Does My Child Need a Multivitamin?
By: Kerry Lett, MPH, RDN, LDN, CLC
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One of the top questions that I receive as a pediatric dietitian is, “does my child need a multivitamin?” The issue with this question is that it is complicated, because every child’s nutrient needs are completely different based on their age, sex, size, gut health, medications, health conditions, growth, activity level, and dietary restrictions. However, throughout this article, I am going to try my very best to help you determine if your child would benefit from a multivitamin and if so, what to look for to make sure that multivitamin is doing its job of filling in the your child’s nutrition gaps.
Nutrient Needs for Kids
Childhood is a stage of growth, development, and exploration and we know that getting the proper nutrition is crucial to every child’s well-being. Research shows that healthy eating can help children maintain a healthy body weight and even reduce their risk of developing health conditions, such as high blood pressure, short stature, type 2 diabetes, certain cancers, eating disorders, delayed puberty, nutritional deficiencies, cavities, increased injuries, and poor bone health. We have also seen that eating a healthy diet along with getting adequate hydration can help improve children’s cognitive function and memory, improve their mood, improve their school performance and attendance, and support their optimal growth and development (9, 10).
Do Kids Need a Multivitamin?
The general rule of thumb is that if children are eating a healthy, balanced diet and are not having any medical concerns, such as gut health issues or growth issues then they likely do not need a multivitamin. This follows the standpoint of the American Academy of Pediatrics (AAP) and the USDA as well that healthy children older than 1 year old who eat a balanced diet do not need supplements and instead parents should focus on feeding their children a variety of fruit, vegetables, grains, dairy products, and protein.
However, we know that there are exceptions to every rule. We also know that many children struggle to eat a balanced diet - especially vegetables and protein. Therefore, there are certain circumstances when a multivitamin or a specific vitamin/mineral supplement may be beneficial, such as:
Children following a vegetarian or vegan diet
Children who have a food allergy or intolerance
Children who are picky eaters, especially those eliminating a whole food group
Children who have a conditions or take a medication that affects the absorption of or increases the need for certain nutrients, such as celiac disease, cancer, cystic fibrous, inflammatory bowel disease (IBD), and some epilepsy, birth control, and diabetes medications
Children who have had surgery that affects the intestines or stomach
Children with limited sun exposure, obesity, darker skin tone, or those living above 37 degrees N latitude
Supplements for Plant-Based Diets
Children following a vegetarian or vegan diet can get most, if not all, of their nutrient needs from food along as long as there is variety, balance, and a little bit of planning. Without planning, kids may be at risk for deficiencies in calcium, iron, zinc, and vitamins B12 and D (1), which can lead to serious consequences for their health and growth, such as developmental delays, poor growth, and low appetite (3, 4). We also know that it can be hard for kids to get enough DHA, an omega-3 fatty acid that is essential for healthy functioning and development of the brain and retina (2).
Omega-3 Fatty Acids
Vegan/Vegetarian Foods: Nuts, seeds, plant oils, DHA-fortified products
Supplement: Garden of Life Kids Plant Omega-3 Liquid is one of my favorite omega-3 supplements for kids due to is well-accepted strawberry flavor, good distribution of omega-3 fatty acids, vegan ingredients (no fishy flavor), and third-party testing.
Vitamin B12
Vegan/Vegetarian Foods: Nutritional yeast, dairy products (milk, yogurt, cheese)
Supplement: Vimergy Kids Vitamin B12 is one of my favorite vitamin B12 supplements for kids who are vegan due to its low-dose, vegan ingredients, and third-party testing.
Supplements for Kids with Food Allergies & Intolerances
While science has made great strides in recent years, avoidance of all known food allergies is still the recommended treatment for those with food allergies. Due to this food restriction or minimization (in the case of intolerances), research has found that children with food allergies are at an increased risk of inadequate nutrient intake, which can lead to poor growth and vitamin & mineral deficiencies, such as calcium, vitamin D, and B vitamins (5, 6). Learn more about the nutrients that your child may be missing due to their food allergies and alternative food sources here.
Supplements for Picky Eaters
When considering if your picky eater would benefit from a supplement, there are four questions to consider:
Does your child eat at least one food from each food group?
Does your child eat more than 20 different foods?
Have your child’s bloodwork & labs been normal?
Is your child’s growth & weight gain been normal? In other words, are they following their own growth curve?
If you answer “yes” to all of these questions, then your child may not need a multivitamin or supplement. However, if you answered “no,” then your child may benefit from a supplement. If your child had abnormal bloodwork, such as low iron or vitamin D, then it is important to ask your child’s pediatrician or registered dietitian the appropriate supplement and dose to take. If your child is very restrictive and limited in the foods that they will accept, then they may benefit from a multivitamin (and additional labs tested, if they have not already been performed). If your child is falling off of their growth curve or struggling to gain weight, then they may benefit from a kids nutrition shake.
Multivitamin for Kids
Renzo’s Picky Eater Kids Multivitamin with Iron is one of my favorite multivitamins for picky eaters, because it is complete, has adequate levels of vitamins & minerals for kids, is sugar-free, and third-party tested.
Nutrition Shake for Kids
Orgain Kids Protein Nutrition Shake is one of my favorite nutrition shakes for kids, because it has vitamins & minerals added to it along with protein allowing it to also act like a multivitamin, it comes in a variety of flavors, and it does not contain any artificial dyes.
Vitamin D
Vitamin D deficiency and insufficiency is more common that you may think. In the US alone, 24.6% of the population has moderate or severe vitamin D deficiency and 40.9% of the population has vitamin D insufficiency (7). The problem with this is that vitamin D is important for so many things in the human body from absorption & maintenance of calcium & phosphorus, reducing cell growth & inflammation, immunity, hormonal balance, mood regulation, and insulin response. The reason that I believe vitamin D deficiency and insufficiency is so common is because adequate vitamin D is fairly hard to get, since it is only in four food groups (below) as well as sunshine. However, it takes up to 30 minutes of sun exposure daily for those with lighter skin and over 2 hours of sun exposure daily for those with darker skin to reach the same level of vitamin D production (8). For those living above 37 degrees N latitude (above North Carolina) and those with obesity, they are at an increased the risk for vitamin D deficiency.
Vitamin D-Rich Foods: vitamin D-fortified foods (some dairy products & alternatives, juices, & cereals), egg yolks, fatty fish (salmon, tuna, & trout), mushrooms exposed to UV light
Vitamin D Supplement: Cymbiotika Kids Toddler Vitamin D3 + K2 is a great way to make sure that your whole family is getting enough vitamin D. This product has vitamin D in this active form, comes with vitamin K2 for better absorption, has a dose that is adequate for everyone 1-99 years old (unless there is known vitamin D deficiency or insufficiency), and is third-party tested.
Summary
In general, most kids are able to get the nutrients that they need from their diet alone. Even if they have some foods that they do not like or cannot eat, there are typically able to other foods rich in the vitamins and minerals they need to grow or thrive. However, children with extreme dietary restrictions due to picky eating, food allergies/intolerances, or cultural/religious/chosen dietary restrictions, or those who have health conditions that impact their nutrition absorption or needs, then they may benefit from a supplement.
When choosing a supplement for your child, it is always best to consult their registered dietitian or pediatrician to make sure that it is truly necessary and that the dose is appropriate for them. Supplements are not regulated and therefore the amount recommended on the product can often vary from what your child actually needs. If it is determined that a supplement is necessary, aim to choose one that is:
Third-party tested
Kids specific (unless otherwise indicated by your child’s healthcare provider)
Age-appropriate
Limited in additives and added sugar
Disclaimer: This information contained in this blog is based on the experience of the author and science-based research. It is not intended to replace medical advice or diagnosis from a physician or other medical provider. This blog is not intended as a substitute for a consultation with a physician or other healthcare provider. The author is not responsible for any adverse effects or consequences resulting from the use of any suggestions discussed in this blog.
Last medically reviewed on January 29, 2024
Kerry Lett, MPH, RDN, LDN,CLC is the pediatric & maternal registered dietitian and owner of Milestones Pediatric & Maternal Nutrition in Cary, NC. Kerry is passionate about helping growing families navigate life and achieve all of their milestones along the way. Schedule an appointment today.
