Vitamins to strengthen children's immunity? When it is okay and when not to give supplements to children without analysis, explains the pediatrician

Parents always want all the best for their children and sometimes get to administer the little vitamins “to be good”. But what does “good” mean when you do not have up -to -date analysis, when you do not know what vitamin or mineral deficiencies? Supplements, these “helping” pills can do harm? Has multiple recommendations for parents pediatrician Raluca Bidiga: In what situations you can give supplements without medical opinion or analysis, but also when it is safer to not.

In healthy children, with varied diet, supplements are not routine. The American Pediatric Academy recommends that in those children who receive a normal and well -balanced diet, we do not supplement vitamins over recommended diet (DZR). A healthy child, who eats varied (including fortified foods), goes out daily and receives 1-2 portions of fish a week, routine multivitamins do not bring proven benefits. Supplements do not replace a good diet. However, there are some clear exceptions in which some children can receive vitamins without medical analysis.

Who, usually, needs supplements, under what conditions and what these supplements are

In the absence of analyzes, there are some well -defined situations when supplements make sense. The first is the baby's age: all babies need Vitamin D. In prophylactic dose, 400 IU a day from the first days of life. After one year, if food intake and sun exposure does not cover the need, the target becomes 600 IU/day. The American Pediatric Academy recommends that teenagers who do not receive 600 IU of vitamin D through food should receive a supplement containing this amount.

The second situation concerns the breastfeed infants exclusively between 4 and 12 months. Here we are talking about ironwhich is usually administered in the dose of about 1 mg/kg/day, until it constantly enters food rich in iron or fortified products. “Premature have special schemes established by the attending physician, so they do not improvise,” the pediatric attention draws.

Another clear case is the vegan diet in children (and sometimes strict vegetarianism). For these children, Vitamin B12 is mandatory and frequently are required and vitamin D and iodineespecially when iodized salt is not used in the house or fortified foods are consumed. European studies show a real risk of insufficient iodine intake in vegan children.

fluoride It is not a “daily vitamin”, but it remains essential in the prevention of caries. Basic rule: fluoride toothpaste, adapted to age, from the moment the first tooth appears. Systemic fluoride supplementation is considered only when drinking water contains below 0.6 ppm fluoride and the child has an increased risk of cavities. The decision, even if it does not impose medical analyzes, is taken with the pediatrician or the dentist, in line with the international recommendations.

In short, where there is solid evidence and simple criteria (age, type of diet, water fluoride), supplements without analysis can be justified. Otherwise, the priority remains the correct nutrition and the medical consultation if needed. These exceptions are easy to remember and prevent both the deficit and the excesses.

Signs of deficit that parents can see when medical evaluation is required

to lack of iron, The signs that parents can see are the pallor, the unusual fatigue, the craving for ice or even soil (pica), brittle nails, fast heartbeat and frequent infections. In infants, irritability and weight stagnation are added. If such indications appear, medical evaluation is needed, usually with hemolithogram and ferritin.

“Iron is dosed at kg body, so errors are possible if we administer” by ear “. However, toxicity appears at very high doses,” says Dr. Raluca Bidiga.

to deficit of Vitamin D.bone pain, delay in motor purchases or fractures for minor trauma may occur. In the little ones, the doctor follows signs of rickets. The suspicion is confirmed by the dosing 25-OH-vitamin D, at the pediatric recommendation. “The prophylactic dose of vitamin D is 400-800 IU/day, and at this dose there is toxicity only in particular situations, very rare (metabolic diseases). So, we can administer vitamin D in prophylactic doses even without medical indication and without anticipable risks,” says the pediatric doctor.

Vitamin B12 deficiency (especially in children with vegan nutrition) can be manifested by pallor, red and painful, tingling in the hands and feet, difficulty concentrating or regressing/delay in neurocognitive development, sometimes with megaloblastic anemia. And here, the confirmation is done by analyzes recommended by the doctor.

“If the diet excludes animal products, B12 is mandatory. In breast -feeding, the intake depends on the mother's reserves, and the neurological signs can occur before anemia. I recommend a constant source (fortified foods or dedicated supplement), dosed with age, together with the pediatrician.

When iodine is missingmay increase thyroid (goose), persistent fatigue, slow growth and learning difficulties. The deficit supported in childhood is associated with neurocognitive delays, which is why the intake of iodized salt/food is important.

In the case of one insufficient contributionearly signs are demineralized stains and early onset of caries. For this reason, guides recommend fluoride toothpaste adapted to age and, depending on the child's risk and water fluorine content (

“The first step is the fluoride paste: from the first tooth, suitable for age-as a grain of rice (0-3 years) and as a pea (3-6 years), it does not rinse. The fluorine varnish is applied to the cabinet to children at risk of caries”, is the pediatrician.

Can we make mistakes by administering food supplements to children? Yes, here's how!

Overcoming the right dose. The risk is higher in fat -soluble vitamins (A/D/E/K). “Adult” doses or more products in parallel can easily exceed safe limits. “Vitamins A and K are given only at the medical indication, due to the risk of intoxication,” the pediatrician points out.

Administration of supplements can “mask” a real problem. By administering “preventive” iron over chronic inflammation, an infection or a loss of undiagnosed blood can blur the signs and postpone the correct diagnosis. “In the case of iron, it is not possible to speak of toxicity, which appears only at very high doses. But the lack of iron is manifested by pallor, fatigue. Constant fatigue, agitated sleep, irritability can also be the signs of a chronic infection,” the pediatric attention draws.

Non -specific symptoms. Therefore, fatigue, pallor, lack of appetite can have many causes. Supplements taken on guess can provide a false sense of safety and can delay the medical consultation.

Doses/wrong shapes. Systemic fluoride without knowing the water fluoride (systemic supplements are taken into account only if we know that the water also has, it is to be avoided to duplicate doses when the child simultaneously “multivitamins” and fortified foods/foods. “Multivitamins have relatively small amounts of each component, balanced. ”

In conclusion, “more” does not mean “better”. At high doses, some supplements can do harm and do not prevent serious diseases. The base remains the correct nutrition. Supplements are used targeted, with doses suitable for age – ideally, according to a plan established with the doctor.