“Children can meet their nutritional needs without eating vegetables,” my nutrition professor announced to my college nutrition class. Every mom in the room gasped with relief. Of course the topic of healthy eating for picky eaters wasn’t high on my priority list at the time. But I’ll never forget the impact it had on parents – and now I understand why.

When it comes to feeding kids, it’s the parent’s job is to offer a nutritious diet. But we all know that the food we choose doesn’t always make it into the mouths of “>picky eaters. So what’ s a parent to do?

Have a plan!

Because it can take a while for little palates to come around, try pairing these easier-to-accept foods with other items they aren’t ready to eat (yet).

1. Offer tasty cantaloupe: Rich in both vitamin A and C, nutrients kids need on a daily basis, cantaloupe packs nutrition and a sweet taste. Have it as part of breakfast or for a snack and feel good knowing your little one is getting the same vitamin A found in green veggies.

2. Stock the pantry with ready-to-eat cereal: Picky eaters may not be eating many iron-rich foods, especially at-risk kids age 3 and younger. Finding a cereal that contains iron along with whole grains and fiber is key. One example is Cheerios which contains more than 40% of the Daily Value for iron and is a good source of fiber (try to keep sugar at 10g or less per serving).

3. Include vitamin C-rich fruits: Vitamin C increases the absorption of iron at meals. For picky eaters, make a habit of including strawberries, cantaloupe, orange slices and kiwi with meals, especially breakfast.

4. Serve sweet potatoes: Also rich in vitamin A, sweet potatoes have a sweet flavor that many kids like. Serve sweet potato fries with a sandwich and watch your kids attack.

5. Sneak in whole grains: You child won’t be able to tell that their macaroni and cheese is made with whole grains. There are many whole grain products on the market to experiment with — whole grain waffles, crackers and pasta. Check this listing from the Whole Grains Council.

6. Provide palatable protein sources: Most children get their share of protein from milk and yogurt but it’s the nutrients in eggs, meat, fish, and beans – iron, omega-3 fatty acids and zinc – that are essential for growth. Make healthier versions of chicken tenders at home, try French toast using a DHA-rich egg, serve meatballs with toothpicks and include nutritious beans as part of a burrito or finger foods for younger children.

7. Try veggies and dip: Keep serving veggies at meals but also try them at snack time. Kids like to dip veggies like carrots, zucchini and cucumbers in tasty dips like hummus or ranch dressing. A recent study showed kids age 4 to 10 prefer crunchy veggies.

8. Offer nuts: While nuts can be a choking hazard for younger children, they make a tasty and nutritious snack for kids. Try dry roasted almond slices which are crunchy and great topped on yogurt. Most nuts are rich in vitamin E, magnesium, zinc, selenium and copper.

9. Watch out for fillers: Children getting too much juice and milk may eat less food throughout the day. Stick to the American Academy of Pediatrics (AAP) recommendation to limit juice to 4-6 ounces for children 1 to 6 years old and 8-12 ounces for kids 7 to 18 years old. And to meet their calcium needs, kids aged 2 to 8 years old need 2 milk products daily and older kids need 3.

10. Consider supplements: If your child won’t eat entire food groups like fruits and veggies, talk to your pediatrician about a multivitamin.

But even if you child doesn’t need a multivitamin, they might need other supplements. The American Academy of Pediatrics recommends breastfed infants and older children drinking less than 4 cups of milk per day get 400 IU of vitamin D daily. Omega-3 fatty acids are another supplement that might make sense for children who don’t eat fish. See Kids & DHA: The Complete Guide for Parents to see if your child is getting enough.

Do you have picky eaters at home? Are you worried about their nutritional status?

For more on what to feed your kids see our Nutrition for Children section.

I’ve been concerned about swine flu since the very first media report. And while a part of me wants to keep my children locked up in the house, I realize that’s not a very smart (or realistic) strategy.

So instead of worrying myself sick with what I have no control over, I’ve decided to focus on what I can do. And that’s helping my kids build a super-strong immune system. So in addition to washing their hands and making sure they get enough sleep, I’m maximizing their nutrition at every meal and snack.

Nutrition deficiencies compromise the body’s (cells’) ability to effectively ward off disease. Research shows that specific nutrients are especially important for a functioning immune system. So here are 10 easy ways to bolster you family’s defenses with everyday foods.

1. Have an orange a day – During infections and stress vitamin C levels decline. Because vitamin C helps maintain the integrity of disease-fighting cells, low levels can compromise the body’s ability to fight back. Other vitamin C-rich fruits include strawberries, cantaloupe, kiwi and mango.

2. Make yogurt a regular snack – The gastrointestinal (GI) tract is the largest organ involved in the immune system. Yogurt contains live and active cultures, healthy bacteria called probiotics that are health food for the gut. Look for yogurts with the Live and Active seal.

3. Top that yogurt with some nuts – Nuts are a good source of magnesium which plays a role in the development and function of immune cells. Remember nuts can be a choking hazard for young children. I get the unsalted dry toasted sliced almonds from Trader Joe’s – they are super-crunchy and perfect for yogurt.

4. Supplement with D – Are you sick of vitamin D yet? I’m not! A recent study in Archives of Internal Medicine revealed that people with low vitamin D levels caught more colds than people with normal levels. At your next doctor’s appointment get your levels checked and consider following the AAP’s recommendation to supplement children with 400 IU daily.

5. Make winter squash a menu mainstay – One of my favorite fall foods is vitamin A-rich butternut squash. Research shows that adequate dietary intake of vitamin A is clearly needed for a strong immune system. Erin from 5 Dollar Dinners shows how easy it is to bake butternut squash. Your kids will love it!

6. Get milk – Milk contains the micronutrient copper. Deficiencies of copper can adversely affect the immune response. Don’t worry if milk is not your family’s thing as copper can be found in variety of foods including whole grains, nuts, seeds and chickpeas.

7. Make room for protein at meals – Red meat, poultry, beans and nuts are all good sources of zinc, the most studied nutrient when it comes to the immune system. A zinc deficiency can wreak havoc on the body’s ability to fight infections.

8. Be smart about fats: Studies show that getting “in balance” with fat can help the body in disease-fighting mode. So try cooking with olive and canola oils, eating fatty fish and cutting back on products made with soybean and corn oils (next month we’ll have an expert on fat explain this in great detail – so if you haven’t subscribed yet do it now!)

9. Spread avocado on a turkey or cheese sandwich – Avocados are an excellent source of vitamin E, an antioxidant that protects cells from the damage of free radicals. If you don’t love avocado there is plenty of vitamin E in nuts and canola and olive oils.

10. Have eggs for breakfast – Eggs are an excellent source of selenium. Through complicated biological processes, selenium helps prevent the formation of disease-causing free radicals. Not a big fan of eggs? Other sources include tuna, beef and rice.

Armed with a strong immune system, your family will be ready to fight anything that comes their way this winter even if it is the Swine flu.

Like what you see? Subscribe to Raise Healthy Eaters to be alerted of new posts.

References

Kubena KS, McMurray DN. Nutrition and the immune system: a review of nutrient-nutrient interactions. J of the Am Diet Assoc. 1996;96:1156-64.

Ginde et al. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med.2009; 169: 384-390.

US Probiotics.org

Weaver et al. Effect of dietary fatty acids on inflammatory gene expression in healthy humans. J Biol Chem. 2009 Jun 5;284(23):15400-7.

You hear a report about school-aged kids’ poor nutrition and think “that’s so far away” for your little baby or toddler. But because most food learning occurs during the first 5 years of life, what you do from day one can affect your child’s health – and what they eat – when they get older.

So let’s go through each of the stages of growth and see how you can increase the odds that your kids will grow up to be healthy adults.

Infants: Birth to 6 months:
Everyone knows that infants need breast milk or formula the first few months of life. While breast milk is still the preferred nutrition source, formula is a good second choice.

Nutrition highlights: The AAP recommends 400IU of vitamin D* daily for breastfed infants. Nursing moms who don’t eat fish should consider fish oil supplements that contain at least 300mg of DHA* because levels in breast milk are directly related to mother’s intake. Many formulas are fortified with DHA to enhance brain health.

Feeding Tip! Try not to overfeed or underfeed your baby. If baby is crying and feeding time was recent, try other ways of soothing before feeding. On the other hand, if nothing else will calm your baby, by all means see if they need milk. Basically, let baby – not a schedule– guide you in how much milk he or she needs.

Infants: 6 to 12 months
At 6 months babies’ iron stores deplete and they need nutrition from additional sources. This is a time of rapid food transitions starting with watery-textured food, gradually increasing to puree, advancing to lumpy puree and finally moving up to soft, cut up finger foods. See our Infant Feeding Guide for step-by-step advice.

Nutrition highlights: After 6 months, babies will need more than half of the following nutrients from complementary foods: Iron (iron fortified cereals, meat), vitamin D (supplements, formula), B6 (cereal, whole grains, enriched grains), niacin (cereal, egg yolks, turkey), zinc (some cereals, meat), vitamin E (vegetable oils, avocado, cereals) and phosphorus (cereal, fish, meat and eggs).

Feeding Tip! Most babies are accepting of a variety of tastes and textures so take advantage of it. Research shows that the more flavors introduced early in life, the more likely it is children will accept new foods later. Remember, this is a rapid transition time so when your child is doing well step up the texture to guide him or her to the next stage (without forcing of course!).

Toddlers: 1 to 3 years:
Toddlers under 2 still need a high fat diet (30-45%) including whole fat dairy products. After one, children are either drinking whole milk (2-3 cups per day) or breast milk (after 2 they can switch to low fat dairy). If a toddler has progressed to finger foods, he or she can eat what the whole family eats, but watch for choking hazards. Gradually increase the consistency of food as they get older, cut up food into small pieces and always supervise at mealtime. See Toddler Feeding Section for more detailed guidance.

Nutrition highlights: Children under 2 are still at risk for iron deficiency so include iron-fortified cereal with a vitamin C-rich fruit or veggie (cantaloupe, tomatoes, strawberries, oranges, kiwi and broccoli), green veggies and meat. After turning one, growth rate decreases. Somewhere between 18 months and two years of age, toddlers get skeptical of certain foods. Babies no longer drinking DHA-supplemented formula or breast milk can get the DHA** by eating fish including salmon, light tuna and halibut.

Feeding Tip! Eating a variety of foods takes time and repeated exposure just like other learned behaviors (like reading and writing). Protect your child’s natural ability to self-regulate food by providing regular meals and snacks and letting them decide “how much” to eat. Instead of eating special food, toddlers greatly benefit from eating with the family.

Preschoolers: 3 to 5 years
If you’ve continued to expose your little ones to a variety of foods without trying to get them to eat less or more, you’ll watch them grow in to more adventurous eaters. On the other hand, if there’s been ongoing tension at the table their eating habits may get worse. For more specifics on what to feed see MyPyramid for Preschoolers.

Nutrition highlights: This is a time when kids become more independent, notice what their friends are eating and start to eat food outside of the home. Studies reveal that children at this stage are more likely to eat higher quantities of fat, saturated fat and sugar from sweets and sweetened beverages. It’s important to maintain balanced meals and snacks at home to reinforce the foundations of healthy eating.

Feeding Tip! Preschoolers want to be just like their parents so eat with them as often as possible. This is the perfect time to have your child help pick out food and prepare dinner – skills they will need later in life!

School-aged Children
Once your child is in school full time they will be eating more meals outside the home. Much of the work you’ve put in will start to pay off. If you’ve made mealtimes pleasant and provided your child with a variety of foods – without being controlling – they are likely to be competent eaters outside of the home. For more specifics on nutrition needs at this stage see MyPyramid for Kids.

Nutrition highlights: Research surveys reveal the five nutrients most likely to be low in school-aged children are vitamin E (nuts, seeds and vegetable oils) calcium (dairy products), magnesium (nuts, whole grains, beans), potassium (dairy, fruits, veggies and whole grains) and fiber (beans, whole grains, fruits and vegetables). After age 8, calcium needs increase (e.g., 3 cups of milk products daily). 80% of school-aged children do not consume the recommended amount of fruits and vegetables. Sweetened beverages often replace milk as the beverage of choice.

Feeding Tip! Adolescents who eat dinner with their family on a regular basis have better diets and lower weights than those who don’t. Serve fruits and vegetables with every meal and have the family eat together most nights.

*The AAP recommends all kids drinking less than 4 cups of milk day be supplemented with 400 IU of vitamin D.

**Most children and adults do not consume enough DHA and EPA from fish sources. If you and your children do not consume fish a couple of times per week talk to your doctor about supplementation.

Subscribe to Raise Healthy Eaters (or tell a friend) for more child-feeding tips.

References
Butte N, Cobb J, Dwyer J, Graney L, Heird W, Rickard K. The start healthy feeding guidelines for infants and toddlers. Journal of the American Dietetic Association. 2004;104(3): 442-450.

Krebs NF and Habidge MK. Complementary feeding: clinically relevant factors affecting timing and composition. American Journal of Clinical Nutrition. 2007;85(2):639S-645S.

AAP Vitamin D Recommendations

Birch SR, Daniels MW, Gilman AH, Lichtenstein KT, Steinberger J, Stettler N, Van Horn L. Dietary recommendations for children and adolescents: A Guide for Practitioners. Pediatrics. 2006:117:544-59.

Secrets of Feeding a Healthy Family: Orchestrating and Enjoying the Family Meal by Ellyn Satter, MS, RD, LCSW.

Everyone seems to have an opinion about whether or not children should drink juice. Some parents wouldn’t dream of bringing it in to their home while others couldn’t last a day without giving it to their kids. But what’s the real scoop behind juice and its role in your little one’s diet?

Here are 5 things every parent needs to know about buying and serving the fruity drink that most kids love.

1. Look for 100% fruit juice:
When choosing fruit juice look for “100% fruit juice” on the package. This tells you that the juice is squeezed from the fruit or made from juice concentrate with some other ingredients like additional vitamin C. Fruit juice, like whole fruit, contains a variety of vitamins and minerals important for a balanced diet.

A recent study published in the Archives of Pediatric & Adolescent Medicine, looked at the diets of children 2-11 years old. The kids who consumed 100% fruit juice had lower intakes of fat and saturated fats and higher intakes of vitamin C, vitamin B6, folate, iron, and whole fruit than those not drinking juice. There was no association between fruit juice intake and being overweight.

2. Check “how much” you are serving up:
While 100% juice can play an important role in a balanced diet, letting your child sip on it all day isn’t a good idea. That’s because, unlike fruit, juice doesn’t contain fiber and it can be consumed in large amounts very easily, taking the place of other nutritious foods in the diet.

The American Academy of Pediatrics (AAP) recommends limiting juice to 4-6 ounces for children 1 to 6 years old and 8-12 ounces for kids 7-18 years old. Many of the sippy cups for toddlers and older children hold up to 16 ounces so measure the amount recommended once and then eye ball it. If your child wants more try watering it down.

3. Be on the look-out for juice drinks:
Drinks that contain less than 100% juice are often called “juice drink,” “juice cocktail” or “juice blend.” These drinks contain less than 100% juice, have added sweeteners and are often fortified with vitamin C. Some contain so much sugar and little juice that they are, nutritionally speaking, similar to a can of soda. Take Sunny Delight for example. It may have added vitamin C (and now has calcium and D) but it’s first two ingredients are water and high fructose corn syrup and it contains 2% or less juice.

4. Watch “when” and “how” you serve juice:
Sipping on juice throughout the day can increase the risk of dental cavities. The AAP recommends parents give juice in a cup, never in a bottle, for babies 6 months or older. And the best way to combat the risk of cavities is to serve juice with a meal or snack while letting your little one sip on water between meals.

5. Get adventurous with juice:
Who says you have to serve only apple, orange or cranberry juice? In fact, there are many antioxidant-rich juices on the market these days. Try pomegranate, blueberry or grape juice, which are especially high in antioxidants. Darker juices tend to be higher in these disease-fighting nutrients.

Try darker juices while making smoothies or simply use it as the juice of choice for the week.

When done right, 100% juice can play an important role in your child’s diet. And it’s especially refreshing all summer long.

Subscribe to Raise Healthy Eaters to stay up on the latest in childhood nutrition.

For more on what to feed your kids see our Nutrition for Children section.
References

Nicklas TA, O’Neil CE, Kleinman R. Association between 100% juice consumption and nutrient intake and weight of children aged 2-11 years. Arch Pediatr Adolesc Med;162(6) 557-565.

The Use and Misuse of Juice in Pediatrics. Pediatrics. May 2001.

People eat for reasons other than hunger. They eat when bored, to celebrate or to get through difficult times. But what no one talks about is how these habits develop in the first place. Do people engage in this behavior because food is plentiful or is it a learned behavior?

I believe the majority of eating habits are formed early in life. It took me years to get over my have-to-eat-when-I-watch-TV habit. I grew up mindlessly eating while watching my favorite programs so it’s no surprise it continued into adulthood.

As parents, we have the power to prevent our children from making food associations that cause over-eating. But like any dietary pattern, kids tend to follow their parents’ footsteps. So like most of the advice given on this blog, it applies to the whole family.

Here are 5 mistakes parents make when feeding their children – and how to fix them.

1. Eating to cure boredom: You don’t need me to tell you that kids get bored very easily. Sometimes parents offer food to distract their kids from boredom. Of course, doing this once in a while won’t hurt but getting into a regular habit of offering food to occupy time backfires. That’s because kids learn that eating is the solution to boredom. And food – when used to solve non-food problems – always makes matters worse.

Instead, stick to consistent meals and snack times for you and your children. When your kid gets bored let them feel bored. You can also suggest solutions that will help with boredom like completing chores, playing with a certain toy or working on a project. Or you can ask them what they think they should do. Soon they will learn the skills to combat boredom.

If you haven’t done it yet, sign up for the email updates on the upper right hand corner of this page. You’ll be alerted of new posts, warned of expert interviews (so you can submit questions) and informed of new resources at RaiseHealthyEaters.com.

2. Rewarding behavior with comfort foods: There are many ways parents can use food to reward children – saying they can have cookies if they finish their dinner or clean their room. If they do well in school a parent might offer a child an enticing meal or favorite food. What’s the big deal? Studies show that making certain foods accessible only after completing a specific task, increases children’s preferences for that “reward” food.

A child who engages in this reward model of eating may become an adult who searches for reward-type excuses to eat comfort foods. Whether they indulge because “it’s Friday,” they are on vacation or even during pregnancy, once they find the appropriate excuse they tend to over-eat.

Instead, provide your child (and yourself) with your favorite high-calorie, palatable foods 2-3 times a week as a regular part of meals and snacks. For example, cookies and milk as a snack on Monday, chips with lunch on Wednesday and fries over the weekend. This teaches kids how to eat the high-calorie foods as part of balanced diet – and makes comfort foods less of a focus.

3. Using food to distract from uncomfortable feelings: It’s understandable that parents want to ease their children’s bad feelings. Offering favorite foods to a child is tempting but it teaches them the wrong message – that food can cover up difficult feelings. Food only temporarily makes kids feel better and it adds a new problem of potentially being overweight.

Instead, let your child feel upset and encourage them to talk about what’s bothering them. If you find them seeking food on their own, talk to them about it. Teaching your child to accept difficult emotions as a regular part of life is an important lesson.

If you find yourself eating in response to stress or difficult emotions, find non-food ways to solve problems or ease stress. And above all, allow yourself to eat foods you love as part of your regular diet so you don’t search for excuses to eat them (like in #2).

4. Providing snacks during TV time: Studies show that excessive TV viewing in children is associated with high weights and poor eating habits. According to a 2008 study in the International Journal of Obesity, for every additional hour kids watch TV they consume 106 extra calories. This causes children to eat out of habit, not hunger.

I’m not talking about having popcorn while watching a movie on Saturday night. But making the rule of no eating while watching TV – and making sure you the parent follow it too – is a smart move. Having a designated place for meals and snacks (like the kitchen table) will decrease the likelihood that your kids will associate eating with such a sedentary activity.

5. Eating in the car: One final food association that can cause over-indulgence is eating in the car. Once a child gets used to noshing while riding in the car they will expect food in the car and want it even when they aren’t hungry. Don’t get me wrong. There are times (more like emergencies!) that you’ll need to feed your child in the car – even to distract them. Like anything, make it occasional so a habit never develops.

Mealtime should be sacred, something to be enjoyed and savored. When we bring food and eating into other “non-food” areas we not only increase the likelihood of over-eating but we leave problems unsolved. Let your children keep their gift of eating when hungry and stopping when full. And then make them your role model.

Subscribe to Raise Healthy Eaters for get more strategies on how to feed your kids.

References

Fish JO, Birch LL. Restricting access to foods and children’s eating. Appetite. 1999;32, 405-419.

Jackson DM, Djafarian K, Steward J, Speakman JR. Increased television viewing is associated with elevated body fatness but not with lower total energy expenditure in children. Am J Clin Nutr. 2009; 89(4):1031-36.

Sonneville KR, Gortmaker SL. Total energy intake, adolescent discretionary behaviors and the energy gap. Int J Obes (Lond). 2008;Suppl 6:S19-27.

AAP Policy Statement on Television Viewing

I recently taught a class to a room full of moms about toddler eating problems. I heard moms complain about how their children were no longer good eaters. The question of the day was “How do I get my toddler to eat?”

There were also some parents worried that their children were eating too much at mealtime. And with all that you hear about childhood obesity, their concern is understandable.

The way to handle both of these concerns is surprisingly simple. Let me show you why.

The responsibility of feeding a child is a two way street
Ellyn Satter, MS, RD, LCSW coined the term “The Division of Responsibility” and has done a substantial amount of research on childhood eating over the past 40 years. When you apply her theory you’ll find that it solves – and can prevent– many childhood feeding problems.

The idea is that both the parent and child have a responsibility. It’s the parent’s job to decide the “what” and “when” of feeding and the child decides “how much” to eat. Problems usually occur when someone, either parent or child, crosses this division of responsibility

Example 1: Child running the show
Little Charlie insists he gets certain foods at meals so his mom gives in afraid he’ll starve to death. As a result, his diet consists of macaroni and cheese, fries and waffles. The problem? Charlie has taken over his mom’s job of deciding “what” to eat.

If Charlie’s mom were following the Division of Responsibility, she would tell him that even though she takes his requests into consideration, it’s her job to decide what he eats – and he can decide whether or not to eat it. She plans his meals with his food preferences in mind but doesn’t resort to feeding only his favorites.

In her most recent book, Secrets of Feeding a Healthy Family: Orchestrating and Enjoying the Family Meal, Satter explains that children need ample opportunity and time to learn to like certain foods. At around 18 months of age many toddlers become skeptical of certain items, like vegetables, but this is just a stage. By continually offering foods your child may not like (without pressuring) you give him the opportunity to learn to like that food. If you take away the food, you take away the opportunity.

Example 2: Parent controlling their child’s food intake
In this example, Charlie is eating very little at meal time and his mom says “That’s all you’re gonna eat?” She even starts to make him eat at least half of his plate before he can  watch TV or play with his favorite toy.

Another example is Sadie, a girl with a hearty appetite. Her mom purposely limits how much she eats because she’s already 90th percentile for weight.  When Sadie asks for more her mom says, “That’s all there is.”

In both examples, the parent is crossing the line of responsibility by deciding how much a child eats. Why is this bad? Studies show that children tend to eat less when pressured and more when they feel food is scarce. Additionally, you want your child to maintain their ability to self-regulate intake. This is a gift that most adults would die for, to eat when hungry and stop when full.

My daughter has just started eating very little at breakfast. Do I like it? No! I could make her finish her breakfast before she gets her morning dose of Barney but what would that accomplish? She would probably come to dread eating breakfast because of the negativity of being forced to eat. We’d have a morning showdown with her crying and me saying “No Barney today.” Or I could trust that she’s not hungry and will eat her snack 2-3 hours later. She remains pleasant at breakfast and will probably start eating more in a couple of weeks.

So as parents our job is to provide the “when” and “what” of feeding. This site offers resources on how best to do your job of providing regular meals and snacks.  Watch out for future posts on Quick Dinners – mom-made super simple dinner recipes.

And when children are left to do their jobs, they relax a little and are more likely to be cooperative because they feel respected.

When parent and child divide the responsibility of eating in this way, it solves most childhood feeding problems. And it sure does make life – and mealtime—a lot more pleasant.

I highly recommend Satter’s most recent book, Secrets of Feeding a Healthy Family: Orchestrating and Enjoying the Family Meal where she explains The Division of Responsibility in detail. I will review more of her books here in the future.

Subscribe to Raise Healthy Eaters for more book reviews on childhood nutrition.

A recent study published in the Archives of Pediatrics and Adolescent Medicine brought up a topic that many moms wonder about: do children benefit from taking multivitamins?

When you think about how picky children can be with food, especially toddlers, it seems to make sense. Take a supplement, get a little insurance. But it doesn’t always work out that way and I’ll show you why.

How Many Children are Taking Vitamins?
In the above study researchers tracked over 10,000 children and adolescents 2-17 years of age from 1999 to 2004 and found that over one-third had taken a multivitamin in the last month. The interesting finding was that those children that were taking multivitamins didn’t necessarily need them. They tended to be the children with regular access to healthcare, balanced diets and had parents with higher incomes.

The study questioned whether multivitamins are being used appropriately – and on the right children.

How to Tell if Kids Need Multivitamins
First off, there’s no evidence that multivitamins are beneficial for children at all. In fact, the American Academy of Pediatrics (AAP) and the American Dietetic Association recommend that vitamin and minerals come from diet, not supplements. That’s because the benefits of vitamins and minerals are not isolated. Fruits and vegetables, for example, also contain fiber and antioxidants. Additionally, many foods are already fortified with vitamins and minerals (e.g., cereals, nutrition bars, specialty food items) making supplementation less of an issue.

In general, if your child eats a variety of foods (dairy, meats, whole grains, fruits and vegetables) and is at a healthy weight he or she probably doesn’t need a multivitamin. But if your child eats very poorly, is underweight, is on a restricted diet (that includes strict vegetarians) or has any other nutrition-related concerns then talk to your child’s pediatrician to see if a multivitamin, or supplementing with specific nutrients, is appropriate.

A Better Strategy
When children aren’t eating in a consistent manner, mothers think that giving a multivitamin will help cover their unmet needs. But doesn’t it make more sense to evaluate their diet and see what they’re missing — and then try to fix it with food?

Check the Resources section of this site for age-specific nutrition information which will continually be updated. If you can’t find what you need there, check MyPyramid for kids and get age-specific guidelines for your child’s nutritional needs. When you find your child’s diet is lacking in a certain area, then make an effort to add the food group back into his or her diet.

For example, if your infant or toddler eats very little meat you’d want to offer iron fortified cereals or other sources of iron with vitamin-C rich fruits/veggies to help increase the absorption. This is especially true for non-meat sources of iron which are not absorbed as well.

School-aged children tend to have low intakes of vitamin E, calcium, magnesium, potassium and fiber so make an effort to provide foods from these sources throughout the week. And many young children shy away from vegetables but readily accept fruit. Keep offering vegetables without forcing but vary their fruit intake by including vitamin-A sources of fruit such as cantaloupe and more acceptable vitamin-A rich veggies like carrots and sweet potatoes.

When Diet Isn’t Enough
Throughout this blog you’ll often see me write about vitamin D, a nutrient that has become a major public health concern. The scientific community is learning that most people (kids and adults) do not get enough – and most health experts believe current recommendations are too low.

The American Academy of Pediatrics recently changed its recommendation for breastfed infants to receive 400 International Units (IU) of vitamin D the first days of life. This should continue throughout childhood (whether they were breastfed or formula-fed) unless children are drinking one liter (four cups) of milk a day. The major source of vitamin D is the sun and with the increase in sunscreen use, most children — and adults — fall short. Insufficient vitamin D has been linked to everything from compromised bone health to the development of cancer to a variety of autoimmune diseases.

It’s also important for adults to make sure that they are getting enough vitamin D. A good place to start is with your annual physical. Ask for a vitamin D test to see if you have enough in your blood. If you don’t, your doctor is likely to recommend supplementation. This is important for those of you who want to have more children. If you are vitamin D-deficient during pregnancy, you’re likely to have a baby that is also lacking in vitamin D.

So check with your doctor, offer your child a variety of foods they need and supplement when there is good reason – and you can’t go wrong.

For more information on vitamin D check out the article: Is Your Family at Risk for Vitamin D Deficiency?

Subscribe to Raise Healthy Eaters to stay updated on childhood nutrition.

References/Resources:

http://archpedi.ama-assn.org/cgi/content/full/163/2/192

Prevention of Rickets and Vitamin D Deficiency: New Guidelines for Vitamin D Intake