What are supplements? Supplements can be anything given by mouth that is not in the form of food, including vitamins, herbal supplements, body-building supplements, etc. Some supplements contain items that occur naturally in food but in higher concentrations than you would get from a typical diet. Many supplements are not regulated by the Food and Drug Administration (FDA), so the dosing and purity are not necessarily accurate. These often have not been tested in children, and what is deemed safe for an adult may not be safe for a child.
A spoonful of supplements
If your child eats a well-rounded diet with lots of fruits, vegetables, dairy, and grains, they should not need a supplement, but there are several exceptions.
Children with a limited diet, and picky eaters, are not likely to get all that they need in vitamins and minerals; a children’s multivitamin with iron daily is appropriate.
Pubertal girls who don’t drink milk should take a calcium and vitamin D supplement - they need 1300-1500 mg of calcium and 600-800 IU of vitamin D.
Menstruating girls often need an iron supplement, as it is hard to get enough of this mineral in the diet. If uncertain, have their iron level checked. It is also recommended that all women of childbearing age get 400 mcg of folic acid.
Kids in competitive sports may need a daily vitamin with iron if they don’t have a well-rounded diet or aren’t eating enough calories.
Children, who are vegan or vegetarian, should be monitored for specific deficiencies: iron, calcium, zinc, and vitamins D and B12. Those who do not eat animal products are at risk.
Some children with ADD or ADHD have been found to have low iron or ferritin. It may be worth having these levels checked and if low, consider an iron supplement.
Children living at high altitudes have an increased risk for anemia and iron deficiency and should be monitored.
Know that iron can be poisonous, so keep vitamins out of reach of little ones.
What about performance-enhancing supplements or body-building supplements?
These supplements are not designed for children or anyone who has not completed puberty. They are intended for adults and have not been tested in children. In addition, some may contain ingredients not listed that can be harmful (heavy metals, steroids, and stimulants).
Although this is not an exhaustive list, the following are included in these types of supplements:
Anabolic agents (testosterone derivatives)
Prohormones (DHEA and androstenedione)
Caffeine and other stimulants
hGH (human growth hormone) and IGF-1 (insulin-like growth factor 1)
The best approach to building muscle is through a healthy diet and exercise program with appropriate training and supervision.
The American Academy of Pediatrics has stated that children and adolescents should not consume energy drinks. The amount of caffeine in energy drinks is not regulated. Consuming these drinks before exercising in hot weather can be dangerous due to an increase in body temperature and blood pressure.
Protein shakes with whey protein with no other additives can be used as a snack, especially after a workout. Other supplements in this category are not designed for or needed by children.
Sleep Aids, including Melatonin
Melatonin has been commonly used as a “sleep-inducer” for all ages. The use of melatonin increased during the COVID-19 pandemic. Since it is also a naturally occurring hormone, it was thought to be safe. More research is needed on this hormone and its use in children. Short-term use seems relatively safe, but there has been some concern regarding melatonin and interference with the hormones that control puberty. This research is ongoing.
Melatonin should not be used for children three and younger and should not be used long-term. It should also be used in the lowest possible dose, starting at 0.5 - 1.0 mg for children, in addition to working on behavioral issues and a consistent bedtime routine. There has been a surge of melatonin ingestions and overdoses in children, especially the gummy form, prompting calls to Poison Control, emergency room visits, and two deaths. Before considering its use, you should discuss it with your child’s doctor.
All medications, prescription or over-the-counter, should be kept in childproof containers and out of sight and reach of little ones.
Variety of Herbal or "Natural" Supplements
There are many herbal, homeopathic, botanical, or “natural” supplements on the market. Natural does not necessarily mean safe. First and foremost - children are not small adults and cannot take any herbal supplement adults take. Proceed with caution. Bear in mind that these products are not required to prove purity, efficacy, or safety. Some of these supplements can also have interactions with prescription medications and may have their own side effects.
It can be tempting to try: chamomile for colic, echinacea or elderberry for colds, ginger for tummy upset, or cranberry for urinary tract infections. Some may be beneficial, some not, but what is safe for an adult does not always apply to a child.
Getting the nutrients we need through diet with whole, natural foods are best. If you serve your child whole grains, fruits, and vegetables daily and beans, seafood, and eggs several times a week, they should get what they need. Polyunsaturated fats and omega-3 fatty acids are vital but can be obtained through diet. If you are considering a supplement for your child, it would be best to discuss this with your child’s doctor.
The bottom line is that foods are the best nutrients you can give your child. Focusing on a healthy diet will often give them everything they need.