By Nicole Avena, PhD – Sept – Oct, 2019: Originally posted on Natural Practitioner Magazine.

Dietary supplements play a huge role in the lives of Americans. In fact, according to a 2018 CRN (Council of Responsible Nutrition) Consumer Survey, 75 percent of U.S. adults take supplements.1 For children aged 0-19, it is estimated that about one-third use dietary supplements.2 These numbers, as well as the industry, appear to be increasing each year.

Considering the growing (and immense) popularity of dietary supplements, you’re likely wondering if you should you be giving your children supplements. It makes sense to do so, especially since children need to get all the right vitamins and minerals for proper growth and development, and children’s diets aren’t exactly the best. According to the CDC (Centers for Disease Control and Prevention), most children in the U.S. do not meet the recommendations of fruit and vegetable intake on a daily basis.3

Despite this widespread use, the FDA (U.S. Food and Drug Administration) warns that dietary supplements are not intended (nor can they market themselves as such) to treat, diagnose, cure, or alleviate the effects of diseases.4 Yet, many rely on supplements for various reasons.

What Exactly is a Dietary Supplement?

The FDA defines dietary supplements as something that contains a “dietary ingredient.” This means the supplement can come in the form of vitamins, minerals, botanical or herbal products(including probiotics or algae like spirulina), amino acids or enzymes.4 Supplements can also take many forms, like pills, drinks, bars, powders, etc.

Children are given supplements for many different reasons by parents, such as to calm fussiness or an upset stomach, to improve overall health and wellness, to improve sports performance, to increase energy, to prevent, manage or treat disease, or even for weight loss.5,6

Which Vitamins Are Commonly Needed in Children?

According to the American Academy of Pediatrics (AAP), children who are well-fed and receive a normal, balanced diet do not need supplementation of any kind above the recommended dietary allowances.7 However, the AAP also points out that many children (athletes and non-athletes) do not get enough iron and/or calcium in their diets.8 We also know that many children do not eat the recommended amount of fruits and vegetables each day, thus children with a poor appetite or those who drink a lot of sugar-sweetened beverages like sodas or juices typically may need a supplement as well.6

In addition to possibly needing iron and calcium supplementation, the AAP recommends that children receive some sort of vitamin D supplementation if they are not consuming at least 32 oz. of vitamin D-fortified milk each day.8

Certain dietary restrictions or conditions can also call for supplementation, even if your child is well-fed. For example, children who are vegetarian or vegan may need a vitamin B12 supplement, since it’s only found in animal-based foods and products. Children who have celiac disease, Crohn’s disease or other chronic medical conditions (such as severe allergies) that interfere with nutrient intake or absorption may also need to take various supplements.

What Are the Benefits of Supplementation in Children?

If your child falls into one of the “at-risk” categories for nutritional deficiencies, then supplementation may be a good solution, if it is not possible to solve the problem with food alone. Nutrient deficiencies in children can lead to a variety of issues, such as stunted growth, cognitive delay, weakened immune system and increased risk of disease.9,10

Thus, giving your child the necessary supplements he needs, or even just a multivitamin, may increase his energy, improve focus in school, improve mood, and boost his immune system so he feels better overall.11 Especially if it turns out that your child is deficient in a certain vitamin or mineral, you could really make a difference by correcting that deficiency with a simple supplement.

Three Things You Should Know About Supplements Before You Buy Them

Federal regulations for supplements are less strict (if at all) than prescription and over-the-counter drugs, therefore contamination, safety and quality come into question. For example, many dietary supplements have been found to contain ingredients not listed on the label, including allergens or other contaminants like drugs, metals or chemicals. This could also mean that the supplement is mostly a filler, and the listed ingredients are only a very small portion of what’s in the product.

This also brings us to the next point, that “natural” doesn’t necessarily mean “safe.” So not only do supplements run the risk of having potentially harmful ingredients not listed on the label, supplements could also have side effects on their own or when taken with other medications. Even basic supplements like vitamins and minerals can be problematic, since some like vitamins A, C, or D can produce toxic symptoms in children (and adults) if given in large doses.7

Lastly, using supplements improperly can also be harmful, especially when it comes to children. Reports show that about 4,500 children go to the emergency room each year due to dietary supplements. Most of the time, this was due to taking a supplement unsupervised.4,5

Despite the risks involved, there is value in dietary supplements for children. Ask your child’s health care provider before starting any supplement regimen, and discuss any safety concerns or possible side effects.

Which Supplements Are Recommended For Children?

First of all, you’ll want to look for vitamins that are free of artificial colors, additives, sweeteners or flavors. It’s important to find a product that is as natural as possible. Something else to keep in mind is sugar. Since children’s supplements are, well, for kids, they are typically loaded with sugar (especially gummies). Always double-check the dosage as well, and try to find supplements that are geared towards children since they typically will provide a safe amount, versus adult brands.

As a kid, I remember taking vitamins and hating them for their awful flavor. I also didn’t like the idea of swallowing pills, so I was stuck with chalk-like chewables. Now, there are brands like Frunutta that make taking supplements way easier for kids. Specifically, Frunutta created sublingual vitamins that quickly dissolve under the tongue and they’re clean—no artificial colors, fillers or chemicals. So in addition to avoiding artificial ingredients, look for something that your child will enjoy or not mind taking. This will make both of your lives easier.

When it comes to giving something to your newborn, baby or toddler, you’ll want to go with a trusted brand like Childlife Essentials. They are a brand that is focused on baby, and all products are alcohol-, gluten- and GMO (genetically modified organism) free, and 100 percent natural. I recommend their organic vitamin D3, since one dose is 400 IU, which is the recommended limit for newborns under 1 year.12 In addition, the ingredients are simple—vitamin D3, organic virgin olive oil, and natural berry flavor. Also, because it’s liquid and the serving size is one drop, it is a super easy supplement to give to your little one.

If you’re unsure if your child really needs a supplement but want to find a way to help improve your child’s health, you can start with a prebiotic. With all the research today that shows how important gut health is to health, a prebiotic supplement could be a great starting point when thinking about boosting your child’s health through supplementation. Prebiotics, as far as we know, lack severe or life-threatening side effects and have been positively associated with improvements in many aspects of human health.13 I suggest trying Prebiotin, a popular prebiotic fiber supplement that can help to increase calcium and magnesium absorption, increase bone density and may even reduce intestinal infections, all of which are important for child health.

Final Thoughts

Finding the right (and safe) supplement may sound scary, or like a difficult task, but really it comes down to doing your research. See what’s out there, compare and don’t be afraid to ask questions to your child’s doctor. Although the dietary supplement industry can seem mysterious, thanks to the lax regulation from the FDA, there are good brands out there that are trustworthy.

As the AAP recommends, consider using dietary supplements only in the event that your child may be at risk of nutritional deficiencies to avoid any unwanted side effects or the chance of taking too much of any one nutrient. If you decide to give your child a supplement, remember to always look at the ingredients label, check for third party testing, and double check with your child’s doctor to make sure it’s safe.

References:

  1. 2018 CRN Consumer Survey on Dietary Supplements. Retrieved from www.crnusa.org/CRNConsumerSurvey
  2. Qato DM, Alexander GC, Guadamuz JS, et al. Prevalence of Dietary Supplement Use in US Children and Adolescents, 2003-2014. 2018. JAMA Pediatr 172(8):
    780-782. Retrieved from https://jamanetwork.com/journals/jamapediatrics/fullarticle/2685282
  3. CDC: 2018 State Indicator Report on Fruits and Vegetables. Retrieved from www.cdc.gov/nutrition/downloads/fruits-vegetables/2018/2018-fruit-vegetable-
    report-508.pdf
  4. US Food and Drug Administration. FDA Dietary Supplements 101. Retrieved from www.fda.gov/consumers/consumer-updates/fda-101-dietary-supplements.
  5. National Center for Complementary and Integrative Health. 10 Things To Know About Dietary Supplements for Children and Teens. Retrieved from https://nccih.nih.gov/health/tips/children
  6. Academy of Nutrition and Dietetics. Does My Child Need a Supplement? 2019. Retrieved from www.eatright.org/food/vitamins-and-supplements/dietary-supplements/does-my-child-need-a-supplement
  7. American Academy of Pediatrics. AAP Where We Stand: Vitamins. 2014. Retrieved from www.healthychildren.org/English/healthy-living/nutrition/Pages/Where-We-Stand-Vitamins.aspx
  8. American Academy of Pediatrics. AAP Nutrition and Supplement Use. 2012. Retrieved from www.healthychildren.org/English/healthy-living/nutrition/Pages/Nutritionand-Supplement-Use.aspx
  9. UNICEF. Micronutrients. 2018. Retrieved from www.unicef.org/nutrition/index_iodine.html
  10. National Center for Complementary and Integrative Health. Children and Dietary Supplements: What the Science Says. 2012. Retrieved from https://nccih.nih.gov/health/providers/digest/children-science
  11. Haskell CF, Scholey AB, Jackson PA, et al. Cognitive and Mood Effects in Healthy Children During 12 Weeks’ Supplementation With Multi-Vitamins/Minerals. Br J Nutr 2008; 100(5): 1086-1096. Retrieved from www.ncbi.nlm.nih.gov/pubmed/18507881
  12. American Academy of Pediatrics. AAP Vitamin D: On The Double. 2016. Retrieved from www.healthychildren.org/English/healthy-living/nutrition/Pages/Vitamin-D-On-the-Double.aspx
  13. Davani-Davari D, Negahdaripour M, Karimzadeh I, et al. Prebiotics: Defi nition, Types, Sources, Mechanisms, and Clinical Applications. 2019. Foods 8(3):92. Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC6463098/
Dr. Nicole Avena

Dr. Nicole Avena is a research neuroscientist and expert in the fields of nutrition, diet and addiction, with a special focus on nutrition during early life and pregnancy. Her research achievements have been honored by awards from several groups including the New York Academy of Sciences, the American Psychological Association, and the National Institute on Drug Abuse. She is an assistant professor of neuroscience at the Ichan School of Medicine at Mount Sinai, in New York, NY and is a visiting professor of health psychology at Princeton University in New Jersey. Dr. Avena has written several books, including What to Eat When You’re Pregnant and What to Feed Your Baby and Toddler. She regularly appears as a science expert on the Dr. Oz Show, Good Day NY and The Doctors, as well as many other news programs. Her work has been featured in Bloomberg Business Week, Time Magazine for Kids, The New York Times, Shape, Men’s Health, Details, as well as many other periodicals. Dr. Avena blogs for Psychology Today, is a member of the Penguin Random House Speakers Bureau and has the No. 2 most watched TED-ED Health talk, “How Sugar Affects Your Brain.” You can follow Dr. Avena on Twitter (@DrNicoleAvena), Facebook (www.facebook.com/DrNicoleAvena) and Instagram (@drnicoleavena), or visit www.drnicoleavena.com.

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