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Coming to the end of yet another school physical season, my mind is focused on anticipatory guidance and well child care. Inevitably, nutrition is a main focus of these back to school visits – a very common question is, "Should my child take a vitamin?" While there are relatively clear recommendations for vitamin supplementation in infancy, there seems to be less clear consensus regarding vitamin supplementation in toddlers and school-aged children. Over my years of practice, I have developed a few guiding principles for my recommendations, which have definitely evolved over the years as more evidence becomes available.
• I always ask if a child is taking any kind of vitamin or other supplementation. Routine supplementation with a standard children’s multivitamin is very safe, and I essentially never discourage it. However, high doses of vitamins can be dangerous. Without being asked, most parents don’t think to mention vitamin use, but it is definitely something I want to know.
• For children who are not taking vitamins, but whose parents have concerns about their diet, I recommend a standard chewable multivitamin with iron. The risks of this type of vitamin supplementation are low, and the potential benefits great if a child isn’t getting everything he or she needs through the diet. Of course, I also take the opportunity to discuss strategies for improving diet and nutrition, since that is the best way to get your vitamins and minerals! For children who seem to have healthy well-balanced diets, I suggest it to parents as an option to consider. My recommendation in this situation is less strong, and more driven by parent preference. That said, I do let parents know that even children with seemingly good diets can sometimes not be getting enough of particular vitamins or minerals, most typically vitamin D, iron, or calcium.
• If a child is taking vitamins, or the parent is considering starting the child on vitamins, I recommend standard chewable children’s multivitamins (whatever brand is on sale) rather than gummy vitamins. Many brands of gummy vitamins have lower amounts of vitamin D or other vitamins than do their chewable counterparts. If a child really prefers gummy vitamins, I recommend that parents carefully compare the nutritional information to be sure that if they are going through the expense and trouble of giving a daily vitamin the child is getting all the vitamins and minerals that he or she needs. Lastly, parents should be reminded that vitamins are medications and should be safely stored! Thoughtfully used, vitamin supplements can be an important part of a healthy child’s nutrition.
Dr. Beers is an assistant professor of pediatrics at Children’s National Medical Center and the George Washington University Medical Center, Washington. She is chair of the American Academy of Pediatrics Committee on Residency Scholarships and president of the District of Columbia chapter of the American Academy of Pediatrics. E-mail Dr. Beers at pdnews@ frontlinemedcom.com.
Coming to the end of yet another school physical season, my mind is focused on anticipatory guidance and well child care. Inevitably, nutrition is a main focus of these back to school visits – a very common question is, "Should my child take a vitamin?" While there are relatively clear recommendations for vitamin supplementation in infancy, there seems to be less clear consensus regarding vitamin supplementation in toddlers and school-aged children. Over my years of practice, I have developed a few guiding principles for my recommendations, which have definitely evolved over the years as more evidence becomes available.
• I always ask if a child is taking any kind of vitamin or other supplementation. Routine supplementation with a standard children’s multivitamin is very safe, and I essentially never discourage it. However, high doses of vitamins can be dangerous. Without being asked, most parents don’t think to mention vitamin use, but it is definitely something I want to know.
• For children who are not taking vitamins, but whose parents have concerns about their diet, I recommend a standard chewable multivitamin with iron. The risks of this type of vitamin supplementation are low, and the potential benefits great if a child isn’t getting everything he or she needs through the diet. Of course, I also take the opportunity to discuss strategies for improving diet and nutrition, since that is the best way to get your vitamins and minerals! For children who seem to have healthy well-balanced diets, I suggest it to parents as an option to consider. My recommendation in this situation is less strong, and more driven by parent preference. That said, I do let parents know that even children with seemingly good diets can sometimes not be getting enough of particular vitamins or minerals, most typically vitamin D, iron, or calcium.
• If a child is taking vitamins, or the parent is considering starting the child on vitamins, I recommend standard chewable children’s multivitamins (whatever brand is on sale) rather than gummy vitamins. Many brands of gummy vitamins have lower amounts of vitamin D or other vitamins than do their chewable counterparts. If a child really prefers gummy vitamins, I recommend that parents carefully compare the nutritional information to be sure that if they are going through the expense and trouble of giving a daily vitamin the child is getting all the vitamins and minerals that he or she needs. Lastly, parents should be reminded that vitamins are medications and should be safely stored! Thoughtfully used, vitamin supplements can be an important part of a healthy child’s nutrition.
Dr. Beers is an assistant professor of pediatrics at Children’s National Medical Center and the George Washington University Medical Center, Washington. She is chair of the American Academy of Pediatrics Committee on Residency Scholarships and president of the District of Columbia chapter of the American Academy of Pediatrics. E-mail Dr. Beers at pdnews@ frontlinemedcom.com.
Coming to the end of yet another school physical season, my mind is focused on anticipatory guidance and well child care. Inevitably, nutrition is a main focus of these back to school visits – a very common question is, "Should my child take a vitamin?" While there are relatively clear recommendations for vitamin supplementation in infancy, there seems to be less clear consensus regarding vitamin supplementation in toddlers and school-aged children. Over my years of practice, I have developed a few guiding principles for my recommendations, which have definitely evolved over the years as more evidence becomes available.
• I always ask if a child is taking any kind of vitamin or other supplementation. Routine supplementation with a standard children’s multivitamin is very safe, and I essentially never discourage it. However, high doses of vitamins can be dangerous. Without being asked, most parents don’t think to mention vitamin use, but it is definitely something I want to know.
• For children who are not taking vitamins, but whose parents have concerns about their diet, I recommend a standard chewable multivitamin with iron. The risks of this type of vitamin supplementation are low, and the potential benefits great if a child isn’t getting everything he or she needs through the diet. Of course, I also take the opportunity to discuss strategies for improving diet and nutrition, since that is the best way to get your vitamins and minerals! For children who seem to have healthy well-balanced diets, I suggest it to parents as an option to consider. My recommendation in this situation is less strong, and more driven by parent preference. That said, I do let parents know that even children with seemingly good diets can sometimes not be getting enough of particular vitamins or minerals, most typically vitamin D, iron, or calcium.
• If a child is taking vitamins, or the parent is considering starting the child on vitamins, I recommend standard chewable children’s multivitamins (whatever brand is on sale) rather than gummy vitamins. Many brands of gummy vitamins have lower amounts of vitamin D or other vitamins than do their chewable counterparts. If a child really prefers gummy vitamins, I recommend that parents carefully compare the nutritional information to be sure that if they are going through the expense and trouble of giving a daily vitamin the child is getting all the vitamins and minerals that he or she needs. Lastly, parents should be reminded that vitamins are medications and should be safely stored! Thoughtfully used, vitamin supplements can be an important part of a healthy child’s nutrition.
Dr. Beers is an assistant professor of pediatrics at Children’s National Medical Center and the George Washington University Medical Center, Washington. She is chair of the American Academy of Pediatrics Committee on Residency Scholarships and president of the District of Columbia chapter of the American Academy of Pediatrics. E-mail Dr. Beers at pdnews@ frontlinemedcom.com.
