Are gummy vitamins a good choice for a daily vitamin for my child? I see many other supplements for kids on the shelf. Do children need anything other than a daily?


Parents are often surprised to learn that most children do not require a daily multivitamin. In the U.S., a number of kids’ foods, particularly cereal marketed to children, are fortified with the nutrients your child requires. Even picky eaters are likely to be properly nourished.


 This might not quell the fears of some parents worried about their child’s nutrient intake. If that’s the case, then giving your child a daily multivitamin is not harmful, as long as some key precautions are followed. Many parents worry about their children having deficiencies in iron or vitamin D. Parents should be vigilant about their children lacking these nutrients. However, a real deficiency is unlikely to be addressed by a multivitamin. Learning what multivitamins can and cannot do is an important first step for any concerned parent.


 



Assessing your child’s diet  

 


As a pediatrician, I often hear from parents concerned about nutrients because their children have not taken a liking to vegetables or meat. After learning more about the child’s diet, however, I am often able to reassure parents that the proper nutrients are being consumed. Children’s cereals are often a great source of vitamins, as many of them are fortified — except perhaps for certain organic brands. Luckily, this information is easily visible on labels.


 From my experience, it is more common to find that children could be getting more protein, which can be obtained through foods such as eggs, milk, yogurt, beans, fish, chicken, and other dairy and poultry options.



Taking caution with multivitamins

 While taking a daily multivitamin will not have a negative impact alone, there are precautions that parents should take. Overdosing on certain vitamins such as iron can be extremely harmful and even deadly to children. Many children’s vitamins look and taste like candy, and parents need to make sure vitamins are stored out of children’s reach. I often recommend storing them with medicines to stress to children that vitamins are not candy. Some parents attempt to coax their children into taking vitamins by presenting them as candy, but this approach could be dangerous and is often unnecessary.


 Further, children should also brush their teeth after taking a multivitamin that is not sugar-free. Gummy vitamins are especially troublesome and not recommended when it comes to your child’s dental health.


 



Watching for vitamin deficiencies

 


Two of the most common — and most commonly asked about — vitamin deficiencies in children are a lack of iron and vitamin D. These deficiencies often require supplements other than a multivitamin, which is unlikely to address the problem.


 The U.S. has a standard newborn screening program that examines children for anemia. Those shown to have certain risk factors, including a family history of anemia, are monitored closely for signs and symptoms of anemia; a pediatrician or hematologist might recommend an iron supplement. As children age, fatigue and pale skin can be anemia symptoms that appear over time. Routine screenings for anemia take place at ages 1 and 2, and sometimes at age 3.


 Lead poisoning can also lead to iron deficiencies and anemia. In this scenario, children may be entirely asymptomatic or symptoms of lead poisoning may appear while anemia symptoms may not be seen right away. Children are screened for lead at ages 1 and 2, and doctors may recommend iron supplements if children have elevated lead levels.


 When it comes to vitamin D, signs of a deficiency can include bone pain and tenderness, as well as rickets, a condition in which the legs point outward. (Knees pointing outward is normal for toddlers, but it should be watched as children age). Most baby formulas include vitamin D, but mothers who breastfeed are recommended to give their child a vitamin D supplement.


 When children turn 1, we recommend that parents introduce whole milk (most 1-year-olds need the additional calories), and that they switch to low-fat milk at age 2. As girls become teenagers, they should be sure to take in foods rich in vitamin D and calcium to help prevent osteoporosis later in life.


 Parents are advised to speak with their pediatrician about their child’s vitamin intake and any causes for concern. Keeping an eye out for common vitamin deficiencies is important, but parents should also be realistic about the inability of multivitamins to address such deficiencies, and be aware of multivitamins’ potential risks. Many parents considering multivitamins can benefit from discussing their child’s diet with a pediatrician first — it might contain more nutrients than you think.  


 


Mary Brown, M.D., is a pediatrician at Floating Hospital for Children at Tufts Medical Center and an assistant professor at Tufts University School of Medicine.