I get all kinds of questions from parents about vitamins! I too had concerns when my kids were little, worrying about whether they were getting enough of the right nutrients. The good news is that if you're doing your best to provide a balanced diet, your child is likely receiving all the essential vitamins they need.
Even those children who seem to subsist on a diet of chicken nuggets and mac 'n' cheese somehow manage to glean the necessary vitamins from their seemingly limited menu. I mean, I strongly encourage you as a parent to continue to try. Offer a variety of nutrient-rich foods like broccoli, asparagus, sweet potatoes, squash, bell peppers, frozen peas or green beans, etc. Try to sneak spinach or kale into soups, smoothies, or eggs or blend it into ketchup or spaghetti sauce :)
Let's dive into all this a little deeper...
Why Whole Foods Beat Supplements
Essential vitamins and minerals, with the exception of Vitamin D (more on that below), are abundantly present in a wide variety of foods. We parents worry about our kids not getting enough of these nutrients due to their often limited and picky eating habits. But rest assured, they're likely doing just fine. The supplements you find on store shelves aren't regulated by the US Food and Drug Administration, and this raises concerns among physicians like me. When you and your child take these vitamins, it's a bit of a gamble – you could be getting either too much or even very little of what's listed on the label. Also, the vitamins in these supplements are in a manufactured form, different from the natural and healthier counterparts found in fruits, vegetables, meats, nuts, grains, and seeds. These natural sources are absolutely the best way to nourish your body, compared to the synthetic vitamins in over-the-counter pills, gummies, chewables, or liquids.
There are even documented cases of vitamin supplements being detrimental to your health. Children can (rarely) develop a condition called "hypervitaminosis A" from excessive vitamin A intake, simply from taking a daily multivitamin alongside their regular (albeit picky) diet. Overdoing it on other vitamins can lead to side effects like hair loss, gastrointestinal problems such as cramps, nausea, and diarrhea, skin rashes, and headaches, although please don’t let this add to your worry, these are all quite rare.
In the grand scheme of things, kids are getting adequate amounts of essential vitamins and minerals, even if your child belongs to that 1 in 4 kids who only nibble at vegetables once in a while. Our bodies are remarkably efficient at extracting every bit of available nourishment, so remember to offer a colorful variety of foods, encourage healthy eating without pressure, and keep in mind that even a simple peanut butter and jelly sandwich can be a rich source of essential vitamins and nutrients!
The Exception: Vitamin D!
Here's where we encounter a different story — Vitamin D. We humans naturally produce Vitamin D when our skin absorbs UV rays from the sun. However, now we wisely use sun protection to prevent skin cancer, but this has led to a widespread Vitamin D deficiency. Vitamin D plays a pivotal role in our health, particularly in maintaining strong, non-brittle bones, aiding calcium absorption, bolstering our immune system, and reducing inflammation. Natural food sources of Vitamin D are relatively scarce, found in small amounts in foods such as mushrooms, eggs, seafood, and liver. Thankfully, many types of milk and certain dairy products are fortified with Vitamin D, making a couple of cups of milk a day an excellent choice for children, providing both Vitamin D and calcium. For those who don't like milk, a Vitamin D supplement is highly recommended (for both kids and parents! I take this everyday and so do my kids). The recommended dosage varies by age group. Units are typically given in the form of IU (International Units) or mcg (micrograms):
Breastfed infants: 400 IU daily (formula has Vitamin D added)
0-12 months: 400 IU/day or 10 mcg/day.
12 months - 12 years: 600 IU/day or 15 mcg/day.
13+ years: 800-1000 IU/day or 20-25 mcg/day.
Some older adults: 1000-2000 IU/day or 25-50 mcg/day.
When choosing a Vitamin D supplement, I recommend straight Vitamin D3 instead of calcium with D3:
Older children + adults: USP-approved Vitamin D3. Kirkland Signature is USP-approved for all my Costco loving parents out there ;) ! (see below for more info about this "USP-approved" stuff)
For kids: my Nature's Made Kids First Pediatric Multivitamin is my favorite of the bunch, mostly because it's USP-approved (I cannot find an USP-approved kid-friendly straight Vitamin D), but read more about brands and other options below.
For breastfeeding babies: DDrops is what I have always recommended, however in writing this article I wasn't able to find any infant or children brand Vitamin D that is USP-approved! Boo! But I still like these and recommend them!
The Takeaway: you and your children probably don't need a multivitamin. However, if milk isn't a part of your daily routine, Vitamin D is highly recommended, and do your best to stick with the USP-approved vitamins!
Common questions:
What brands are the best?
Because vitamins and other supplements are not regulated, I have a difficult time recommending any brand with confidence! However, the US Pharmacopeia (USP) is an organization which verifies the quality of supplements like vitamins, but it’s done on a voluntary basis. So if a vitamin or supplement company voluntarily chooses to get quality verification, it submits itself to the USP, and if their product passes, they get a USP mark on the outside of the package. That’s the mark you want to look for! You can check any product on their website here, although the approved products are unfortunately almost all adult pills. Li’l Critters, Nature Made Kids First, and Vitafusion are the pediatric brands that are approved by USP. If I were to recommend one pediatric (chewable, liquid, or gummy) vitamin, it would be this one (USP approved with Vitamin D and Omega-3!): Nature's Made Kids First Pediatric Multivitamin However, navigate to "Feeding and Vitamins!" for a list of personal favorites vitamins HERE!
Should I avoid gummy vitamins?
Gummy vitamins can be a suitable choice for kids. While they do contain a tad more sugar, the key is ensuring they are USP approved, as these should still deliver the essential nutrients. The slight trade-off in the form of a couple of milligrams of sugar is well worth the boost in vitamin D. If you opt to give them to your little ones just before bedtime (including melatonin, see section below on this), remember to diligently brush their tiny teeth and rid them of any excess sugar!
Do we need Iron?
Iron is a mineral essential for the human body. Its primary role involves helping make hemoglobin, a crucial component enabling blood cells to transport oxygen throughout the body. During routine well check-ups at my office, hemoglobin levels are typically checked, often with a simple toe or finger prick. Low iron levels cause anemia, characterized by fatigue, weakness, compromised immunity, and behavioral changes like reduced attention span and irritability.
Fortunately, most people maintain adequate iron levels because iron is available in many foods, particularly in meats, seafood, and leafy greens. Yet, two specific age groups - infants and teenagers - have a higher likelihood of developing anemia, especially teens involved in athletic activities like running.
Newborns start out with plenty of iron stores, but by around 4 months, these reserves diminish unless they're primarily drinking iron-fortified infant formula. For breastfed babies, starting iron drops or introducing pureed iron-rich foods such as baby cereals, vegetables, or meats is recommended to prevent iron deficiency.
Teenagers, especially menstruating females and active athletes, require approximately 15mg to 25mg of iron daily. These young adults are more susceptible to anemia due to rapid body growth and high energy use. Checking for anemia is especially important in adolescents because iron is so important for optimal brain functioning and energy levels. Those teenage years are difficult enough, so it’s super important to do our best to keep their health in tip-top shape! This is one of the many reasons why their annual check-ups are not to be skipped!
Melatonin?
For all the Harry Potter enthusiasts among us, remember the wise words of Horace Slughorn when it comes to Felix Felicis (aka liquid luck): "But taken sparingly, and very occasionally..." Much like Felix Felicis, melatonin can indeed be a valuable aid when used appropriately.
On one hand, Melatonin can offer some temporary assistance and relief, but on the other hand, I'm wary of anyone becoming overly reliant on it. If you're considering using melatonin for your children, I would advise following Horace Slughorn's advice. Please do not become overly reliant on it, use infrequently and, of course, try and stick to the USP approved brands that I've mentioned earlier in our discussion.
Hair, Skin, + Nails
This answer is primarily directed to all the mamas out there, as I don't endorse this for children, and it's not readily available in a pediatric version. However, this serves as a prime example of a vitamin that may not necessarily deliver substantial benefits, yet taking it somehow brings a comforting sense of well-being (and isn't going to negatively affect me). It's a part of my daily routine (I take this one, which isn't even USP approved), and though I probably don't require these extra nutrients, the boost it gives me in my perception of health makes it a worthwhile addition to my day. While I'm more relaxed about vitamins like these, I do intentionally avoid taking a multivitamin or calcium supplement because I believe we can easily exceed our requirements for these nutrients, and potentially even cause harm.
Food Sources for some Vitamins and Minerals?
ZINC: red meat, poultry, seafood, eggs, legumes (beans, peanuts, chickpeas, lentils…), whole grains, dairy products, seeds, nuts. Vitamin C: mostly raw fruits and veggies: citrus fruits, tomatoes and tomato juice, potatoes, brussel sprouts, cauliflower, cantaloupe, mango, broccoli, strawberries, bell peppers, kiwi, spinach, etc. Vitamin E: Nuts, peanuts, seeds, all vegetable oils including sunflower, safflower, olive, soybean, canola, corn, and wheat germ oil (this is the highest!), leafy green vegetables, kiwi, avocado, spinach, and broccoli. Vitamin D: Sunshine! Few foods naturally contain Vitamin D, but fatty fish (salmon, trout, and light tuna) and fish liver oils are among the best sources. Beef liver, egg yolk, and mushrooms have small amounts, and most milks have vitamin D added, (but generally not yogurts, cheeses, or ice cream).
Iron: many breakfast cereals are iron-fortified (Cheerios, Rice Krispies, Kix, Malt-O-Meal…), oysters and seafood, beans (especially white beans) and lentils, beef liver, spinach and other leafy dark greens, tofu, beef, poultry and eggs, nuts, dried fruit. Calcium: All dairy (milk, yogurt, cheese, ice cream), fortified orange juice, squash, edamame and tofu, canned sardines, dark leafy greens like spinach, soymilk, nuts like almonds, salmon, chia seeds, beans, broccoli. Folate: Dark leafy greens like spinach and romaine lettuce, broccoli, asparagus, brussel sprouts, peas, beans, wheat germ, fortified breakfast cereals, beef liver, peanuts, oranges, bananas, beef, poultry. Vitamin B12: Salmon, beef, fish, clams and other shellfish, beef liver, fortified nutritional yeast, cow’s milk and dairy products. Vitamin A: Beef liver, seafood, eggs, dairy products, carrots, sweet potatoes, pumpkin (pumpkin pie!), leafy green veggies, broccoli, squash, cantaloupe, mango, tomatoes, red bell pepper, fortified breakfast cereals, dried apricots, beans. Vitamin K: mostly dark leafy greens like spinach, collard and mustard greens, kale, broccoli, lettuce (even iceberg!), cabbage, pumpkin, blueberries, pine nuts and cashews, chicken, grapes, vegetable oils.
Magnesium: Green leafy veggies like spinach, nuts (almonds, cashews), whole grains, seeds (pumpkin, chia, sunflower), legumes, bananas, avocados, beans, wheat germ, peanut butter, soymilk.
This is informative !