December 2021

Multivitamins Don’t Always Hit the Mark

Questions about multivitamins are very common. Children’s multivitamins and prenatal vitamins can be particularly confusing categories. Here are a few things to consider when counseling parents and patients.

There’s no standard or regulatory definition for “multivitamins'' in the US. Product formulations vary significantly. In fact, a recent study reviewed formulations of 288 children’s multivitamin products. Fifty-six percent of the products containing vitamin D didn’t provide even half of what is necessary to meet daily needs. And none of the potassium-containing products met daily requirements. Conversely, 49% of the folic acid-containing products provided amounts above upper tolerable intake levels (UL). And most multivitamins contained 16 additional nutrients that most children already obtain from the diet in adequate amounts.

If parents ask you about multivitamins for kids, specifically toddlers and up, tell them to consider their diet first. If possible, it’s best to address potential nutritional gaps through dietary changes. The American Academy of Pediatrics currently states that children receiving a well-balanced diet don’t need a multivitamin. They also recommend against giving children products containing vitamin megadoses due to potential toxic effects. If parents still wish to give their child a supplement, tell them to check product labels closely to ensure they include enough, but not too much, of certain nutrients like vitamin D, iron, potassium, calcium, folic acid, and zinc. And remind parents to look for products verified by a third party, like USP, to ensure that what’s on the product label is what’s actually in the bottle. Also, keep in mind that nutritional needs for infants aren’t the same as older children. Parents should talk to their pediatrician before giving any supplements to infants.

If you get questions about prenatal vitamins, tell patients their best bet is to look for products that meet dietary reference intakes (DRIs) during pregnancy. Product formulations vary significantly, and not all products contain the necessary nutrients. Gummy prenatal vitamins are a good example of this because they typically don’t contain iron. Patients who take gummy products may need to obtain enough iron from foods or another supplement.

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