Some parents make a multivitamin part of the breakfast routine, others never do, but whether to multi or not to multi is one of the most frequently asked questions in my practice. There is no real consensus on it — experts disagree about vitamins for children who don’t display signs of deficiency. The naysayers claim that children don’t need large amounts of vitamins and minerals and say that even picky eaters should get enough from food. On the other side are those who think of a basic children’s multivitamin as an “insurance policy” that can fill in the gaps of a not-so-great diet.
In my office, we approach this on a case-by-case basis. If it’s clear that a kid is not eating a well-rounded diet, we may recommend a children’s “multi” — and possibly “calcium plus D” (more about that below). If we conclude that the child is doing fine, we try to reassure the parent that a multi isn't needed.
If you do decide to give your child a multivitamin (and your pediatrician agrees),choose one that’s formulated specifically for children, and make sure it provides about 100 percent (not much more!) of the RDA for all the vitamins and minerals listed. Here are a few reputable children's multivitamins:
- Flintstones Complete
- Puritan’s Pride Multi Gummies
- One-a-Day Kids Complete (chewable, not their gummies)
- Freeda Vitalets (100% vegetarian, and yeast-, gluten-, and lactose-free)
Follow the dosage listed on the label, keep the jar tightly capped on a high shelf, and make sure your kids know that vitamins are NOT candy. Children can overdose on vitamins, so be vigilant!
Calcium and D
After multivitamins, calcium supplements are what parents ask me about the most. It’s true that children don’t drink as much milk as they used to — and therefore aren’t getting calcium from one of the best sources around. But that's the reason a lot of kid-friendly foods are now fortified with calcium. So before going the supplement route, parents should do a weekly “calcium tally” with their children to determine whether it’s needed. (Don’t worry if they fall short on certain days, since it’s their overall weekly intake that matters most in the long run.)
- Ages 1–3 = 500 mg a day
- Ages 4–8 = 800 mg a day
- Ages 9–18 = 1,300 mg a day
If your child comes up short on the weekly tally and you can't find a way to get more calcium-rich foods onto the menu, talk to your pediatrician. If you decide to add a supplement, look for one that contains vitamin D, which we need to help absorb calcium. (We used to get it from exposure to sunlight, but now that we’re slathering on sunscreen, vitamin D deficiency has become a big problem in this country.) D3 — or cholecalciferol — is the most potent form of D, so always look for it on the bottle.
Viactiv calcium chews come in a variety of flavors and tend to be well accepted by children of all ages. On the other hand, if your child has braces or is anything like my 14-year-old daughter, Jesse, who will not go near a chewy, you can resort to a pill. And if your child cannot swallow a pill, you can mash up one “Caltrate 600 plus D” and mix it in vanilla yogurt or pudding.
Fiber is also important for kids: Fiber-rich foods help regulate weight and mood, and they help prevent constipation. A great rule for determining how much daily fiber your child needs is “age + 5 grams.” For example, a ten-year-old child requires about 15 g of fiber a day.
First and foremost, try to increase fiber through kid-friendly whole grains, fruits, and vegetables. High-fiber breakfast cereals and grains are an easy way to provide a fiber fix. But if your child is struggling with chronic constipation and requires an extra dose, talk to your pediatrician about adding a fiber supplement. You can try some of the following:
- Benefiber powder
- Juice+Fibre (10 g fiber per 8-ounce box)
- Now’s Inulin Powder (found at Trader Joe’s)
Last but not least: Make sure your kids brush their teeth after taking chewable vitamins. Do not leave vitamins or any other supplements within reach of children. And be sure to talk to your child's doctor before you begin any vitamin or supplement routine.