Multivitamins for babies: A paediatrician’s advice

Multivitamins for babies. Should your child be taking a multivitamin
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Vitamins are a multibillion-dollar industry, and whether we should be giving vitamins to our children is certainly a million-dollar question. There is just so much information out there — and so many choices — that parents often find themselves wondering what multivitamin would be best for their child. Written by BYY expert peaditrician, Dr Maraschin.

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Articles published by the Mayo Clinic and in the American Journal of Paediatrics state that “Multivitamins aren’t necessary for most healthy children who are growing normally. Food remains the best source of nutrients. Regular, well-balanced meals and snacks can provide all the nutrients most preschoolers need”. 

So, in an ideal situation where children are eating well, tolerating all food groups, and growing normally, supplements aren’t necessary. That said, multivitamins for babies do need to be considered for children who aren’t meeting these requirements through the food they’re eating.

What is the role of vitamins & minerals in the body?

Imagine an orchestra with all the complexities of each instrument being played in a unique way to produce a single symphony. Your body produces muscle, skin, and bone each and every day. It also produces red blood cells that carry oxygen all over your body.

The oxygen received allows every single cell in your body to perform very complex functions. It takes at least 30 vitamins, minerals, and other dietary components to get this right. The vitamins and minerals are obtained from outside of the body. Ideally, this would be from a well-balanced diet, but not everyone has a perfect diet. 

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Some major functions of vitamins and minerals:

As you can tell by now, vitamins and minerals play an important role in a happy, healthy life for your baby. So, let’s take a deeper dive into the major functions of these compounds and why baby multivitamin syrup may be necessary in some instances. 

Preventing birth defects

Mothers who lack certain vitamins may give birth to a baby with severe abnormalities. A lack of folic acid may result in the baby having brain, spine, or spinal cord defects such as spina bifida. For this reason, mothers are advised to take supplements during pregnancy.

Building immunity 

3 vitamins play a huge role in the body’s ability to fight infection. Vitamin C is the biggest immune booster, while vitamin B6 supports the biochemical reactions in the immune system, and vitamin E is a powerful antioxidant that fights infection.

Building strong bones & teeth

A combination of calcium, vitamin D, vitamin K, magnesium, and phosphorus protects your bones against fractures. A lack of vitamin D causes a disease known as rickets. Children with rickets develop abnormalities in their bones, such as bowed legs.

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Clotting blood

Vitamin K plays a very specific role in bone metabolism and blood clotting. A lack of vitamin K in adults is rare but common in newborns. For this reason, a baby is usually given a vitamin K injection at birth. 

This releases clotting factors from the liver and prevents bleeding disorders. A recent study conducted in Tennessee reported that there had been an increase in the number of parents who are refusing vitamin K injections at birth. These parents perceive it to be unnatural and unnecessary in full-term babies. 

This, however, is not fact. We know that vitamin K is not transferred well through the placenta to the unborn child. Over and above this, a newborn’s gut flora is immature and is not able to produce vitamin K. Very little vitamin K is found in breast milk, so newborns often lack vitamin K. 

The result of this refusal has led to an increase in the number of tiny babies being brought to casualty by concerned parents. After investigation, many of these babies are found to have suffered brain bleeds. This condition is very severe — it can lead to retardation and even death.

Eyesight

Vitamin A helps keep cells healthy and protects your vision. It is particularly important for vision in dim light. Children who lack vitamin A may, in fact, go blind.

Growth & development

Maintaining normal growth and development ensures that our children progress as they should. If any baby presents with failure to thrive or a regression in their development, your doctor may well suspect a vitamin B12 deficiency. 

A baby who is exclusively breastfed may become vitamin B12 deficient if the mother has anaemia or is following a vegetarian diet. Ultimately, this may cause poor growth and, in severe cases, brain damage. Another cause for failure to thrive may, in fact, be a lack of zinc.

Collagen production 

Collagen knits together wounds, forms a base for teeth and bones, and supports our blood vessels. Vitamin C is very important for the production of collagen (this is certainly not the only function of vitamin C but a significant one). The best way to avoid this is through fresh fruits and vegetables.

Releasing energy

There are a number of vitamin Bs, and these help the body release the energy we get from eating food so that we are able to function normally. Vitamin B1 combines with phosphorus and enables the body to metabolise carbohydrates, fats, and proteins. If a child lacks vitamin B they will most certainly feel tired most of the time and will most probably not enjoy physical activities.

What is the role of vitamins and minerals in the body

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Pros and cons of using baby supplements and multivitamins for babies: 

There’s an old saying, “Too much of a good thing is bad”. This goes for vitamins and minerals as well.

Let’s take a closer look at some of the major vitamins and minerals in more detail. The table below may help to examine the most commonly supplemented vitamins and minerals. It will then assess the effects of too little or too much of each dietary supplement.

Name of Vitamin or mineral Main source Too little Too much
Vitamin A Breastmilk, infant formula, vegetable oil, liver, egg yolk, butter, green leafy  vegetables, sweet potatoes, carrots, whole grain bread, cereals Night blindness, dry eyes, prone to infections, poor bone growth Vomiting, jaundice, abdominal pain, night sweats, vertigo, dry cracked skin
Vitamin C Breast milk, formula, citrus fruit, strawberries, pawpaw, potatoes, cabbage Bleeding disorders, diarrhoea, Scurvy Abdominal cramps, nausea and the possibility of kidney stones
Vitamin D Sunlight, fatty fish, egg yolk, liver, infant formula Soft bones and growth delays in children, in adults muscle weakness, bone loss and fractures Vomiting, high blood calcium, retarded growth

Vitamin B1

(Thiamin)

Breast milk, formula, lean pork, potatoes, legumes, wholegrain breads and cereal Heart failure, oedema, Beriberi  

Vitamin B6

Pyridoxine

Breast milk, formula, liver, meat, whole-grain breads and cereal, legumes, potatoes Irritability, anaemia, convulsions Weakness, numbness, sensitivity to light

B12

(Cobalamin)

Breast milk, formula, cheese, fish, poultry, meat, egg yolk, liver (Vegans and Vegetarians are often deficient of B12) Impaired brain function, anaemia  
Vitamin K Vegetable oils, green leafy vegetables such as spinach and kale, pork, liver Excessive bleeding especially in newborns This is very rare but may result in jaundice, anaemia or kernicterus in infants
Iron Breast milk, formula, red meat, seafood, canned sardines, legumes, wholegrain breads and cereals, seeds such as pumpkin and sesame Dizziness, headaches, weakened immune system, unusual tiredness, anaemia, fast heart rate, brittle nails, dry damaged hair and skin, restless legs, anxiety

Joint pain, diabetes, irregular heartbeat,

Abdominal paid

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Name of Vitamin or mineral Main source Too little Too much
Folate Breast milk, formula, green leafy vegetables like broccoli and spinach, oranges, bananas, lean beef, legumes, cereals Poor growth, specific type of anaemia, birth defects, mouth sores, fatigue, tongue swelling Masks Vit B12 deficiency, accelerates age-related mental decline, may slow brain development in children
Calcium Breastmilk, formula, cheese, yoghurt, milk, green leafy vegetables, legumes Abnormal bone and teeth development Calcification of soft tissue and bones. Vomiting, lethargy
Fluoride Water containing fluoride, toothpaste Increased dental carries Mottled teeth, calcified muscle insertions
Iodine Fish, dairy, seaweed, eggs and it is added to table salt Depressed thyroid function, mental retardation and developmental delays in children, increased heart rate, shortness of breath, weight gain  
Magnesium Whole grains, nuts, green leafy vegetables, dark chocolate Abnormal heart rhythm, muscle cramps, restless leg syndrome, fatigue, and migraines. Diarrhoea, transient hypocalcaemia

The bottom line is that it’s possible to be deficient in almost all nutrients. This is particularly likely in children who are not eating a balanced diet, vegetarians, and vegans. Vitamins and minerals are obtained from a diet that includes meat, fish, eggs, grains, and vegetables.

Without a nutrient-dense diet, your child may well be lacking in some of the vitamins and minerals he or she needs to grow normally and have an adequate immune system with strong bones and teeth. This is why over-processed foods and food void of colour and freshness should make every parent shudder.

The flip side of this is that excessive supplementation may lead to unnecessary health problems. It is virtually impossible to get an overdose of vitamins and minerals from a healthy diet, so these health problems would arise if a child is being given supplements over a long period of time or in a dose that exceeds the daily recommended amount.

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Why would a doctor recommend multivitamin syrup for babies?

Rachel Dawkins, M.D., director of the Paediatric and Adolescent Medicine Clinic at John Hopkins All Children’s Hospital, states, “So typically kids don’t need vitamins, but every kid is different and has different needs, so consult your paediatrician if you are worried. There are exceptions, and under certain circumstances, supplementation is necessary.”

What baby vitamins & supplements are necessary: 

Vitamin K

Vitamin K shots are usually given at birth to prevent a life-threatening condition known as VKDB.

Vitamin D 

Vitamin D is primarily given to exclusively breastfed babies.

Multivitamin with iron 

Premature infants, when being discharged from neonatal ICU, should ideally be given this supplement.

Iron supplement

Full-term infants who are exclusively breastfed should receive an iron supplement at age 4 months. Continue giving your baby the supplement until he or she is eating two or more servings a day of iron-rich foods, such as iron-fortified cereal or pureed meat. Formula-fed babies get the iron from the formula.

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Children with selective diets such as vegetarianism or dairy-free diets

A multivitamin specifically designed for children is recommended. The most important component of the supplements under these circumstances would be iron and calcium.

Children with chronic medical conditions 

Such as asthma or digestive problems, especially if they’re taking medications. You will need to follow the advice of your doctor to ensure your child is getting the correct supplements.

Picky eaters

This is the tough one. Parents do get very stressed when children are difficult to feed. Under these circumstances, a multivitamin may be given. That said, it is not a long-term solution.

Children who are fussy are often sensory defensive and benefit from Occupational Therapy to address the problem. Supplements should never take the place of a healthy diet, but a two to three-month course under these circumstances may be recommended.

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Pre-schoolers

A study has shown that 47% of preschool children are likely to lack iron. If your child is not eating an iron-rich diet, then your doctor may recommend iron supplement drops.

Boosting immunity

Generally, children can get all they need from a healthy diet. 

Having said this, the American Academy of Paediatrics says, “Over-the-counter vitamin supplements are typically safe and come in chewable forms in case your child has difficulty swallowing. Remember, however, that higher-than-­recommended doses of supplements can cause problems. For example, giving high doses of vitamin C in hopes of preventing colds and the flu can cause a child to have nausea, diarrhoea, and cramps.” 

If a parent feels that their child needs a little boost going into winter, then a short course of a paediatric supplement may well help.

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Conclusion: 

Our modern society has left us all in a quandary. Parents often work long hours, so preparing an elaborate meal is difficult. Over and above this, I read an interesting article about soil depletion. The article explains that overall, magnesium in vegetables has dropped by 24%, while carrots specifically have lost 75% of this essential nutrient.

Another problem is that advertisers are also great at convincing children that food in a box is way tastier than the meal mom has cooked. Fast foods often lack the nutrients that children require.

It is a battlefield. We all want our children to grow up strong and healthy. Ideally, this should be achieved through a healthy, well-balanced diet. If this is not possible, then, together with your healthcare practitioner, you should consider supplements under controlled circumstances.

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Sources

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