As parents, we always want to best for our kids, especially when it comes to their health. We get worried and lose sleep when they get sick. And we get paranoid when they don’t eat well, or they look smaller compared to other kids their age. One common question moms ask, “Ano bang magandang vitamins para sa anak ko?”. And then we get confused seeing all the ads claiming that their brand will make your child smarter, stronger or taller. Before we even get to that, the first question we must ask is, “Are vitamins really necessary?”
Dr. Elena Boado and Dr. Jaymie Tang, both pediatricians, shed some light on this matter.
Are vitamins really necessary?
Both doctors agree that vitamins, in general, are necessary for growth and for healthy bodily function for both children and adults. The complete caloric requirement, as well as the needed vitamins and nutrients, can be fulfilled by a daily well-balanced and appropriately recommended food intake of children. Dr. Boado says that we also get these from our environment, the lifestyle we lead or from our very own bodies. So, vitamin supplements are only given to those who are nutritionally deficient, fail to meet expected growth, have restricted diets (pure vegan mothers) or chronically ill with specific vitamin deficiencies.
So how do I know if my child needs these supplements?
According to Dr.Tang, there are vitamin deficiency symptoms that you can watch out for like growth delay, poor weight gain, delay in gross motor development, delayed tooth eruption, irritability, and increased susceptibility to infection. She also shared that according to the guidelines from the American Academy of Pediatrics (AAP), Philippine Pediatrics Society (PPS), and recommendations from the Department of Health (DOH), Vitamin A, Vitamin D, and Iron are the essential vitamins and minerals that are to be routinely supplemented to children.
Dr. Boado adds, “Babies that are not exclusively breastfed, had a rocky course prenatally, born prematurely, or were sick as a newborn may need supplements. Children who are sickly, undergoing chemotherapy, have metabolic deficiencies also need help in the form of specific supplements. Picky eaters, especially those after 3 years old, and those who do not have enough nutrients in their daily diet may also need these supplements. Babies and children who do not meet their standard growth curves, may also need additional nutrients in terms of food and milk intake, and then supplemented with vitamins.”
Of course, it is always best to check early on with your doctor and have your baby or child assessed.
What are the most common supplements?
Vitamins and micronutrients are generally lumped together as supplements to our usual food intake. These supplements are usually multivitamins, multivitamins with buclizine, ascorbic acid (vitamin C), vitamin C with zinc and ferrous sulfate (iron). The over the counter supplements or multi-vitamins often contain fat-soluble vitamins (vitamins A, D, E, and K) as well as others like Vitamin B complex, Vitamin D, Vitamin C, iron, zinc, calcium, taurine, lysine, fluoride, and folate. These vitamins have different functions for growth, development, and immunity. The additional Buclizine in these supplements acts as an appetite stimulant. But as all substances, should be taken in moderation, because of possible side effects or poisoning events.
Are there vitamins that should only be taken for a specific period of time?
Yes, most vitamins can be produced by our bodies or ingested. Any chemical ingested or taken in excess can be harmful especially of the body cannot store it properly or excrete it poorly. Tests can be done to determine vitamin deficiency but can be quite expensive. Doctors instead use clinical parameters to identify specific needs.
The Department of Health recommends Vitamin A supplementation by giving 1 dose between 6-11 months and then subsequently from 12-59 months. Iron supplementation is recommended for infants, especially those who are exclusively breastfed, starting at 6 months of age. The iron supplement is given for 3 months. Children between 1-5 years old is also a target age group. They are given an iron supplement for 3-6 months, with supervised administration. The high incidence of Vitamin D deficiency worldwide prompted the AAP to recommend supplementation too. The following are the recommended Vitamin D supplementation for different age groups: Infants up to age 12 months require 400 international units (IU) daily of vitamin D; children and adolescents require 600 IU daily. These may be acquired through food fortified with vitamin D, including milk, orange juice, cereals, and yogurt. Vitamin D also can be synthesized by the skin through ultraviolet (UV) light or sun exposure. However, due to the unpredictability of sun exposure, as well as the increased risk of skin cancer, consumption of vitamin D through diet is the preferred way to ensure its adequate intake.
Other time-limited vitamins include those that are needed because of the seasons. So for patients who have winters and have reduced sunlight exposure, it is common in their regions to be supplemented with Vitamin D. Sunlight helps activate the production of usable vitamin D in our bodies. Iron is usually needed during fast growth periods. So this is usually prescribed to premature babies who have exponential growth but limited stores, in pre-pubescents in the cusp of adolescence (girls about the have their periods), and puberty. In excess, iron could be a poison in the body, so appropriate doses should also be strictly followed. Vitamins that enhance appetite are also usually given in a time-limited manner because they are only supposed to jumpstart the appetite of the child while the food behavioral aspects are improved. Once the behavior and habits are formed, usually these supplements are no longer needed.
What should parents and guardians remember when giving supplements?
Parents and guardians must always remember that vitamin supplements are there just to bridge the gap. These are given to children with specific conditions (i.e. infants, children with highly selective food intake, children with undernutrition, children with chronic diseases, etc). Adequate caloric intake and a healthy variety of food is still the best way to provide adequate nutrition to our children. Let’s also remember that our children watch what we do, so if we take in the healthy habit of including a wide variety of proteins, and carbs and fruits and veggies in our diet, our children will follow suit.
Special thanks to Dr. Maria Elena Boado MD, DPPS (Centuria Medical Center, Makati & Patient First Medical Center) and Dr. Jaymie Louise Tang, MD, DPPS (Medical City Pasig).