Multivitamins for Kids?

Many parents don't know whether to give their children vitamins. The vitamin industry is made up of countless products that can leave parents feeling overwhelmed. We talked to Dr. Katie Alvord, local pediatrician, about whether children need vitamins. Here's what she had to say:

My patients have asked me many times whether their child should be taking a multivitamin. This is a very popular subject with lots of questions involved. I think the easiest way to present the information is to break it down by ages.

• Premature babies: A multivitamin drop is recommended beginning at birth in premature babies.
• Breast-fed babies: Breast milk does not provide enough vitamin D to meet daily requirements. By 4 months of age, make sure you have started a multivitamin drop that contains vitamin D. If the nursing mom is a strict vegetarian, start the drops at birth.
• Formula-fed or mix of breast- and formula-fed babies: A multivitamin drop can be administered if the child is not taking 32 ounces of formula per day.Once your baby has been weaned from the bottle or breast and is tolerating 24 ounces of vitamin D-fortified milk, you may discontinue the multivitamin drops. This is usually right around 12 months.
• Older children: The average American child who does not have an underlying condition and eats a healthy diet of dairy, fruits, vegetables and protein does not require vitamin supplementation. However, there are a few exceptions to be aware of:
  If your family eats a vegetarian diet or if your child might not be eating adequate dairy products, fish and fortified cereals, supplementation with vitamin B12 is recommended. Menstruating adolescents need iron-rich diets; that includes foods like beef, turkey, pork, spinach, beans and prunes. There are some cereals that include modest amounts of iron. If your teenage daughter is not eating any meats or iron- rich vegetables/legumes, I recommend iron supplementation.

So what do I buy?
For infants and toddlers, a multivitamin drop with iron or the individual vitamins A, C, D formulation along with iron. I have found that some of the multivitamin drops have a stronger flavor. If your child will not take them, use the A, C, D formulation. This has much less of a flavor and scent. The recommended dose is one ml per day by a dropper or by mixing it into a bottle of milk.

An important note about Vitamin D and calcium.
We absorb vitamin D from dairy sources and sunlight exposure. We require 400 International Units (IU) a day. There is more and more evidence of Vitamin D deficiency in our nation. Because we cannot quantify sunlight exposure and advocate daily sunscreen use, we need to obtain our vitamin D through our food. A child should be drinking vitamin D-fortified milk or juices and be eating fish like salmon or tuna. If you find your child is not drinking three 8-ounce cups of milk a day or eating fish, start a supplement. Calcium is critical for bone development and growth. It's found in milk, yogurt, cheeses, broccoli and kale. There are a whole host of calcium-fortified foods like juices and cereals that parents can provide.

Can multivitamins cause harm?
Mega doses of some vitamins have been proven to be toxic. Parents should remember that vitamins are medicine. Place vitamin bottles in safe place, as a child may view them as candy and consume the whole bottle. If this occurs, please seek medical treatment for potential toxicities.