Which Vitamins Do My Child Really Need?

As moms and caregivers, we could drive ourselves crazy trying to make sure our kids get their fair share of fruits and vegetables. But, try as we might, sometimes the picky eaters win!

The good news is it usually takes more than just a distaste for broccoli and green beans to cause a nutritional deficiency. And there are a variety of supplements available for children who follow a strict diet, such as vegan or vegetarian, have one or more food allergies or have medical conditions that result in malabsorption—like leaky gut. In addition, it’s not uncommon for children to have challenges that require additional nutritional supplementation beyond just a healthy diet. Some of these issues are a genetic predisposition (they’re born with it), illnesses that create a high need for certain nutrients or just a poor diet. Whatever the cause, these nutritional deficiencies can be the root cause of many common pediatric conditions and issues including asthma, allergies, behavior, ADD, ADHD, depression, anxiety, inattention, low immune function and even obesity.

While most pediatricians will recommend an over-the-counter children’s multivitamin, I come from the school of thought where I believe it’s better to address the specific deficiencies of each patient on an individual basis whenever possible. A detailed medical and dietary history can help identify deficiencies, as well as testing for specific nutritional deficiencies.

Here’s a quick guide to understanding the nutritional needs of your child and ensuring he has what is needed for healthy growth and development.

How do you know if your child needs supplements?

First of all, focus on a balanced diet for your child that includes dairy (remember: keep it full-fat dairy products for kids, even over the age of 3), plenty of fresh fruit and veggies (leafy greens are the best!), lean proteins (meat, chicken, fish and eggs) and whole grains (like steel-cut oats, brown rice), and he should be in great shape. But, if we’re being honest, we all don’t have the time to cook a home-cooked meal every night that covers all of the nutritional bases and if your child was born with these deficiencies, it won’t matter even if you are feeding him perfectly! This is where supplementation can come in handy.

Additionally, as I briefly mentioned earlier, kids with chronic medical conditions (asthma, allergies (food and seasonal), etc.), especially if they’re prescribed medication, can benefit from added nutrients from supplements. And if your little one wants to be a vegetarian like Mama, he will also need a nutritional boost.

Top vitamins to supplement into your child’s diet:

Vitamin A: This vitamin helps keep your little one’s peepers in tip-top condition, as well as promoting tissue and bone repair and boosting immune system function. Good sources are milk, cheese, eggs and yellow-orange vegetables like sweet potato and squash (try cutting these veggies up, rubbing in coconut oil, sprinkling cinnamon atop and baking at 375 for 25-minutes). If your kiddo isn’t a big fan of those mentioned, or cannot tolerate dairy, try a green smoothie to boost his daily vitamin intake. One cup of greens, any frozen fruit, a banana and some honey can be a daily boost of vitamin for your child. If your little one has malabsorption or leaky gut, deteriorating eyesight or is getting sick a lot, a vitamin A supplement (around 2000 IU) will do the trick.

B vitamins: The entire B vitamin family is integral in your child’s growing body—B2, B3, B6 , B9 and B12 specifically. These help aid in metabolism , energy production and play a prominent role in the mental health and cognition of children. If you notice your child is stressed, anxious, prone to picking up every bug and virus, you might want to consider supplementing with a B-vitamin. Start with a liquid B vitamin, ideally with each of the ones listed. Vegetarian and vegan diets are particularly low in B vitamins, so nutritional yeast may make for a good supplement for them. Aim for 15 mg of each B element for children over age four, 200 ug of folic acid and 200 mg B12 children over age four. You can increase to 400 folic acid/folate and 500 ug B12 for children over age 10.

Vitamin C: For healthy muscles, tissue and skin cells, this vitamin is crucial. It’s also a well-known immune booster. You can easily find it in a variety of fruits and vegetables (oranges, red peppers, kale, brussel sprouts, and strawberries). Many times when a child first starts showing the symptoms of getting sick—like when they’re extra tired, irritable or having trouble sleeping, prior to the runny nose and cough—I’ll start supplementing with 500 mg of a chewable vitamin C for children ages five or older. Children ages 12 and older can take 1 gram.

Vitamin D: Nearly 90 percent of the vitamin D our body gets comes from sun exposure, but you don’t want your child over-exposed to the sun’s harmful rays. Instead, you can fuel him up with D-rich foods like salmon and milk, if he can tolerate dairy. Little (and adult) bodies need D to properly absorb calcium. It also helps promote bone health and tooth formation, and helps with immunity. Reach for 1000 IU of vitamin D at the first sign of illness and use it for at least three days.

Calcium: All parents want their kids to have strong bones! They’re important as children grow and develop. If your little one avoids dairy, or has a dairy allergy, calcium-rich nuts like almonds and leafy greens can be a great option (almond milk with calcium can also be used as an alternative). However, if your child cannot do milk or nuts and needs to supplement, consider doing 200 mg of chelated calcium for all ages.

Iron: Iron builds muscle, helps with focus and is essential for healthy red blood cells. Often low in many children, iron plays a role in focus, energy and hormone metabolism. I typically suspect low iron in children when they have inattention, fatigue or muscle weakness.  A simple prick test can help detect your child’s iron levels. I usually recommend 15 mg of elemental iron daily.

Magnesium: Magnesium is a very common nutritional deficiency and can result in constipation, anxiety, insomnia and poor hormone metabolism. Magnesium is found naturally in nuts, seeds and many vegetables. Our current soil however is also deficient in magnesium. If your little one is struggling to have regular or soft bowel movements, or is overly anxious, has nervous energy and/or irritable, try adding in magnesium with Kids Natural Calm (which is found over the counter). This powder is easily added to cold or warm water and the natural flavors taste delicious! I love packing this product on road or plane trips when I know my kids may struggle with calming down in a new environment to sleep or have travel-related constipation.

Multi-vitamin: So I mentioned above that I am not the biggest fan of multivitamins because there’s no one-size fits all. However, I do recommend reaching for one of these when you cannot identify the key nutrients your child may need above their regular diet.

Fat: Not technically a vitamin, but it is vitally important for vitamin absorption. Vitamins A, D, E and K are all fat soluble; meaning they have to be consumed with fat. Healthy unsaturated fats like olive oil, avocados and nuts are all- important for children and should not be restricted. The omega 3 fats help everything from ADHD to eczema. Omega 3 fats are found in fatty fishes, nuts, and seeds like flax or chia. Often, children do not have a palate for these foods, so omega 3 supplements will appear frequently on my treatment plans. I love the Nordic Naturals Omega Chews for kids and they are a popular pic among pediatric patients at our Centres in Atlanta.

I can’t mention anything about healthy fats without mentioning fat malabsorption. This may be a new concept to some of you, but it’s extremely important. It matters in all of us but in children it’s extremely important because when they’re not absorbing fats, they cannot absorb nutrients or supplements, which can lead to everything from developmental delay, mental health issues, poor immunity and more. When fats are improperly broken down, children develop leaky gut, which can cause all types of issues.  If you suspect your child isn’t breaking down all of the healthy fats your providing him with through diet and supplementation, have his stool checked for fats or look in the toilet—stools that float are often not absorbing, while those that skin are. I recommend an enzyme with lipase and ox bile to help metabolize fat and often prescribe creon.

A few things to keep in mind about children and supplements:

• The word “natural” doesn’t always mean safe, especially when it’s a product you’re buying over the counter. Federal regulations for dietary supplements are less strict than for prescription medication, so you’ll want to get a recommendation from—or run a certain brand by—your pediatrician.
• In addition, keep in mind that dosing supplements in children is dependent on age as well as weight, since that measurement can fluctuate quite a bit. Ideally, supplements are determined once a child’s key issues and weaknesses are identified.
• Most children tolerate supplements better after food rather than on an empty stomach.