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As parents, we’re always looking for ways to ensure our children’s health and well-being. Social media and frequent Google searches are constantly bombarding us with hundreds of ways to manage our children. Whether it’s how to discipline your child, potty train your toddler or feeding methods. Only to leave us feeling discouraged by the constantly conflicting messages. So let’s clear up a frequently asked question, and that is, “Do kids need a multivitamin?”. As a registered dietitian and mom to 3 little ones, I also want to do my research to make sure what I’m providing is evidence-based and appropriate for my kids. As a reminder, this post is for educational purposes only. Always consult with your child’s pediatrician for specific questions related to your child’s needs.
Do Kids Need a Multivitamin?
The answer to the question, “Do kids need a multivitamin?” isn’t necessarily straightforward. Let’s take a closer look at the factors that might influence whether or not your child should be taking a multivitamin. First off, the vitamin and supplement industry is a huge money business, so you really have to be cautious about what you’re purchasing and whether or not these items are truly necessary. Also, be cautious of influencers who are not a dietitian or have a medical background that are promoting supplements.
Unfortunately, vitamins and supplements are not regulated in the same way as food. The Food and Drug Administration is not authorized to review dietary supplements for safety before they are marketed. There are many brands that do get their products third-party tested in a lab that is not affiliated with or owned by them so consumers can feel better about choosing their products. But not all brands do this because it is cheaper and faster to skip this test.
Nutrient Deficiencies in Children
One of the primary reasons that parents consider giving their children a multivitamin is due to concerns about nutrient deficiencies. Nutrient deficiencies in the United States are not overly common, but we do find many children in the U.S. fall short on several key nutrients, including calcium, vitamin D, omega-3 fatty acids, and iron. While it’s important to note that many children can get the vitamins and minerals they need from their diets alone, some children may not be eating a well-balanced diet.
How do I know if my child needs a vitamin supplement?
I’m a strong advocate for choosing food over supplements whenever possible. A lot of vitamin supplements on the market are quite pricey, but they also can contain excess nutrients that are later excreted in the urine. However, there are definitely instances when your child does need supplementation, and you don’t need to feel guilt or shame for that either.
Things to consider when trying to decide if your child needs a supplement
1. Determine if your child is eating less than 2 servings of fruits and vegetables on a daily basis.
2. Determine if your child consumes at least 4-5 different foods daily?
This is obviously not the gold standard for determining the appropriateness of a vitamin supplement, but it can act as a rough guide to evaluate the variety in their diet.
Kids with food allergies, celiac disease, or those following vegetarian or vegan diets may need a supplement depending on their diet. If you recognize that there are gaps in their diet, consider if offering more variety would be beneficial for them to meet their nutrient needs. However, I realize that sometimes you are offering all you can and doing your best to provide variety but your kid is still lacking in their diet. It is totally fine to supplement if needed.
Keep in mind that vitamin and mineral supplements don’t always have the nutrients that your kid is not consuming. For example, if your child does not consume dairy daily, they may not get adequate calcium sources for healthy growth in a vitamin. However, if you’re really on top of providing ample sources of non-dairy items fortified with calcium, they likely are doing fine. But be aware that too much calcium can be harmful. So if you are considering a calcium supplement for your child, talk to your healthcare provider.
What if I have a picky eater?
As frustrating as it is to have a picky eater at home, many other parents can empathize with you. However, some kids do struggle with an overly restrictive diet or food aversions. These are real issues that shouldn’t be ignored and you should consult with your child’s doctor for further guidance and their expertise on supplementation. You can also download my Food Preference Tracker to better identify what foods your child is “learning to like”, “likes”, or “loves” to help determine where there are nutritional gaps in their diet. Keep in mind, maybe they don’t eat certain food groups, but they are still able to get those nutrients in other foods too.
Nutrients of Concern
A study published in the Journal of the Academy of Nutrition and Dietetics found the most common nutrients in supplements include (listed in rank order): vitamins C, A, D, E, B6, B12, zinc, biotin, pantothenic acid, iodine, and folic acid. The 2020-2025 Dietary Guidelines for Americans found nutrients of concern for children include vitamin D, calcium, and potassium. Of these nutrients of concern, they have found that 56% of children’s vitamins contained vitamin D, 4% contained calcium, and none contained potassium. They also found 49% of children’s supplements exceed the upper tolerable intake level for folic acid, vitamin A, and zinc.
According to the American Academy of Pediatrics, common nutrients that are insufficient in kids (such as calcium and iron) are not met with vitamin supplementation. They actually receive excess nutrients of one or more nutrients when offered a supplement. A study in Nutrition and Health noted that out of 52 children’s supplements found in the U.S., 1/3 of them contained amounts of vitamin A that were equal to or exceeded the tolerable upper limit for kids ages 1-3.
Let’s Break Them Down
While every child is different in their food preferences and daily intake, there are a few nutrients that appear to be commonly low for many kids. This is not a blanket statement saying that all kids are low in these. These are listed to help bring awareness to you that your child may or may not be consuming sufficient amounts of these and how you can help offer them.
Iron
Iron is one of the more common nutrient deficiencies in kids that can prohibit growth and development if not consumed in sufficient amounts. It is typically not found in multivitamins, especially gummy vitamins. This is primarily because they don’t taste very good.
Recommendations:
Children ages 1-3: 7mg per day
Kids ages 4-8: 10 mg per day
Iron-rich sources include:
Heme iron sources are found in animal products such as red meat, chicken, and turkey.
Non-heme iron sources are found in plant products such as kidney beans, lentils, and tofu.
Non-heme iron sources are not absorbed as well as heme iron. Consuming vitamin C-rich sources (oranges, strawberries, kiwi, bell peppers to name a few) with iron-containing foods can help improve iron absorption.
If your child is not eating iron-rich sources regularly, then you can ask the doctor to test for an iron deficiency to determine if a supplement would be appropriate for them. Symptoms of low iron levels include pale skin or low energy for more than a couple of days. Also, if you observe your child trying to eat dirt or ice chips frequently, they may be iron-deficient. Let’s be real, eating dirt isn’t entirely abnormal for kids, but something to be mindful of.
You can check out this post for more ways to encourage your picky eater to consume more protein. Because iron intake and protein typically go hand-in-hand.
Omega-3 Fatty Acids
If your child consumes fish 2-3x per week then they are likely meeting their recommended dose. Although it’s probably safe for me to say that your child is not a huge fan of salmon, sardines, or tuna. Omega-3, particularly docosahexaenoic acid (DHA), has been found to have numerous health benefits for brain, nerve, and eye development in infants and children along with cognition. It has also been shown to provide anti-inflammatory benefits to protect against chronic diseases. Unfortunately, fish supplements tend to leave you with a fishy taste in your mouth or fishy burps. Tiny Sprouts (use code CHRISTINE10) has a great blend of DHA that is designed specifically for kids. It can also be helpful for constipation.
Recommendations:
Some experts suggest children ages 3-4 get 100-150 mg of EPA and DHA daily combined and 150-200 mg daily for kids ages 4-6.
Sources include: Chia seeds, ground flaxseeds, walnuts, soybeans, and DHA-fortified milk
Vitamin D
This tends to be a common vitamin that people consume an insufficient amount of. According to the American Academy of Pediatrics, infants 12 months and younger should receive 400 International Units (IU) or 10 micrograms of vitamin D daily. Babies that receive breast milk require supplemental vitamin D. Vitamin D drops are a great way to ensure your baby is meeting the recommendation. Formula-fed babies get enough vitamin D from the fortified infant formula. When your child turns 2 years old the recommendations increase to 600 IU of vitamin D daily. To put this into perspective, one cup of milk only provides 80-100 IU of vitamin D.
Below are some suggestions for vitamin D supplements. Always consult your pediatrician for dosage recommendations and if this supplement is appropriate for your child.
Vitamin D drops for babies:
Vitamin D supplements for toddlers:
The sun is an excellent source of vitamin D. However, the amount of vitamin D absorbed can vary depending on your child’s skin tone, time of year, amount of sunscreen applied, time of exposure, and how far you are from the equator. When looking at vitamin D supplementation, look for ones that contain 400-600 IU. Vitamin D supplements are generally more beneficial to use in the Winter when there is less sun exposure.
Forms of Vitamin D
Vitamin D can be found in 2 forms – vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol). Vitamin D2 is found primarily from plant sources while vitamin D3 is mostly found in animal sources. The recommended form is vitamin D3 as it is better absorbed by the body to help increase vitamin D levels.
Sources of vitamin D: cow’s milk, fortified orange juice, salmon, mushrooms, and egg yolks.
Calcium
Whether you choose to follow a dairy-free diet at home or you provide cow’s milk, it is still important to make sure your child is consuming ample amounts of calcium for strong bones, muscle, and heart health.
Recommendations:
Children ages 1-3: 700 mg calcium per day
Kids ages 4-8: 1000 mg calcium per day.
Sources include: yogurt, calcium-fortified orange juice, sardines, cheese, cottage cheese, leafy greens, chia seeds, milk, and milk alternatives, and soybeans
You can check out this blog post for more guidance on calcium sources for your child.
Multivitamin/Mineral Supplements for Kids
While multivitamin or mineral supplements generally aren’t necessary, there are definitely times when it is appropriate for your little ones. Multivitamins also provide other nutrients such as vitamins A, C, B vitamins, and more. These vitamins are generally found easily in food.
Vitamin A
Vitamin A is important for healthy eyesight, skin, and immune system. It can be found in foods such as sweet potatoes, carrots, spinach, and mangoes. Children who do not get enough vitamin A may experience night blindness, dry skin, and a weakened immune system.
Vitamin B Complex
Vitamin B Complex is important for healthy brain development, energy metabolism, and red blood cell production. It can be found in foods such as whole grains, meat, dairy products, and leafy green vegetables. Children who lack vitamin B Complex may experience fatigue, weakness, and poor concentration.
Vitamin C
Vitamin C is important for a strong immune system, healthy skin, and good wound healing. It can be found in citrus fruits, kiwis, strawberries, and bell peppers.
Probiotics for Kids (Optional)
Probiotics provide the “good” bacteria for the gut and can provide some health benefits. While the world of probiotics and the microbiome is still largely unknown, we find there can be many health benefits to maintaining a healthy gut. There is some evidence that reports it can help protect against certain chronic diseases, autoimmune diseases, immune support, and more. However, there is still much more research to be done in this area.
Probiotics can be found in some foods, but the bacterial cell count is still quite low in comparison to a supplement that often has around a billion active cells per serving. Ask your pediatrician if a probiotic is recommended for your child.
Check out this post to find out if probiotics are right for your child. Below are some supplements I would recommend if you and your pediatrician agree it is appropriate.
In Summary
The bottom line is that every child is different, and some kids have different nutrient needs. Taking large doses of vitamins that exceed the recommended daily amount can be toxic and cause symptoms such as diarrhea, nausea, and headaches. As always, your pediatrician for recommendations specific to your child’s needs based on their intake and health. Working 1 on 1 with a dietitian is best to really determine what nutrients your child may be lacking. Grab my free picky eating guide if you have a picky eater and are concerned about consuming a varied diet.
