Does Your Child Need Vitamin Supplements?

Vitamins and minerals are important elements of the total nutritional requirements of your child. Because the human body itself is unable to produce adequate amounts of many vitamins, they must be obtained from the diet. The body needs these vitamins in only tiny amounts, and in a balanced diet they are usually present in sufficient quantities in the foods your youngster eats. Thus, in middle childhood, supplements are rarely needed.

For some youngsters, however, pediatricians may recommend a daily supplement. If your child has a poor appetite or erratic eating habits, or if she consumes a highly selective diet (such as a vegetarian diet containing no dairy products), a vitamin supplement should be considered. Chewable tablets are available for children who have difficulty swallowing pills.

These over-the-counter supplements are generally safe; nonetheless, they are drugs. If taken in excessive amounts (in tablets, capsules or combined with other supplements), some supplements - particularly the fat-soluble vitamins (A, D, E and K) - can be toxic. Scientists are finding that in some special situations and diseases, vitamin supplementation can be an important contributor to health. However, so-called megavitamin therapy or orthomolecular medicine - in which vitamins are given in extremely large doses for conditions ranging from mental retardation to hyperactivity to dyslexia - has no proven scientific validity and may pose some risks. Vitamin C, for example, when consumed in megadoses in hopes of undermining a cold, can sometimes cause headaches, diarrhea, nausea and cramps. Always consult your pediatrician before giving your child supplements. And don't leave a bottle of vitamins on the table as though they were a condiment like salt or pepper; taking vitamins should be done with careful consideration.

Sources for Various Vitamins and Minerals

As much as possible, try to maximize the vitamins your child receives in her regular meals. Following are some of the vitamins and minerals necessary for normally growing children, and some of the foods that contain them.

Vitamin A promotes normal growth, healthy skin, and tissue repair, and aids in night and color vision. Rich sources include yellow vegetables, dairy products and liver.

The B vitamins promote red blood cell formation and assist in a variety of metabolic activities. They are found in meat (including liver), poultry, fish, soybeans, milk, eggs, whole grains and enriched breads and cereals.

Vitamin C strengthens connective tissue, muscles, and skin, hastens the healing of wounds and bones and increases resistance to infection. Vitamin C is found in citrus fruits, strawberries, tomatoes, potatoes, Brussels sprouts, spinach and broccoli.

Vitamin D promotes tooth and bone formation and regulates the absorption of minerals like calcium. Sources include fortified dairy products, fish oils, fortified margarine and egg yolks. Although vitamin proponents insist that large doses of vitamin D - far greater than the U.S. Recommended Daily Allowances - can build even stronger bones, there is no evidence to support this claim, and excessive quantities of vitamin D are potentially toxic. Sunlight also contributes to dietary sources of vitamin D, stimulating the conversion of a naturally occurring compound in the skin to an active form of the vitamin.

Especially during periods of rapid growth, iron is essential for the production of blood and the building of muscles. When iron levels are low, your child may demonstrate symptoms such as irritability, listlessness, depression and an increased susceptibility to infection. However, a deficiency of iron is much more common in adolescence than in middle childhood. Once girls begin menstruation, they need much more iron than boys do. The best sources of iron include beef, turkey, pork and liver. Spinach, beans and prunes also contain modest amounts of iron. Some cereals and flour are enriched with iron.

As your child matures, calcium is necessary for healthy bone development. An inadequate calcium intake during childhood can not only affect present growth but might also help contribute to the development of weakened and porous bones (osteoporosis) later in life. Low-fat milk, cheese, yogurt and sardines are excellent sources of calcium. Some vegetables, such as broccoli and spinach, also contain modest amounts of calcium. Some fruit juices are now fortified and provide a good source of calcium.

Excerpted from Caring for Your School-Age Child: Ages 5-12 Bantam 1999

© Copyright 2000 American Academy of Pediatrics