Are Supplements the Right Choice for Your Child?

Many websites and social media posts encourage the use of supplements for children — sometimes with claims for treating specific medical conditions. How can you know which supplements your child needs, if any? Dr. Reshma Shah, a pediatrician interested in nutrition for children (especially plant-based nutrition), gives us sound guidance with straight talk about supplements.

How Do You Know if Your Child Needs Supplements?

“The best way to ensure that your child is meeting her nutritional needs is to focus on a balanced diet. Whenever possible, it is best to get nutrients from food,” says Dr. Shah. “For parents who struggle with getting their kids to eat a varied and balanced diet, a multivitamin can be useful. However, you should continue to encourage and support meeting nutritional needs through diet as much as possible.”

Although most children don’t need supplements, there are certain situations where a supplement may be indicated. A good time to talk to your child’s pediatrician about nutritional challenges is during the routine well-child exam. The pediatrician will assess your child’s growth, general health and need for nutritional deficiency screening. Some nutritional deficiencies in children noted by Dr. Shah are the following:

Iron deficiency anemia is the most common nutrient deficiency worldwide. It may be treated with a supplement, but parents should also include iron-rich foods in their child’s diet.
Vitamin D deficiency can be caused by a variety of factors. Some of these are skin pigment, obesity, use of sun protection and geographical latitude. Vitamin D deficiency can result in serious health problems in children, including rickets and poor bone health. In addition to sun exposure, most of the vitamin D we get is through supplementation, such as fortified milks, juices or pills. Because too much vitamin D can be toxic, always consult with your child’s pediatrician to decide if supplements are needed and, if so, the right dose.
Vitamin B12 deficiency can result from conditions that interfere with vitamin B12 absorption, such as certain medications or a plant-based/vegan diet.

Can Supplements Make Up for a Poor Diet?

One Austin mom worries that her son isn’t getting enough nutrients because all he will eat is fast food, sugary drinks, candy and cookies. She’s looking for a good multi-vitamin that can fill in the gap.

Dr. Shah responds, “The interplay of nutrients we consume in food is complex and rich. Although we have isolated many vitamins and minerals that are essential to health, the truth is that we do not have a full understanding of how these nutrients interact with one another, let alone come close to identifying them all. Fruits, vegetables, beans, whole grains, nuts and seeds have a variety of nutrients that cannot simply be replaced with a pill.”

Can Supplements Treat Health Problems?

Dr. Shah counsels, “When deciding whether or not to start giving your child a supplement, it’s important to weigh the risks vs. the benefits and to examine the reason you believe the supplement is needed.”

Many parents ask about the use of melatonin for sleep problems. Dr. Shah recommends a thorough review of sleep hygiene and routines before giving a pill. “Often, excessive screen time, lack of routine, caffeine intake, excessive homework, underlying mental health issues or a misunderstanding of sleep cycles and requirements are the culprit for inadequate sleep. Addressing the underlying problem will often resolve the issue without requiring any supplementation. It’s important to note that some of these problems (anxiety and excessive screen time) can be quite challenging to manage and may require quite a bit of patience and even outside support.”

Dr. Shah also cautions that supplements, including melatonin, are not uniformly regulated. “The quality, potency and even ingredient list can vary from one supplement to the next,” she notes. “Melatonin’s efficacy can vary from person to person, and the effects of long-term use in children is largely unknown. Consumerlab.com is a good resource for information about the safety and quality of health and nutrition products.”

Before starting your child on a supplement, Dr. Shah suggests you think about the following questions:

Is it evidence-based?
Will this be a temporary (if so, how long) or an ongoing supplement (which may be necessary in the case of vitamins B12 and D)?
What are the targeted endpoints?
Can my child get this nutrient from food?

What is a Balanced Diet for Your Child?

“Focus on providing your child a variety of whole foods that include a good balance of macronutrients (carbohydrates, protein and fat) as well as an abundant supply of micronutrients (vitamins and minerals),” recommends Dr. Shah. “A general rule of thumb is half the plate with fruits and vegetables, a quarter with protein, and a quarter with starch/grain. Plant sources of protein provide more than adequate protein, with the added benefit of generally being high in fiber.” To learn more, visit Dr. Shah’s website at ReshmaShahMD.com.