Parenting Advice From Your Physicians at Kaiser Permanente

Does giving your child vitamins help keep them healthy? Or, as a friend put it, does it “just make them have expensive pee?” When parents ask me if they should give their children a multivitamin, I explain that it’s not usually necessary to give otherwise healthy children a daily vitamin supplement. Instead, it’s important that their nutrients come from eating a healthy and varied diet – not from a pill.

Most children get enough vitamins and minerals from a healthy diet. Each day, kids should eat:

• Fruits and veggies (5 or more servings)
• Protein (chicken, fish, eggs, beans, nuts, and lean meats)
• Dairy products (milk, cheese, yogurt, or fortified alternatives)
• Whole grains (whole wheat bread, corn tortillas, brown rice, oatmeal)

Focusing on these should cover the bases and keep them healthy!

But sometimes, it’s not that easy, and there are a few more details to keep in mind. Specifically, make sure your kids have enough of these nutrients:

Calcium

Getting enough calcium as a child sets the stage for healthy bones as an adult. The maximum period of bone growth is in the preteen and teen years. During this time, kids need about 1,300 mg of calcium a day. Calcium is in dairy products (milk, yogurt, cheese), some nuts, dark green leafy veggies (including broccoli), some tofu, and fortified orange juice. If you use alternative “milk” products like soy, coconut, almond, or oat, check to make sure they’re fortified with calcium. Each serving of a dairy product has about 300 mg of calcium, so if your child drinks milk and eats some of the other calcium-containing foods, getting enough calcium is easy. If they don’t, then consider giving them a calcium supplement.

Vitamin D

Vitamin D is crucial for health in many ways. It’s found primarily in fish and fortified milk products. Our body also makes vitamin D when exposed to sunlight. For children, its most important function is to support bone health and growth. Vitamin D also helps absorb calcium. The recommended dietary intake of vitamin D is 600 units a day for children over age 1. Infants need to get vitamin D through vitamin drops or in formula – talk with your pediatrician to learn the correct dose for your baby.

Iron

A diet low in iron can cause anemia (a low red blood cell count.) Iron-deficient kids can have problems with growth, learning, and behavior. Iron is found naturally in many foods, including meats, beans, fish, tofu, dark green leafy veggies, and dried fruits. It’s also in iron-fortified cereals and bread products. Before giving your child an iron supplement, please talk with their pediatrician, because too much iron can be dangerous.

A few groups of children may need special attention to their vitamin intake. Talk with a pediatrician or a nutritionist for guidance about feeding kids who are:

• Very underweight or overweight.
• Super picky. Often young children are picky eaters, and parents can worry they aren’t getting all the nutrients they need to grow well. There’s lots of good advice for helping a picky eater!
• Teen athletes require higher levels of iron and calcium to support their muscle and bone growth. They’re often not getting the needed 4 servings of iron-rich foods and 4 to 5 servings of calcium-rich foods per day.
• Vegan or vegetarian. A plant-based diet can be a safe and healthy choice for kids, but should be done carefully to ensure they are getting enough vitamin B12, vitamin D, iron, vitamin A, calcium, zinc, and riboflavin.
• Affected by a chronic medical condition that may increase the risk of nutritional deficiencies.

Most kids like taking vitamin pills or gummies. Many of them look and taste like candy, so keep them out of reach, behind a child lock, and under your control to keep your children safe. Chewable vitamins can be a choking hazard for young children. They should only be given to kids over age 3, while you are there to watch them chew and swallow the vitamin.

In general, work with your pediatrician to ask if your child has a unique medical need for specific vitamin supplementation and at what dose. Know that mega-doses of vitamins can be toxic and should not be used. Parents ask what brands of vitamins to get, but I don’t have specific recommendations. I do say that when it comes to vitamins, more isn’t better, and usually, an expensive vitamin is not a better vitamin – it just makes for more expensive pee!