Hey there fellow parents, caretakers and guardians!

To supplement or not to supplement…. Is it recommended to give our children a multivitamin and or calcium and vitamin D? We hear so much about this and as parents we truly want to ensure we are providing our children with the adequate nutrients to growth and function optimally!

As a registered dietitian nutritionist we always say FOOD FIRST as this is how our bodies are meant to extract nutrients most effectively and efficiently AND aside from just vitamins and minerals in the food, we are getting so many more awesome benefits, i.e fiber and antioxidants!

In terms of the science based recommendations, there is no evidence to prove, and therefore recommend, a multivitamin on a daily basis.  It is recommended that your child consumes a well-balanced diet with lots of produce and lots of variety of food to ensure all nutrition bases are covered. I know you are thinking, but what about my picky eater or what about my child who refuses meals at times or the one that won’t even look at greens let alone eat them…. That is all completely normal and all part of growing and to be expected. This doesn’t mean they will have any particular nutrition deficiencies. As long as your child is following their personal growth chart accordingly and are generally well with no particular allergies, special needs or concerns, your child will be just fine. But again, it’s always best to review your child with their pediatrician as they know your child best! Talk to a doctor and registered dietitian nutritionist for more personalized advice.

Please note that it is not “bad” to give your child a multivitamin. However, these are the current guidelines for the general public.   

In particular, there is a lot of discussion around children not getting enough Calcium and Vitamin D in their diet and as a result many children are showing low blood levels of Vitamin D.  Yes!  Even in sunny countries like Kenya. This is because many children are not going outside as much, they are wearing protective clothing and wearing sunscreen (which is advised to prevent skin cancer, but doesn’t allow them to get Vitamin D from the sun).  Also, there are not many foods that have Vitamin D in them naturally, including milk and most dairy products, especially here in Kenya.

Sources of Calcium – always check the food label

• Milk
• Fortified alternative milks
• Most yogurts
• Kefir
• Maziwa lala
• Cheese
• Some fortified breakfast cereals
• Green leafy vegetables
• Fortified flours
• Fish-when you eat the bones

How much Calcium should your child get per day?

Table 1: Recommended Dietary Allowances (RDAs) for Calcium [1]
Age	Male	Female	Pregnant	Lactating
0–6 months*	200 mg	200 mg
7–12 months*	260 mg	260 mg
1–3 years	700 mg	700 mg
4–8 years	1,000 mg	1,000 mg
9–13 years	1,300 mg	1,300 mg
14–18 years	1,300 mg	1,300 mg	1,300 mg	1,300 mg
19–50 years	1,000 mg	1,000 mg	1,000 mg	1,000 mg
51–70 years	1,000 mg	1,200 mg
71+ years	1,200 mg	1,200 mg

* Adequate Intake (AI)

https://ods.od.nih.gov/factsheets/Calcium-HealthProfessional/

Source of Vitamin D – always check the food label

• Salmon, sardines, trout, tuna
• Cod liver oil
• Egg yolks
• Some mushrooms (maitake and shiitake and mushrooms exposed to UV light)
• Some fortified breakfast cereals and fat spreads
• Some fortified alternative milks
• Fortified cow’s milk (not found in Kenya as it is not mandated)
• Some yogurts

How much Vitamin D should your child get per day?

Table 2: Recommended Dietary Allowances (RDAs) for Vitamin D [1]
Age	Male	Female	Pregnancy	Lactation
0-12 months*	10 mcg (400 IU)	10 mcg (400 IU)
1–13 years	15 mcg (600 IU)	15 mcg (600 IU)
14–18 years	15 mcg (600 IU)	15 mcg (600 IU)	15 mcg (600 IU)	15 mcg (600 IU)
19–50 years	15 mcg (600 IU)	15 mcg (600 IU)	15 mcg (600 IU)	15 mcg (600 IU)
51–70 years	15 mcg (600 IU)	15 mcg (600 IU)
>70 years	20 mcg (800 IU)	20 mcg (800 IU)

*Adequate Intake (AI)

• Please note mamas that are breastfeeding should be on a Vitamin D supplement and giving their baby an oral dose of Vitamin D in order to prevent Vitamin D deficiency. Formula does have enough Vitamin D in it.

https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/

Please note that if your child is lactose intolerant or allergic to dairy or practicing a particular diet, it may be even harder to get enough of these particular nutrients and a supplement may be warranted. Again, it is best to have your child evaluated by their pediatrician and registered dietitian nutritionist to conclude the best way forward for your child.

An individualized approach and assessment is always best as no two kiddos are the same! And as the parent, I want you to remember that you know what is best for your child and will consult the professionals when you feel necessary. If you do end up choosing a supplement, ask your pediatrician and registered dietitian nutritionist what they recommend in terms of brand and amount.  Always get a supplement that is third party tested, from a reputable company and purchased at a reputable shop.

As always, I am available for consult for an individual questions or needs – CLICK HERE

Cheers!

Ashley