The only kids who need vitamins (spoiler alert: there aren’t many)

Gummy vitamins for children.

As a pediatrician, I get a lot of questions whether their children should take a multivitamin or other vitamin supplement. Parents think they will make their children healthier — and some think they will make them eat more (they don’t, sorry). Since our bodies need different vitamins to be healthy, they ask,

Should I give my child a multivitamin?

Not necessarily, actually. It turns out that most children don’t need them, making them an expensive waste of money. They can also be dangerous if children take too many, something that is very possible given that most chewable multivitamins for children taste like candy. And giving a vitamin can give families a false sense of security that their child is getting everything they need — when they aren’t.

Here’s a really important point: the best way to get vitamins is not from a pill but from food. The body digests them better. And indeed, if your child is eating a varied diet that includes fruits, vegetables, whole grains, fortified dairy or dairy substitutes, meat and seafood, chances are they are getting everything they need. That varied diet is always the goal — and always best.

No? OK, but should some children take supplemental vitamins?

Yes. There are some groups of children that can’t get all the vitamins they need from their diet.

  • Breastfed babies. Formula is fortified with Vitamin D, which is important for bone growth and other body processes. Breast milk is not. Now, breast milk is truly the perfect food for babies and mothers should breastfeed whenever possible. Vitamin D is a sunshine vitamin, and if all babies were out in the sun regularly, there would be no need for supplementation. But the reality is that we don’t get little babies out in the sun regularly. If you have a baby whose diet is mostly breast milk, talk to your doctor about exactly which vitamin to give, and for how long.
  • Children with vegetarian, vegan or other alternative diets. This isn’t to say that you can’t get all your nutrients from diets that don’t contain animal products or are otherwise different from the average diet. But it’s not always easy to get kids to eat all the foods they might need in the quantities they might need — and it could take quite a large quantity to get certain nutrients, like iron. Iron is very important for growing bodies and developing brains. Again, talk to your doctor about which supplements make sense for your child.
  • Children with very restricted diets. Examples of this are the children who flat out refuse to eat a fruit or vegetable, the ones who could live on the “white diet” of pasta, rice, potatoes, bread and milk, the ones who refuse everything but chicken nuggets and French fries. Now a vitamin is not the answer here, obviously. You should be working with your doctor to find ways to expand your child’s diet into something healthier. But in the meantime, a multivitamin with minerals may help prevent nutritional deficiencies.
  • Children whose conditions or medications put them at risk of nutritional deficiencies. Some children have difficulty absorbing certain nutrients — and some take medications, like isoniazid or methotrexate, that may require vitamin supplementation. If your child has a chronic condition or takes a medication regularly, ask your doctor if any vitamin supplements are needed or recommended.

If your child doesn’t fall into one of these categories, don’t bother buying vitamins. Instead, spend the money on healthy foods — or tuck it away for that college fund.

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About the blogger: Dr. Claire McCarthy is a primary care pediatrician at Boston Children’s Hospital, an assistant professor of pediatrics at Harvard Medical School, a senior editor for Harvard Health Publications and an official spokesperson for the American Academy of Pediatrics.