Dr. Greene's Answer
This week on Dateline (an American television show), host Jane Pauley casually mentioned not liking vegetables as a child. While this phenomenon is as current as today’s news, it is also as perennial as our oldest nutritional records. An ancient Greek definition of children is short humans who don’t like vegetables.
Vitamins are, by definition, compounds necessary in trace amounts for the normal functioning of the human body. Are they important? They are vital. We need vitamins in order to see the world around us, to grow, to make bones and connective tissue, to fight infections and cancer, to heal wounds, to stop from bleeding to death, and to keep our teeth from falling out.
We are not self-sufficient. We depend on a steady supply from outside sources for these vital compounds. Vitamins cannot be manufactured in sufficient amounts by the body, and must be taken in from the environment. They occur naturally in many foods. Vitamin D is manufactured by the body in response to sunlight exposure. Vitamins are also available as commercial nutritional supplements.
While I have great respect for the results of modern nutritional analysis, I have greater respect for the long-standing relationship between humans and their natural foods. By eating whole foods (fresh vegetables, fresh fruit, whole grains, etc.), your child can get the necessary vitamins in the healthiest way. Vitamins occur in foods in forms that are the easiest for the body to use, and accompanied by important related compounds. One of the challenges of parenting is to make eating these whole foods as pleasant an experience as possible.
While frank vitamin deficiency syndromes are uncommon among American children (even among picky eaters), many children get suboptimal amounts — low enough to affect their health, their intellect, and their behavior. There are at least 13 nutrients where suboptimal levels are common. We live in an age of highly processed foods. Even when we get kids to eat the fruits and vegetables we want them too, conventional produce is often grown using agricultural techniques that minimize the vitamin and mineral contents. Thus, I like giving children multivitamins as supplements to the vitamins they get in their food.
For most children who began eating solid foods by 6 months old, I would begin adding a vitamin supplement at the first birthday. Before one year of age, most children already acquire sufficient vitamins through infant formula or breast milk. The American Academy of Pediatrics recommends starting vitamin D supplements within the first two months of life for breastfed infants. Preemies, babies with low birthweight, and children with iron deficiency anemia may require iron supplements.
Often children in the toddler and pre-school years are picky eaters. As children grow, their tastes change and over time they should begin to eat a more well rounded diet. A vitamin “safety net” takes the pressure off of feeding issues during the early years. Without pressure or worry, you can be free to be creative about increasing whole foods in your child’s diet knowing that vitamins are present to help your child grow strong and healthy.
N.B. Vitamins are a perfect example of “more is not better!” While most vitamins are essential in trace amounts, excessive amounts can be dangerous. Be sure to discuss with your pediatrician what the right amount of vitamins is for your child.