By Pat Blackwell, Ph.D., September 13, 2018
An astonishing number of American children are consuming dietary supplements including but not limited to multivitamins. According to a recent article published by JAMA Pediatrics (2018), approximately one-third of American children under age 19 are using some form of dietary supplements. While most of these products are safe for children, there is scant evidence of effectiveness for most supplements. And in some cases, these products can have an adverse effect on health and wellness.
The History of Vitamins
The vitamin craze in the United States dawned in the 1920s as affluent families enjoyed more processed foods like polished rice and sterilized milk which depleted nutrients and led to conditions such as scurvy and pellagra. Scientists learned how to extract vitamins A and D from cod liver oil, and one of the first household supplements was born (much to the distaste of children who were forced to swallow the stuff).
In 1943 One A Day (vitamin) appeared on the scene in time to appeal to the wealth and well-being of post-war families. Linus Pauling touted the benefits of vitamin C for preventing colds and flu, which led to a continued practice of using vitamin supplements to round out the health and wellness of children in the 1960s and 70s. At about this time a great interest was emerging in “all natural” and “back to the garden” foods and products. Vitamins and alternative health were also in vogue. American parents continue to be attracted to these ideas for children today, and supplements are part of the equation.
Multivitamins are the most common supplements children take. However, with increasing interest in holistic and alternative medicine, parents are also exploring the use of supplements to treat clinical conditions in children such as attention deficit hyperactivity disorder (ADHD), sleep disorders, autism, and depression/anxiety. It is important for parents to recognize that even though dietary supplements can be purchased over the counter, they must still be regarded cautiously.
In the area of mental health, Omega-3 has received a good deal of attention. Clinical research is just emerging about the effectiveness of Omega-3 to treat ADHD, and some studies are promising. However, it is not necessarily an alternative to medication prescribed for this condition. While side effects are rare, Omega-3 is best used as a complement to your child’s prescription medication for ADHD.
St. John’s wort has been touted as a treatment for depression and anxiety, although it may interact in a negative way with prescription medication, so caution should be exercised. Melatonin is a hormone that naturally produces sleep, and there are minimal side effects when used with children.
It should be noted that environmental modifications such as sleep routine should be tried first or at least in concert with melatonin. The effect of extended use of this substance is not yet understood. As the diagnosis of autism spectrum disorder has skyrocketed, various supplements have been marketed to parents desperate to treat severe symptoms (such as flavonoids). However, there is no conclusive evidence that supplements of any form are effective in the treatment of autism-related symptoms.
Don’t Only Rely On Vitamins
The most commonly used supplements are those that sit on our kitchen counter like salt and pepper. The consensus from pediatricians and nutritionists is that dietary supplements are not recommended for children who have a reasonably healthy diet. Cartoon character vitamins are not the antidote to a lousy diet of chicken nuggets and fries.
In the realm of supplements, all natural does not imply completely safe. Additives, incorrect dosage and interaction effects are very real concerns. Taken together, the best advice is to make sure your child has had a thorough evaluation by a reputable healthcare provider, especially if supplements are being used to treat a clinical condition. Continued consultation with your child’s health care provider is essential to using these products safely.