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Vitamins and Supplements for Kids: Do They Need Them?
Dr. Mercedez Cruz leads a discussion on if and when children should be given vitamins or supplements, and how to do so safely.
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Learn more about Mercedez C. Cruz, MD
Mercedez C. Cruz, MD
Dr. Mercedez Cruz is a board-certified pediatrician with BayCare Medical Group, serving the Land O'Lakes community, where she sees patients from birth to 18 years old. She completed her undergraduate degree in biology from the University of South Florida in Tampa, Florida. She then earned her Doctor of Medicine from Howard University College of Medicine in Washington, DC. Dr. Cruz continued her medical education by completing a pediatric residency at Baylor College of Medicine/Texas Children’s Hospital in Houston, Texas specifically in the Primary Care Leaders Evaluating and Addressing Disparities (LEAD) Program. Dr. Cruz is devoted to ensuring the longevity of her patients’ health and developing long-lasting relationships with them while providing compassionate well-rounded care. She takes the time to understand symptoms and give correct diagnoses to ensure the continued health of all her patients. She conducts various follow-ups, well-baby check-ups, annual physical exams, sports physicals and administers routine childhood vaccines. Dr. Cruz is part of BayCare Medical Group serving the Tampa, Florida area. She is also certified in basic cardiac life support and remains up to date with the rapidly evolving field of pediatric medicine as a member of the American Academy of Pediatrics along with the Florida Medical Association.Learn more about Mercedez C. Cruz, MD
Transcription:
Vitamins and Supplements for Kids: Do They Need Them?
Intro: This is BayCare HealthChat, another podcast from BayCare Health System.
Caitlin Whyte: Welcome to BayCare HealthChat. I'm Caitlin Whyte. To supplement or not to supplement? That is today's question. We're talking all about supplements, vitamins, and when they should be used with our children. Joining us is Dr. Mercedez Cruz, a pediatrician with BayCare Medical Group.
So start us off here, Dr. Cruz, with the official AAP or American Academy of Pediatrics' stance on supplements and vitamins please.
Mercedez C. Cruz, MD: Okay. So the AAP believes that all healthy children receiving a well-balanced diet do not need any vitamin supplementation over or above what we already recommend in the dietary allowances and the most important one of them being vitamin D. So for infants, it'd be 400 units per day, and then for children greater than one, 600 units per day.
Caitlin Whyte: So how should we start to get vitamins and minerals into a healthy, balanced diet for our kids?
Mercedez C. Cruz, MD: So the best way to start is just by introducing all of the food groups, so vegetables, fruits, carbohydrates or starches, and then proteins. And then if they are vegetarians, you would do any plant-based proteins and just making sure that children start eating them starting around six months of age or even four months for pureed foods. But for actual vegetables and fruits, you can start at six months with foods they can easily mash. And so the best way to do is earlier introduction, like while they're still a baby to make sure they enjoy the flavor.
Caitlin Whyte: Gotcha. Well, let's move on into infants. Infants who are breastfed or premature, what are their vitamin recommendations?
Mercedez C. Cruz, MD: For infants who are breastfed, solely breastfed more than formula feeding, we recommend daily vitamin D drops, which are also over-the-counter. Sometimes pediatricians prescribe them. And it's the same number I stated, which is 400 units, so it's about one of the droppers per day. And then for premature infants, you would discuss this with your pediatrician or your doctor prior to leaving the hospital, but we usually recommend Poly-Vi-Sol With Iron, which is basically a multivitamin for premature infants.
Caitlin Whyte: Wonderful. Now, I know some pediatric population specifically benefit from vitamins more than others. Can you tell us about those?
Mercedez C. Cruz, MD: Generally, if you have a child who we classify as a picky eater, many parents are familiar. Picky eaters tend to maybe only want to eat the carbs or the macaroni and cheese. We recommend those children take the over-the-counter daily multivitamin for kids. There's no specific brand we recommend. It can be generic. And then certain kids with chronic medical conditions, such as cystic fibrosis or sickle cell disease, we want to make sure their diets are high in iron because they're more prone to anemia or any child with a chronic medical illness, especially children with GI chronic medical illnesses, they're more likely to lose and not retain enough iron in their diet, which causes them to have a low blood level. And then kids on a vegetarian or vegan diet or any other restricted diet definitely should be taking a multivitamin. And there should be a focus on finding a good amount of protein or if needed, if discussed with the pediatrician, some protein supplements, but mainly just protein via plants and making sure there's a focus on getting enough.
Caitlin Whyte: Now, some vitamins and minerals that are critical for growing kids. We have vitamin A, calcium, vitamin D and iron. How do these vitamins help promote health in children?
Mercedez C. Cruz, MD: So I'll start off with iron because I was just mentioning that. That makes sure you have a normal amount of blood flow, which helps with your oxygenation, makes you feel awake and alert, pretty much helps your whole body. So iron is a very important mineral for your circulation and staying alive and breathing well. Vitamin A, many may know you can get that from carrots and it really helps with your vision. Calcium and vitamin D go hand in hand. You can get that from different various dairy products. So if you have a child that hates milk or won't eat any cheese, you can just alternate with maybe yogurts because most kids like yogurts with less sugar in them.
Caitlin Whyte: Now, of course, I want to focus on safety regarding vitamins. I remember my mom was always telling us, you know, we can only have one Flintstone Vitamin a day because they were really good. But can you tell us about safety and vitamins with our kids?
Mercedez C. Cruz, MD: Too much of anything is a bad thing even if it is a vitamin, which is kind of the general rule in medicine or in life. And there are certain syndromes that come along with taking too much, vitaminosis is what we call them. But very commonly, the child may experience nausea, sometimes rashes, headaches, and even more serious GI side effects or gastrointestinal side effects such as vomiting and diarrhea. It's important to keep adult vitamins or even the children's vitamins locked away in a safe place because they make them extremely tasty nowadays and coated in sugar and kids want to eat them exactly like candy.
Caitlin Whyte: Now, a lot of our kids, you know, they're athletes, they're out there, they're active, they're working out. What are supplement recommendations for children who are athletes?
Mercedez C. Cruz, MD: Great question. And so according to the AAP and along with the AAP’s association with HealthyChildren.org, there's an article that states and we all agree, there is no supplementation that is needed for athletes as long as they are eating a well-balanced diet. I get this commonly in my clinic with my teenagers coming and saying, "Oh, my coach says I need to take creatine or I need to start taking protein supplements," and we do not recommend that because the body during puberty has rapid changes that are going to adjust without the supplementation that's needed. And so it could be a little bit on the dangerous side to add extra protein that's not needed going back to our previous question. So the AAP's stance is that making sure they're well hydrated and that they can eat their protein and not take it as a supplement. And the article gives great examples of like eating chicken right after a very intense workout or Greek yogurt, something with a lot of protein in it can help after working out as well.
Caitlin Whyte: Well, doctor, a lot of great tips here. Is there anything else you'd like our listeners and families to know about supplements and vitamins in our kids?
Mercedez C. Cruz, MD: Just know most of all of the parents out here are doing everything that they need to do to make sure their child has a very healthy diet, and so feel free to just stick to what you're doing and avoid adding any unnecessary supplements and speak with your pediatrician about if your child needs a multivitamin or not, especially if you know you give your child fruits and vegetables and they eat meat sometimes, or they eat sources of protein and dairy.
Caitlin Whyte: Well, it's always great to review this information, doctor. Thank you for sharing today. For more information on pediatric care at BayCare visit BayCareKids.org. Please remember to subscribe, rate and review this podcast and all of the other BayCare podcasts. For more health tips and updates, follow us on your social channels. This has been another episode of BayCare HealthChat. I'm Caitlin Whyte. Stay well.
Vitamins and Supplements for Kids: Do They Need Them?
Intro: This is BayCare HealthChat, another podcast from BayCare Health System.
Caitlin Whyte: Welcome to BayCare HealthChat. I'm Caitlin Whyte. To supplement or not to supplement? That is today's question. We're talking all about supplements, vitamins, and when they should be used with our children. Joining us is Dr. Mercedez Cruz, a pediatrician with BayCare Medical Group.
So start us off here, Dr. Cruz, with the official AAP or American Academy of Pediatrics' stance on supplements and vitamins please.
Mercedez C. Cruz, MD: Okay. So the AAP believes that all healthy children receiving a well-balanced diet do not need any vitamin supplementation over or above what we already recommend in the dietary allowances and the most important one of them being vitamin D. So for infants, it'd be 400 units per day, and then for children greater than one, 600 units per day.
Caitlin Whyte: So how should we start to get vitamins and minerals into a healthy, balanced diet for our kids?
Mercedez C. Cruz, MD: So the best way to start is just by introducing all of the food groups, so vegetables, fruits, carbohydrates or starches, and then proteins. And then if they are vegetarians, you would do any plant-based proteins and just making sure that children start eating them starting around six months of age or even four months for pureed foods. But for actual vegetables and fruits, you can start at six months with foods they can easily mash. And so the best way to do is earlier introduction, like while they're still a baby to make sure they enjoy the flavor.
Caitlin Whyte: Gotcha. Well, let's move on into infants. Infants who are breastfed or premature, what are their vitamin recommendations?
Mercedez C. Cruz, MD: For infants who are breastfed, solely breastfed more than formula feeding, we recommend daily vitamin D drops, which are also over-the-counter. Sometimes pediatricians prescribe them. And it's the same number I stated, which is 400 units, so it's about one of the droppers per day. And then for premature infants, you would discuss this with your pediatrician or your doctor prior to leaving the hospital, but we usually recommend Poly-Vi-Sol With Iron, which is basically a multivitamin for premature infants.
Caitlin Whyte: Wonderful. Now, I know some pediatric population specifically benefit from vitamins more than others. Can you tell us about those?
Mercedez C. Cruz, MD: Generally, if you have a child who we classify as a picky eater, many parents are familiar. Picky eaters tend to maybe only want to eat the carbs or the macaroni and cheese. We recommend those children take the over-the-counter daily multivitamin for kids. There's no specific brand we recommend. It can be generic. And then certain kids with chronic medical conditions, such as cystic fibrosis or sickle cell disease, we want to make sure their diets are high in iron because they're more prone to anemia or any child with a chronic medical illness, especially children with GI chronic medical illnesses, they're more likely to lose and not retain enough iron in their diet, which causes them to have a low blood level. And then kids on a vegetarian or vegan diet or any other restricted diet definitely should be taking a multivitamin. And there should be a focus on finding a good amount of protein or if needed, if discussed with the pediatrician, some protein supplements, but mainly just protein via plants and making sure there's a focus on getting enough.
Caitlin Whyte: Now, some vitamins and minerals that are critical for growing kids. We have vitamin A, calcium, vitamin D and iron. How do these vitamins help promote health in children?
Mercedez C. Cruz, MD: So I'll start off with iron because I was just mentioning that. That makes sure you have a normal amount of blood flow, which helps with your oxygenation, makes you feel awake and alert, pretty much helps your whole body. So iron is a very important mineral for your circulation and staying alive and breathing well. Vitamin A, many may know you can get that from carrots and it really helps with your vision. Calcium and vitamin D go hand in hand. You can get that from different various dairy products. So if you have a child that hates milk or won't eat any cheese, you can just alternate with maybe yogurts because most kids like yogurts with less sugar in them.
Caitlin Whyte: Now, of course, I want to focus on safety regarding vitamins. I remember my mom was always telling us, you know, we can only have one Flintstone Vitamin a day because they were really good. But can you tell us about safety and vitamins with our kids?
Mercedez C. Cruz, MD: Too much of anything is a bad thing even if it is a vitamin, which is kind of the general rule in medicine or in life. And there are certain syndromes that come along with taking too much, vitaminosis is what we call them. But very commonly, the child may experience nausea, sometimes rashes, headaches, and even more serious GI side effects or gastrointestinal side effects such as vomiting and diarrhea. It's important to keep adult vitamins or even the children's vitamins locked away in a safe place because they make them extremely tasty nowadays and coated in sugar and kids want to eat them exactly like candy.
Caitlin Whyte: Now, a lot of our kids, you know, they're athletes, they're out there, they're active, they're working out. What are supplement recommendations for children who are athletes?
Mercedez C. Cruz, MD: Great question. And so according to the AAP and along with the AAP’s association with HealthyChildren.org, there's an article that states and we all agree, there is no supplementation that is needed for athletes as long as they are eating a well-balanced diet. I get this commonly in my clinic with my teenagers coming and saying, "Oh, my coach says I need to take creatine or I need to start taking protein supplements," and we do not recommend that because the body during puberty has rapid changes that are going to adjust without the supplementation that's needed. And so it could be a little bit on the dangerous side to add extra protein that's not needed going back to our previous question. So the AAP's stance is that making sure they're well hydrated and that they can eat their protein and not take it as a supplement. And the article gives great examples of like eating chicken right after a very intense workout or Greek yogurt, something with a lot of protein in it can help after working out as well.
Caitlin Whyte: Well, doctor, a lot of great tips here. Is there anything else you'd like our listeners and families to know about supplements and vitamins in our kids?
Mercedez C. Cruz, MD: Just know most of all of the parents out here are doing everything that they need to do to make sure their child has a very healthy diet, and so feel free to just stick to what you're doing and avoid adding any unnecessary supplements and speak with your pediatrician about if your child needs a multivitamin or not, especially if you know you give your child fruits and vegetables and they eat meat sometimes, or they eat sources of protein and dairy.
Caitlin Whyte: Well, it's always great to review this information, doctor. Thank you for sharing today. For more information on pediatric care at BayCare visit BayCareKids.org. Please remember to subscribe, rate and review this podcast and all of the other BayCare podcasts. For more health tips and updates, follow us on your social channels. This has been another episode of BayCare HealthChat. I'm Caitlin Whyte. Stay well.