With labels touting your choice of better "bone health" or "brain support" and "healthier immune function," all wrapped up in one sweet-tasting pill, it's easy to see why parents buy vitamin supplements for kids. In fact, around one-third of kids in the U.S. ages 2 to 17 are taking them.
And yet most child health organizations, including the American Academy of Pediatrics (AAP), point out there's little evidence children need vitamin supplements and don't endorse kids taking them. But – that doesn't necessarily mean you should throw out the idea of kids taking vitamin supplements altogether.
Metro Parent talked to child health experts in Michigan to get their take on some common questions parents may have about whether their child might benefit from vitamin supplements.
I know that vitamins are good for my kids, but can you tell me a little bit more about them?
Vitamins are divided into two categories – fat soluble and water soluble. The nutrient-rich foods your child eats contain these different types of vitamins; each type is stored differently, which comes into play when thinking about what sorts of supplements your child may take.
As the name implies, fat-soluble vitamins are stored in fat. The fat hangs onto these vitamins until they're needed, as long as six months. In contrast, water-soluble vitamins aren't stored. Instead, they make their way through the body in the bloodstream. As a result, water-soluble vitamins need to be replenished more often.
"Fat-soluble vitamins are A, D, E and K," explains Jennifer Burgess, D.O., who's in family medicine at Henry Ford Health System's Commerce Township location. Vitamins B and C are water soluble. "With these vitamins, the body eliminates any extras."
Vitamin supplements can contain any combination of these vitamins, along with minerals like iron and calcium.
Do you recommend that kids take vitamins?
"Probably as a general rule, most healthy children who are growing well and eating a varied diet don't need vitamins," says Emily Ostrowski, a pediatric registered dietitian at Sparrow Health System in Lansing. "Parents need to remember that foods are the best sources of vitamins, and there are other nutrients in healthy foods that are helpful for growing kids besides the vitamins like fiber and antioxidants."
If your child is already getting the vitamins and minerals she needs from the food she's eating, the extra vitamins supplements are just that – extras. They're either stored by the body or flushed out.
When do you recommend that kids take vitamin supplements?
Children with certain health conditions or eating habits may be good candidates for a daily vitamin supplement, notes David Obudzinski, a pediatrician with the Beaumont Health System who practices out of Beverly Hills Pediatrics in Bingham Farms.
"If some children exclude certain food groups or won't eat many vegetables, then I may recommend to their parents that the child takes a vitamin (supplement)," says Obudzinski. "Children who are vegans or vegetarians also need a vitamin supplement to ensure adequate nutrition."
Children who are failing to meet growth milestones and those with digestive disorders, food allergies and other health concerns may benefit from vitamin supplements, too, adds Ostrowski. "In these cases, the child probably needs to be evaluated by a dietitian to determine what vitamin (supplements) are appropriate."
Aren't there some vitamin supplements that are recommended for kids?
Yes! While the AAP doesn't recommend a multivitamin, it has put its seal of approval on taking vitamin D supplements. The reason? Kids often aren't getting enough sun, which is one good source of vitamin D. And even if they are in the sunshine, if they're wearing sunscreen (which the AAP also recommends), "sunscreen keeps the skin from manufacturing vitamin D."
The AAP advises "a daily intake of 400 IU per day of vitamin D during the first year of life beginning in the first few days, and 600 IU for everyone over age 1." It goes on to encourage parents to consult with their child's health care provider to determine the right amount of vitamin D for their child, since some children may need more or less than that amount based on the time they're spending outside and other factors.
Without enough vitamin D, children's growth can be stunted and bones can become weakened. Obudzinski recalls seeing firsthand the impact of vitamin D deficiency in his own practice: "I had a 12-year-old boy with symptoms of depression, and we found that he wasn't getting enough vitamin D." Once the boy began taking in more vitamin D, which for him involved drinking more fortified milk, his mood improved. "(Lack of vitamin D) really can have an impact."
With infants, the vitamin recommendations are different based on whether they are breastfed or not. For example, the AAP advises vitamin D supplements and, in some instances, iron supplements. For breastfed babies, a vitamin D supplement may be recommended, while iron would be suggested for formula-fed infants.
I'm still confused. As long as vitamin supplements don't hurt kids, is there any real harm in having them take them?
Tricky question. There is no real harm in taking a vitamin supplement, explains Burgess, who typically does recommend a daily vitamin supplement to her pediatric patients. But the decision about whether to take a vitamin supplement or not, and then what kind, is really a conversation between you, your child and your child's health care provider.
Through asking questions about your child's diet and activity level, his health care provider can make recommendations on vitamin supplements your child might take or foods he needs to add to his diet.
Are there any concerns about children taking vitamin supplements?
Burgess suggests avoiding any supplement listed as mega or super. "A regular child vitamin supplement is all they need." She points out that, unlike over-the-counter medications, vitamins are not regulated by the U.S. Food and Drug Administration. For that reason, her recommendation is to stick with big-name brands or generic store brands when purchasing vitamins supplements. "Do your research," she notes.
Along with being careful when choosing a supplement, make sure that you're storing the bottle in a place that's not accessible to kids. While rare, it is possible to overdose on supplements. "You always want to be careful not to take too many vitamin supplements," says Obudzinski.