Walk down the children's vitamin aisle and you would think every child needs a daily gummy. The packaging is bright, the flavors are fun, and the claims about growth, focus and immunity are reassuring. But most healthy children who eat a reasonable variety of foods get what they need from their meals. There are, however, some important situations where a supplement genuinely helps. Here is how to tell the difference.
The general rule
The American Academy of Pediatrics says healthy children who eat a balanced diet usually do not need vitamin supplements. A varied diet with fruits, vegetables, grains, protein foods and dairy or fortified alternatives covers most needs. The MyPlate kids' resources offer practical ideas for balanced meals and snacks.
When a supplement often makes sense
Babies who are breastfed: vitamin D
Breast milk is excellent nutrition, but it is low in vitamin D. Pediatricians usually recommend 400 IU of vitamin D drops a day for breastfed and partially breastfed babies, starting in the first few days after birth. Formula is fortified, so formula-fed babies may not need extra. Ask your pediatrician.
Some babies and toddlers: iron
Iron is important for brain development. Babies born early, babies with low birth weight and some breastfed babies after about four to six months may need iron. Toddlers who drink a lot of cow's milk can become low in iron, because milk fills them up and can interfere with iron absorption. Your pediatrician can check with a simple blood test.
Very picky eaters
If your child eats only a handful of foods for a long stretch, a basic children's multivitamin is a reasonable safety net while you keep working on variety.
Vegan and some vegetarian children
Children on a fully plant-based diet need a reliable source of vitamin B12, and often vitamin D, iodine and omega-3 DHA. Iron and zinc also deserve attention. A registered dietitian can help plan meals.
Children with medical conditions
Kids with conditions that affect absorption, such as celiac disease, cystic fibrosis or inflammatory bowel disease, often need specific supplements prescribed by their care team.
Fluoride, in some areas
If your water supply is not fluoridated, your dentist or pediatrician may recommend fluoride. Do not give it without their advice, because too much can cause marks on the teeth.
What about omega-3s for brain development?
DHA, an omega-3 fat, is important for the developing brain and eyes. The best source is fish. The FDA and EPA recommend that children eat fish once or twice a week, choosing lower-mercury options. Evidence that DHA supplements boost learning or behavior in healthy kids is limited. See DHA for kids for more.
Safety first
Children's vitamins are one of the most common things young kids accidentally swallow, because they look and taste like candy.
- Store them up high and locked away, not on the counter.
- Never call vitamins candy.
- Be especially careful with iron. Iron overdose can be very dangerous for young children.
- Do not double up. If your child takes a multivitamin, check before adding another product, and look at fortified cereals and drinks too.
- Use children's products, not adult ones, unless your doctor says otherwise.
- Call Poison Control at 1-800-222-1222 in the US if your child swallows more than one dose of a supplement, or contact your local emergency number.
Melatonin deserves a special mention. Accidental melatonin ingestion by children has risen sharply in recent years. If you are considering melatonin for a child's sleep, talk to your pediatrician first. Read more in melatonin: what to know.
Choosing a children's vitamin
If you and your doctor decide a supplement makes sense:
- Choose one that provides about 100% of the Daily Value for your child's age, not several times more. See what % Daily Value means.
- Look for independent testing such as USP or NSF.
- Check the sugar content in gummies.
- Avoid products with herbs or "proprietary blends" for children.
Food habits matter more
The habits you build at the table will matter long after the vitamin bottle is empty. Eat together when you can, offer new foods many times without pressure, and let kids help in the kitchen. Our article on family meals and healthy habits has practical ideas.
The bottom line
Most healthy kids do not need a daily vitamin. Vitamin D for breastfed babies, iron in some cases, B12 for vegan kids, and a basic multivitamin for very picky eaters are the common exceptions. Talk to your pediatrician, store supplements safely, and focus on building good eating habits.