parents at www.healthychildren.org, Mayo Clinic, “Should I give multivitamins to my preschooler?” at: http://www.mayoclinic.org/healthy-living/nutrition-and-healthy-eating/expert-answers/multivitamins/faq-20058310.



Connie Goldsmith RN, BSN, MPA writes health and science books for young people and continuing education courses for nurses. She worked as a pediatric triage nurse on a 24/7 nurse advice line for several years. Her newest book, about dietary supplements, debuts fall 2015.
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