By Joan Avolio,  R.D., L.D.N.


Many parents want to know, “Should I give my child a vitamin supplement?” Good question, and finding an answer can be confusing. Do a web search and you will find numerous articles that say that vitamin supplements are not necessary even for less than ideal eaters; or just the opposite — that yes, it is a good idea to give at least a multivitamin to insure that a child’s vitamin and mineral needs are met.

Gisela Angela Telis at the Washington Post describes the dilemma:

 I didn’t take vitamins growing up, so when I pass the supplements aisle at the grocery store and see bottle after gleaming bottle of children’s vitamins — in their enticing chewable, candy-flavored and cartoon-shaped glory — I can’t help but wonder: Is this really necessary? Do kids actually need supplements?

Many parents seem to think so. After all, about half of all young children (and 30 percent of teens) have taken dietary supplements, according to a 2004 study in Pediatric Annals. But scientists aren’t so sure.


Telis gets two experts to weigh in:

“In general, the data regarding the benefits of taking vitamins is weak,” said biochemist Thomas Sherman, a neuroendocrinologist and an associate professor at Georgetown University School of Medicine. “And the data for children is pretty much nonexistent.”

What researchers do know is that most kids can get the nutrients they need from a healthful diet alone. Thanks to fortified milks, cereals and other foods, even children with less-than-ideal diets will still be okay, said William “Biff” Rees, head of the Virginia chapter of the American Academy of Pediatrics.

“I’ve been in practice a long time,” said Rees, who has been seeing families in Fairfax County for 37 years, “and I can’t remember seeing a vitamin-deficient child who didn’t have some sort of illness underlying the deficiency. It’s really hard to get vitamin-deficient — you almost have to work at it.”


Both experts recommend that children should be able to get their daily requirements of vitamins and minerals from a diet that is rich in fruits and vegetables.  That is sometimes easier said than done!  One important vitamin which experts acknowledge may not be acquired through food in sufficient amounts is vitamin D.  In fact, many experts recommend vitamin D supplementation for kids of all ages.

Over the past few years vitamin D has been getting a lot of attention, and daily recommended intakes have been recently increased by the American Academy of Pediatrics and the Institute of Medicine’s Food and Nutrition Board.  These intakes range from 400 IU -800 IU  (International Units) depending on age.

The main problem with vitamin D is that it is naturally present in very few foods.  It must be added to other foods such as milk, cereals, some yogurts, and orange juice to insure that most children can meet the daily requirement.  Also, vitamin D is synthesized by our body when our skin is exposed to sunlight and ultraviolet rays.  Researchers at the National Institutes of Health Office of Dietary Supplements suggest 5-30 minutes of sun exposure at least 2 times/week without sunscreen to provide sufficient vitamin D synthesis.  The problem here is that exposure to ultraviolet rays can cause skin cancer. We want our children to have strong bones and a healthy immune system without the risk for cancer, so a logical solution for some would be a daily vitamin D supplement.

Here’s my answer: Most healthy children can get the vitamins and minerals they need from diet alone, but certain vitamins and minerals like vitamin D are tricky, so supplementation may be necessary during different stages of childhood.

Check out the table below to get an idea of the vitamin D content in foods, and good luck with the cod liver oil!


Food                                                                    Vitamin D 


Cod liver oil, 1 Tablespoon                                                    1360

Fish — cooked, 3 oz.

Swordfish                                                                                   566

Salmon                                                                                        447

Tuna, canned, water drained                                                   154

Fortified foods — 1 cup (check labels as amounts vary)

Orange Juice                                                                               137

Cow’s Milk, all types                                                                 115-124

Cereal, ready to eat                                                                     40

Egg, 1 large, include yolk                                                            41


** Joan Avolio is a registered dietician.  She sees children and their families at the Arcadia Division of Pediatric Alliance.  Joan is a regular contributor to The PediaBlog.  You can read her Taste Buds columns here.