Does your child need a supplement?

Nutrition is important at every age, however during the toddler and child years it is of particular importance to help support growth, learning, and overall development.

I am often asked by parents if their little one needs a supplement, do they need vitamin D, a multi-vitamin, omega 3s? What if my child is picky, do they need extra supplements? Having a toddler myself I can relate to some of the concerns around nutrient intake, especially when they might love vegetables one day and dislike them the next. In today’s post, I am going to share details about supplements for toddlers and provide some general advice as to whether they need them or not.

Reminder: it is always best to check with your own healthcare provider or dietitian/nutrition expert if you are looking for individualized advice.





Let’s start by discussing what nutrients are important during early childhood.


1. Iron

All babies are born with iron stores, around 6 months of age these stores start to become depleted, this is why when introducing solids, it is very important to start with iron rich foods. Iron is needed to support rapid growth and the major increase in blood volume that comes with rapid growth. It is required for hemoglobin synthesis, development of the central nervous system, and protection from infection (Canadian Pediatric Society).


How much iron does your little one need?




How can you ensure your little one gets enough iron?


  • Offer iron rich foods at least twice per day. Iron rich foods such as, meat, beans, tofu, eggs, dark leafy greens, peas, and iron fortified products like breads or baby cereals and oatmeal.

  • Serve iron rich foods with foods that are rich in vitamin C. Vitamin C enhances the absorption of iron. For example, try serving a bean based pasta with tomato sauce, that way your little one gets iron from the pasta and vitamin C from the tomato sauce.

  • After 12 months of age limit milk intake to a max of 2 cups (250 ml) per day. Too much milk intake can 1) fill your child's belly and limit how much food they are consuming, which means less opportunity to fill up on iron rich foods and 2) the calcium intake from the milk can inhibit iron absorption.


Does your little one need an iron supplement?

Your child does not need an iron supplement unless they have low iron stores.


What are signs of low iron?

Fatigue

Frequent illness

Pale skin

Weakness


If you suspect your child is low in iron, speak to your healthcare provider and get your child tested before you consider supplementing.


2. Healthy Fats


Fat plays a crucial role in brain and body development. In particular omega 3 fatty acids (DHA & EPA) are important for the normal development of the nervous system, retina and brain.


How can you ensure your little one is getting enough omega 3s?


  • Offer omega 3 rich foods regularly. Omega 3s can be found in fatty fish like sardines, salmon, trout, mackerel, etc. They can also be found in plant based sources such as, nuts and seeds (flaxseeds, chia seeds, walnuts) and plant oils (flaxseed oil, canola oil, etc.).

  • Consumption of low mercury fish/seafood 1-3x per week should be encouraged to ensure adequacy (low mercury fish include, salmon, anchovies, sardines, fresh water trout and herring).


Does your child need a supplement?


A Canadian study found toddlers mean intake of DHA per day to be 41mg in 18-24 month olds and only 95mg/day in 25-36 month-olds.

“Optimal” amounts of DHA/EPA per day in studies:

  • 12-24 mo’s- 100mg DHA per day

  • >24 mo’s- 250mg DHA + EPA per day, thus Canadian intake seems to be under.


Bottom line: Young children could benefit from omega 3s (in supplement form) if they do not consume fish regularly. This is one of my favourite supplements, if you want additional recommendations, please reach out.



3. Vitamin D


Vitamin D plays a critical role in bone development during early childhood. It also helps to regulate the immune system and our neuromuscular systems. Vitamin D comes from the sun (this is our main source), food (very few foods contain vitamin D naturally but some foods are fortified with vitamin D like such as milk and other dairy product. However, supplements are often needed to get enough.


Does your child need a supplement?


If I was going to recommend any supplement for a toddler, it would be vitamin D. Vitamin D is synthesized under the skin based on sun exposure. Living in Canada means less sun exposure year round, so unfortunately your little one is likely not getting enough (and you likely aren’t either).

If you exclusively breastfed your baby you likely gave them 400 IU per day up until 2. After 2 years of age, your little one might be consuming foods/drinks fortified with vitamin D such as milks, yogurts, cheeses etc. However, as children get older the recommended vitamin D intake also increases.

To put dosing into perspective, 1 cup of milk contains about 100 IU per cup, so even if consuming 2 cups of milk her day that isn’t quite meeting your little ones needs.

Interesting fact: A study by Dawodu & Wagner reviewing serum vitamin D status in pregnant mothers found significant amounts of severe vitamin D deficiency in Canada – indicating infants may be born with low vitamin D stores.

A frequently asked question, does my child need a multivitamin?


In most cases I would say no, your child is likely getting or can get everything they need from food. This would be my answer if your child is eating a relatively well balanced diet that includes sources of veggies, protein, fruits, carbohydrates, and healthy fats. As a parent, I recommend focusing on what your child consumes over a week rather than ensuring they get each and every type of nutrient daily (daily variations are VERY normal with toddlers).


When might you consider a multivitamin?


  • Picky eating

  • Development of self-feeding skills & food preferences

  • Several food allergies

  • Growth issues/concerns


If you have any questions about supplements for your little one, please reach out, I’d love to help you and your family.


Until next time,


Angela – Eat Right Feel Right


References:

Dawodu & Wagner (2007). Mother-child vitamin D deficiency: an international perspective https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2084036/

Jaeger, G. (2020). Fish Oil for Kids: What’s the right dose? https://www.nordicnaturals.com/healthy-science/omega-3-for-kids-what-is-the-right-dose/

Tamas, D. (2014). Gaps in Meeting Nutrient Needs in Healthy Toddlers Published online: September 6, 2014. https://search-proquest-com.subzero.lib.uoguelph.ca/docview/1616482473?pq-origsite=primo

https://www.albertahealthservices.ca/assets/info/nutrition/if-nfs-ng-healthy-infants-key-nutrients-iron.pdf

https://www.cps.ca/en/documents/position/iron-requirements

https://www.albertahealthservices.ca/assets/info/nutrition/if-nfs-ng-healthy-infants-key-nutrients-vitamin-d.pdf

https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/vitamins-minerals/vitamin-calcium-updated-dietary-reference-intakes-nutrition.html

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