Written by Sandra Graba, MD
With so many vitamin options available, choosing the right vitamin for your child can be a daunting task.
Not all vitamins are all the same! The age and health history of your child are important factors to consider. A premature infant will have different requirements than a healthy 2 year old.
My goal here is to give a sense of direction in the vitamin isle, but it is important to discuss individual needs with your doctor.
Often doctors will prescribe vitamins for your newborn, so that makes it much easier! Other times, they tell you the name of the vitamin to choose in the isle. The vitamins your pediatrician recommends at this age is a little different depending on whether your breastfeeding your child or not.
Vitamins For Newborns
Vitamin K is very important in the newborn period but thankfully all babies get a vitamin K shot right at birth and the subsequent needs are met by breastmilk and formula. Breast-fed babies need extra vitamin D: 400 IU and iron supplement of ~ 11mg daily starting at 6 months.
Six Month Old
Typically, pediatricians will give D-visol (vitamin D) through 6 months of age, then switch to poly-vi-sol (multivitamin) with iron starting at 6 months, but some pediatricians opt to start the multivitamin from the start. Either choice is fine. All formulas are iron and vitamin fortified to contain at least the recommended daily amounts for the first year of life.
12 Month Old
After the 1st birthday, life is completely different! Your little baby is turning into a toddler and with it comes a whole new challenge: feeding. We switch them from their vitamin fortified breastmilk or formula to whole milk and table foods.
The tricky part is that toddlers are inherently picky! They manage to get enough calories through all of the “picking” of their food, but do they get enough vitamins and minerals?
Consider this: One cup of whole milk (about 8 oz) has only ¼ of the recommended daily allowance of vitamin D, ½ to 1/3 of the amount of calcium, and no iron. This means that your child will need to drink 16- 32 oz (2-4 glasses) of milk to get all the vitamin D and calcium they need – but you would still need to consider their iron needs.
Also, high volume of milk intake (more than 16 oz a day) can lead to anemia. Translation: your mom was right that milk is good for you but there is too much of a good thing.
So, what to do? In general, all vitamins and minerals are important, but some are easier to get them to eat than others. We can focus on a few important ones: vitamin D, calcium, iron, B vitamins, and folate.
Iron is important in red blood cell formation and neurologic development among other things. It is plentiful in meat, dark leafy green vegetables, beans, tofu, cereal and bread. 1-3 year olds need about 7mg per day, 4-18 year olds about 10-12 mg per day except for menstruating adolescent girls who need about 15mg daily.
B vitamins are important for production of oxygen carrying cells and can be found in fish, poultry, meat, eggs, dairy, leafy green vegetables, beans/peas, breads and cereals. B6 and B12 are fairly easy to get in the diet. 1-8 year olds need about 0.5 – 0.6 mg per day and teenagers need about 1.0-1.3 mg/day.
Calcium is very important for growing bones. Some sources of calcium include cheese, yogurt, orange juice, fortified breads and cereals, spinach, and salmon. 1-3 year olds need ~ 500 mg a day, 4-8 yo need ~ 800 mg a day. and 9-18 year olds need ~ 1,300 mg a day.
Vitamin D is a tough one! The best source is the sun…but we spend most of our year bundled in sweaters, coats, scarves…you get the idea. There are a few natural food sources: cod liver oil, salmon, mackerel, tuna, liver, and egg yolk. My 3 year old definitely won’t eat liver. Thankfully, cereals and dairy are fortified. The current recommendation for all age groups is a minimum of 400 IU daily.
After sorting through the vitamin isle, it seems that either Flintstones’ Complete – it is ½ tablet for 2-3 year olds and a full tablet for older than 4 years or Centrum Kids Complete Multivitamin are the best bet for toddlers and school age kids.
Even still, they don’t provide 100% of the calcium and vitamin D in 2-3 year olds but they are pretty good for iron, B vitamins, and folate.
There are so many character and flavor choices available but the nutrition guide for these two vitamin types can at least provide a guide to compare the other vitamins to while your head is spinning in the isle. Overall, remember that vitamin supplements are just that – supplements to a healthy diet. Children with any special needs will have different requirements.
A few words on Gummy vitamins…
Though they taste good and are probably easier to get your children to take, the vast majority I have seen fall short in providing the necessary daily nutrients. Many contain ¼ to ½ the amount of vitamin D and 10% or less of the needed calcium;No gummies contain iron. Many have the minimum amount of B vitamins but less than the recommended folate. Each gummy does, however, contain about 3g of sugar. If the serving size for your child is 2 gummies, giving them their vitamins is about the same as giving them a ¼ cup of soda!
Dr. Graba is a practicing pediatrician at Salud Pediatrics.