"Doctor, do I need to give my child vitamins?" asked the parents of the 15-month-old novice walker, the father of the 4-year-old new preschooler and the mother of the 15-year-old sophomore with the fresh driver's permit.
A diverse group indeed, but what these kids did have in common was that each was very healthy, growing along steady height and weight curves, and eating a respectable, if not always perfect, diet. So, I was able to say that no, I didn't feel that daily vitamin supplements were needed for this particular collection of kids.
In their Pediatric Nutrition Handbook, experts at the American Academy of Pediatrics comment that, "Supplemental vitamins are expensive and probably unnecessary for the healthy child older than 1 year who consumes a varied diet."
Without a doubt, there are children who can benefit from certain vitamin and mineral supplements. For patients who don't drink enough milk or have limited dairy intake due to lactose intolerance, targeted calcium and vitamin D supplementation can help promote bone health.
Purchase products carefully, however, since the academy notes that some of these supplements don't actually contain enough of the "marginal nutrients" such as calcium and zinc that are most likely to be deficient in young children's diets.
The AAP advises that vitamin and mineral supplementation be considered for children at "nutritional risk" due to eating disorders, chronic disease, failure-to-thrive, and deprivation or neglect. Kids participating in weight-loss programs for obesity management and children on vegetarian diets who do not consume an adequate amount of dairy products may also need supplements to fill in the nutritional gaps.
Ironically, it appears that kids who don't really need supplements are actually the most likely to be using them. In a 2009 study in the Archives of Pediatrics & Adolescent Medicine, researcher Dr. Ulfat Shaikh and colleagues report that approximately 30 percent of American children use vitamin and mineral supplements.
These young supplement takers tend to be better milk drinkers who are on lower fat and higher fiber diets, and who also achieve greater levels of physical activity and have better access to health care.
The AAP finds that vitamin and mineral use is often fueled by advertising as well as parental concerns. Recognizing that many parents just want a little insurance against any possible "shortcomings" in their child's diet, the pediatric group states that, "A vitamin pill containing the RDA given to the child daily, although unnecessary, probably does no harm."
Since excessive doses of the fat-soluble vitamins -- A, D, E and K -- and overdosage of iron supplements can be toxic, care should be exercised when dosing and storing these and other supplements. Vitamin and mineral supplements should be treated like medicine and kept out of reach of youngsters attracted by the wide variety of kid-friendly tastes, shapes and colors.
• Dr. Helen Minciotti is a mother of five and a pediatrician with a practice in Schaumburg. She formerly chaired the Department of Pediatrics at Northwest Community Hospital in Arlington Heights.