Many people with childhood memories of cod liver oil may be scratching their heads in disbelief at this week’s news that parents are reportedly spending an average of £234 a year on vitamins and supplements for their children.
According to research from the buy-now, pay-later platform Clearpay, 92 per cent of parents have purchased vitamins and supplements for their child over the past year, with the primary aim of enhancing immunity and focus. But are they an important enhancement to our children’s diets — or just an exercise in branding?
“My view on supplements is that they should be just that — targeted supplementation for specific reasons,” says Lucy Upton, a specialist paediatric dietician registered with the British Dietetic Association and the author of The Ultimate Guide to Children’s Nutrition. With the exception of vitamin D, children should be able to get what they need from food, she says.
Lucy Upton: “Supplements should be just that — targeted supplementation for specific reasons”
If you choose to buy a supplement for your child, it doesn’t need to be expensive, says Danielle Petersen, a registered dietician specialising in childhood nutrition. “A general multivitamin or vitamin D from the supermarket will often be of similar quality to an expensive brand costing five times as much.”
So what else should parents bear in mind?
You can’t beat a good diet for gut health
Gut health is as important for children as it is for adults, Upton says. “The first three to five years of a child’s life is when their gut microbiome is developing rapidly, and the community of bacteria they develop will be a blueprint for their immunity and brain health.
“However, there is no great evidence that a generalised probiotic gut-health supplement will help otherwise healthy children, and it’s much better to focus on food.”
Danielle Petersen: “If your child is a fussy eater then it’s worth considering a multivitamin”
If the goal of consuming 30 different plant-based foods a week seems unattainable, Upton’s key message is to aim for some variety, including beans and pulses, nuts and seeds, and wholegrain cereals and oats.
The one non-negotiable is vitamin D
NHS guidelines for children under five state that they should take a vitamin D supplement year round, unless they are drinking more than 500ml of infant formula daily, Petersen says. “We do see deficiency quite a lot and that can affect immunity, bone health and muscular health.”
The recommended dose is 10mcg a day for babies and school-aged children.
“Look for a vitamin D3 supplement rather than D2, as there is evidence it is better absorbed,” Upton says. “And check the dose — some children’s supplements only contain 2.5mcg or 5mcg.”
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Multivitamins can help — but beware the double dose
Children who eat a good, balanced diet with plenty of fruit and vegetables don’t need a multivitamin, Petersen says. “But if your child is a fussy eater then it’s worth considering one.”
However, if you give your child other supplements, check the micronutrients in each, as some may be repeated and you may end up unknowingly giving a dose that is too high.
Plant-based diets may lack calcium and vitamin B12 
Vitamin B12 is found in fortified food such as breakfast cereals
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A vegan or plant-based diet may be lacking in certain nutrients, mainly iron, calcium, vitamin B12, iodine, riboflavin and zinc, Petersen says. “Vitamin B12 is found in fish, meat, dairy foods and also fortified food such as bread, breakfast cereals and some yoghurts, but not in plants.”
Plant-based sources of calcium include almonds, Brazil nuts, some fortified calcium-set tofu, Ready Brek and sesame seeds. Some plant-based milks are fortified with calcium as well as vitamin B12 and iodine.
“It’s difficult to get a multivitamin with enough calcium in it, so you may need a separate supplement,” Petersen adds, “but be aware that most calcium supplements have vitamin D in them too.”
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Some children may need extra iron
About one in five children in the UK is iron deficient, which can present as paleness, headaches, shortness of breath, lethargy and sleepiness. “Children between 6-24 months can be at higher risk because their iron requirements relative to their body size are quite high,” Upton says.
Eggs, meat, oily fish and fortified foods all contain iron. Upton adds: “Plant-based sources are trickier to absorb. I suggest three solid sources of iron a day; for example, beans, pulses, nuts, seeds, tofu and fortified cereals.
“Deficiency does not happen overnight, but if there are concerns, parents should speak to a GP about a blood test [and they] might prescribe a supplement if anaemia is diagnosed.”
Magnesium supplements are overrated
Half a banana is equivalent to the dose of magnesium many supplements provide
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Research shows a steep rise in the use of magnesium supplements. “The marketing really preys on things that parents worry about, such as sleep,” Upton says. “But there’s no evidence that children are falling short of magnesium, which can easily be obtained from food.”
Half a banana, a slice of wholemeal bread, or a bowl of oats with dairy are the equivalent to the dose of magnesium many supplements provide, she says.
They’re unlikely to need a supplement for immunity and focus
“There is no robust evidence that supplements improve focus in children unless they are deficient in something,” Upton says. Instead, feed them a broad range of foods that will support energy levels and stable blood sugars, and give them enough iron and omega-3. And make sure they get enough sleep.
Zinc (found in meat, beans, shellfish, dairy, eggs and wholegrains) and vitamin C play a role in supporting immunity, but no supplement will “boost” the immune system, Upton says. “In fact, we do not want to boost it, as an overactive immune system is not helpful. We want to support it to function as normal.”
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Most children get enough vitamin A and C
“Children with a broad and varied diet probably do not need additional vitamin C,” Upton says. “Since it’s water-soluble, if it is not needed on a particular day, it’s excreted in urine.”
Half a kiwi, an orange, 2-3 large strawberries, 3-5 small new potatoes with the skin on, or a quarter to half of a bell pepper all provide enough daily vitamin C for a toddler. Teenagers need about twice that.
Many children aged six months to five years have no problem reaching their vitamin A requirements too, Upton adds. “Vitamin A comes in two forms: from foods such as meat and dairy (the “active form”, aka retinol), and as beta-carotene from orange, red and yellow fruits and vegetables, which is converted to vitamin A. Many children consume more than enough.”
