I have heard a variety of opinions from Moms through my Global Toddlers survey on the topic of nutritional supplements. Some are using them for their toddlers, while others are skeptical about their effectiveness. Personally, we have not used any multivitamin supplements for our twins so far, but we also think about it sometimes. So I decided to research this subject and thought about 5 reasons you may consider giving your child a daily dose of a multivitamin. I have relied heavily on two books, which I strongly recommend to all of you:
- Dr. Spock’s Baby and Child Care, 8th Edition – The One Essential Parenting Book (Find on Amazon here)
- Disease Proof Your Child by Joel Fuhrman, M.D. (Find on Amazon here)
If you are exclusively breastfeeding your child (0-24 months)
Breast is certainly the best and if you have made the decision to breastfeed your child, you should be congratulated. Breast milk provides all the necessary nutrients for your baby’s physical growth and brain development. It also builds a strong immune system which protects your child from disease later in life. However the actual amount of vitamins, minerals and other nutrients a child will get from breast milk depends on Mom’s diet and nutrition during pregnancy and while breastfeeding.
Breast milk contains very little vitamin D, and although you can compensate for it by supplementing your own diet or by having your child get some exposure to sunlight, it might be a good idea to consider a vitamin D supplement for your child. In fact, the American Academy of Pediatrics recommends that all exclusively breastfed infants and toddlers be given 200 IU vitamin D supplement beginning within the first 2 months after birth. Good nutrition and outdoor play is critical for avoiding vitamin D deficiency, which has recently been reported to be on the rise in infants and children.
If your diet is primarily vegetarian, you may also consider a vitamin B12 supplement for your child. Vitamin B12 is one of the 8 B vitamins needed for normal functioning of the nervous system and the brain, and for the formation of blood. It is only available from animal products such as meats, dairy and eggs.
Although breast milk contains a highly absorbable type of iron, the overall amount is low. If your diet is iron-deficient and if your child is not eating iron-fortified complementary foods (formula, cereals, baby foods), you may consider an iron supplement. Iron is very important for maintaining blood oxygen levels and brain development.
If your child’s diet is mainly vegetarian (2-5 years)
Raising your child on a meatless, low fat and mainly plant-based diet is now highly recommended by many nutrition experts and pediatricians. Such a diet has many positive health benefits over the long term. It is indeed possible to get all of the major nutrients from fruits and vegetables. Having said that, we realize that it is not easy to develop a 100% meat-free diet, nor do we think it is necessary. We do believe in reducing the overall meat consumption, particularly red meats. We try to eat only chicken and fish as much as possible, although sometimes we do make a few dishes with lean beef, and once in a while, we do relish some of our lamb recipes.
Vitamin B12 deficiency is a major risk for children on a vegetarian diet. Another risk could arise if they are eating only a limited range of veggies and not including lentils, beans and nuts in their diets. If this is the case, you should consider a multivitamin supplement for your child.
If your child is not eating enough fruits and vegetables (2-5 years)
By far, this is a major concern of most parents! Eating a variety of fruits and vegetables is absolutely essential for healthy nutrition. However, most parents struggle with their children as they try to encourage them to eat more fruits and vegetables. Why this is so, I do not know right now. I do intend to research this problem and think about it some more for future posts.
While you can try to make up for it by selecting so-called “healthy” (vitamin and mineral fortified) processed foods for your child, it is not really a good alternative. Be really careful about sugar, fat (particularly trans and saturated fat), cholesterol and sodium, which may be lost in the fine print on the carefully designed package. But most importantly, even though the processed food may contain all the right ingredients, usually their absorption by our body is not very good. Our digestive system has evolved over a very very long time to extract energy and critical nutrients from natural foods such as fruits and vegetables without overloading any of its critical organs. It is indeed a complex machinery! The science of food – even though great advances have been made in recent years – still is in its infancy. We can add minerals and vitamins to processed foods, but do we really understand how they interact with each other or what happens to them inside the human body? I do not think so.
If you find yourself in this situation, you can consider a multivitamin supplement. Driven by research, these supplements now are formulated to maximize absorption. Since these supplements are not yet regulated by the FDA, there may be huge differences in quality and risks of different brands. Always do your research and consult with your doctor for recommendations.
If you have a picky eater (2-5 years)
Having a picky eater on your hands is another common problem. Although in most cases, it is a behavioral and communication issue, it is possible that your child may have a strong aversion, or even allergies to certain foods. In most cases, the advice I have heard is to be patient and offer different foods to your child at different times. I like to call it a 5-times-5-ways approach, which involves introducing new foods (including fruits and veggies) slowly and in different forms so your child can begin to develop a taste for them on his own and at his own choosing.
The risk in this case is that your child does not get a balanced nutrition and she may develop a deficiency for certain essential nutrients. In fact research has shown that 65% of those who did not use supplements, and even 9% of those who used supplements, had vitamin E intakes of less than the Estimated Average Requirement (5 mg/day). And recently, there have been many reports of vitamin D deficiency in infants and toddlers.
A multivitamin supplement may be considered in this case. In the words of Dr. Spock, “one vitamin pill a day is preferable to fighting with your child to finish his vegetables or eat more raw food“.
If your child’s growth profile is slower-than-normal (2-5 years)
Sometimes you may feel that your child is too thin, or too short in comparison to other children of his age. Whatever you do, he just does not seem to be growing that much. It is a very natural for a parent to feel this way; however this is a very complex issue and you should not take any drastic steps without consulting with your Pediatrician.
Tracking your child’s height, weight and BMI (Body Mass Index) using growth charts is a good way to understand his growth pattern in comparison to a normal growth profile for children of his age. As I have written in my post 5 Things You Need to Know About Growth Charts, these charts are based on a large amount of data collected from various national surveys. You should not worry about a single data point on these charts if it happens to fall below the “50th percentile”, but you should look at the trend over a period of time to see how it looks in relation to the norm. With online tools, you don’t have to wait for your next doctor visit. Resist the urge to check it every week; a quick check every 5-6 months should be sufficient.
If after tracking the growth chart for your child you find that his growth is slower than normal, your doctor may suggest an appropriate diet and a nutritional supplement.
So you have decided to give your child a multivitamin supplement, now what?
Here are few things to keep in mind once you have made a decision to use vitamin supplements:
- Research the brand for quality; not all vitamin supplements are created equal!
- Read the label carefully and do not exceed the recommended dose. There can be dangerous side effects due to vitamin toxicity.
- Look for one without vitamin A – it can lead to loss of calcium in the urine. Instead rely on yellow/orange colored fruits and veggies which provide beta carotenes so that our body can make vitamin A at its own rhythm.
- It should not have more than 2500 IU of beta-carotenes; studies have linked high does beta-carotene supplementation to higher rates of cancer and heart disease.
- It should have the full spectrum of minerals, most importantly calcium, iron and zinc.
- No artificial colors, sweetners or flavors.
- Taste and form acceptable to your child. No use picking a fight over the multivitamin!
Do you use a multivitamin supplement for your child? Why? And what kind? Please share in your comments.

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{ 9 comments… read them below or add one }
Hi there,
Important topic but a few corrections:
1. The AAP now recommends 400 IU of vitamin D as of November 2008. Should be started in the second month of life.
2. Breast milk is now low in vitamin D, it was never supposed to have it in the first place (its not really a vitamin, its a prohormone made from sun exposure). You can compensate for it in your diet, but only if you mega-dose, which should be done only under qualified care with regular blood work. Only high doses will be excreted into breat milk.
3. Children should not be fed low-fat diets, they need fat for their growing little brains. Children and breastfeeding moms should get at least 30% of calories from healthy fats. And meat can be a part of a healthy diet, it eaten with plenty of produce.
4. Breast milk contains enough iron and it is unlikely for a breastfed baby to become anemic because the iron in breast milk is highly absorbable.
Sound advice.
As long as parents don’t get any false assurance from the multivitamin pill.
Many American kids eat a very poor diet that isn’t optimal for their health or weight, yet get plenty of vitamins.
Poor diets are common. Vitamin deficiency (besides Vit. D deficiency) is very rare in the US.
My son takes a “My First Flintstone” or something like that for ages 2 and 3, and he also takes DHA/fish oil capsules for kids (strawberry flavored fish oil…ew…but he likes it) because it is good for eye health and also has been shown to help hyperactivity. And he doesn’t eat a lot of salmon, you know?
the folks from juice plus say that “you crave what you eat” ie, if kids take their vitamins kids will want to eat more fruits and veggies. i don’t know if this is true from vitamins, but from a whole food diet i do believe it to be true. ie, our family eats lots of fruits and veggies and we like, crave, enjoy eating fruits and veggies.
i’m with ayala, don’t use vitamins as an excuse not to eat health promoting foods. there are other things that plant based foods do outside of vitamins for the body (promote proper gut function, provide good energy for body to support an active child’s lifestyle, and a host of other things) that you miss when you rely on a vitamin for health. use vitamins as a short term solution while you work on getting more plant based foods into your or your kids diet.
I glad you mentioned that Debra.
Breast milk is designed as the perfect food for baby. It contains small amounts of vitamin D because nature intended for babies to be exposed to sunshine. Vitamin D in breast milk is intended to supplement the vitamin D that infants make themselves from sunshine; it is not to provide 100% of their daily requirement.
My feeling is that Breast milk is one of those absolutes that we don’t mess with. Really.
Read this info page. Number 6 relates to Vit. D in breast milk.
http://www.kellymom.com/newman/11some_bf_myths.html#6
There is still much we don’t know about the ways nutrients work together. A healthy body is an extremely complex system, and each functional area requires a diverse mix of nutrients. For many reasons, nutritional supplementation should provide nutrients that are both balanced and in adequate doses. For example, certain vitamins supplied in isolation can result in other nutritional deficiencies, and many micronutrients can be toxic at excessive or imbalanced levels. USANA painstakingly designed the Essentials to allow components to work together both safely and effectively.
To be useful, all nutrients must be of high quality and be bioavailable; in other words, in a form the body can absorb and use. USANA makes every effort to obtain the highest quality ingredients; and it tests those ingredients for quality and potency. In addition, USANA imposes rigorous quality control standards at every step of the manufacturing process. USANA Essentials are advanced daily nutritional supplements that supply optimal nutrition for every age group. To help meet the “essential” nutrient needs of children and teens during the years of development, when good nutrition is most important, USANA offers:
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I have been giving my son a “gummy” vitamin for the past year and a half. He LOVES them. But he also loves fruit and vegetables. I have noticed a marked improvement in his health since starting the vitamins however. Other than well child check ups he has not had to visit a Dr in about a years time. We used to be there at least every other month or so for a cold or infection of some kind. He uses a chewable gummy vitamin, I am really not sure what brand, but it is Transformers shapes. the shape is VERY important to him.
Coming from the UK, where I am not aware of such a perceived ‘need’ for multivitamins, I am suspicious of the origins of this.
If children growing up in developed nations ‘need’ multivitamins how on earth do kids in developing countries get by where there are no multivitamin manufacturers around?
It is important for children to have good nutrition in their growing years. This is especially true in today’s world, when our kids are more likely to prefer junk foods and candy to wholesome, nutritious food. I would recommend a chewable multi-vitamin since it is difficult to expect small children to swallow tablets. Liquid vitamins are good too, but children usually love the different-shaped and colored chewable vitamins and eagerly chew them. Choose a multi-vitamin from a good manufacturer as this ensures that your child is getting a quality product that meets label specifications.