Does My Child Need a Multivitamin?

Most healthy children do not need a multivitamin, and that includes most picky eaters. The American Academy of Pediatrics says healthy children on a normal, balanced diet do not need extra vitamins. A few groups do need one specific supplement, such as vitamin D for breastfed babies.

Check what your child eats first

Our app, Sito, adds up the iron, calcium and other nutrients in each day's meals, logged by photo, barcode or search. It shows them next to the goals for your child's age, and the weekly report averages each one over the days you logged. So before you buy a multivitamin, you can see whether there is a gap at all. Bring that week to your pediatrician.

Does my child need a multivitamin?

For most children, no. No US health agency or professional group promotes regular multivitamin use, according to the NIH Office of Dietary Supplements. A pill cannot replace the variety of foods in a healthy diet.

More is not better. The AAP warns that large amounts of vitamins A, C or D can cause toxic symptoms. It asks parents to talk with a pediatrician before giving any vitamin supplement.

My child is a picky eater. Isn't that a reason?

Usually not. Clinicians at Johns Hopkins and Vanderbilt say most kids, picky eaters included, get the nutrients they need from food.

The AAP explains why. The body stores many vitamins, so intake can balance out over a week or two. Even the pickiest eater needs only a few picks from each food group.

The CDC calls favoring a couple of foods normal and says it often fades by about age 5. The AAP adds that a toddler may eat one or two preferred foods for weeks, and that pressure can make children dislike foods.

Parents often assume low iron comes from picky eating, but the AAP says growth cycles play a big role too. Our guide to iron-rich foods for picky eaters covers the food side.

Which children may need a supplement?

Breastfed babies: vitamin D

Fully and partly breastfed babies need vitamin D drops, 400 IU a day, starting shortly after birth, per the AAP and CDC. Babies who get only formula may not need drops. Ask your pediatrician.

Some babies: iron

The AAP says breastfed babies should get an iron supplement from 4 months until iron-rich foods start. After prematurity or low birth weight, it may start earlier. Iron-fortified formula meets iron needs for the first 12 months, per the CDC. The AAP recommends screening all babies for iron deficiency at 12 months. After age 1, it advises no more than 24 ounces of milk a day. If your child drinks a lot of milk and skips iron foods, ask your pediatrician about iron.

Vegan diets: B12 and more

Natural B12 comes only from animal foods, so vegans run a higher risk of deficiency. Fortified foods or a supplement can cut that risk, per the NIH. The AAP lists vitamin D, iron, calcium, zinc and others as possible shortfalls. Ask your pediatrician which supplements and what amounts.

Medical conditions

Conditions that affect eating or absorption may call for specific vitamins: food allergies, celiac disease, cystic fibrosis and inflammatory bowel disease, per UPMC. Ask your pediatrician.

Very limited eaters

A feeding disorder called ARFID is different from picky eating: it is linked to poor weight gain and nutritional deficiency, per a 2023 clinical article. The Boston Children's ARFID program counts a severely limited diet, such as five or fewer foods or avoiding whole food groups, as a sign of severe malnutrition. If this sounds like your child, ask your pediatrician.

How much vitamin D, iron and calcium does my child need?

These are the daily amounts from the NIH Office of Dietary Supplements for vitamin D, iron and calcium. Babies under 1 need 10 mcg (400 IU) of vitamin D.

• Vitamin D is hard to get from unfortified food. Almost all US milk is fortified with about 120 IU per cup; cheese and ice cream usually are not.
• Children aged 2 to 19 average about 196 IU of vitamin D a day from food and drinks. Yet in blood tests, the share at risk of deficiency is lowest at ages 1 to 5, about 0.5%. Low intake on paper does not mean deficiency.
• Most people in the US get enough iron from food, but infants, young children and teenage girls are among those at risk of too little.
• About half of children aged 4 to 18 get less calcium than the requirement.

How can you tell if there's a gap before buying anything?

The simplest way is to log a week of meals in Sito and look at iron and calcium against the goal for your child's age. You can also compare a week of meals with foods rich in the three nutrients above.

• Calcium (per the NIH): 8 oz plain low-fat yogurt, 415 mg. 1 cup calcium-fortified orange juice, 349 mg. 1 cup calcium-fortified soymilk, 299 mg. 1 cup whole milk, 276 mg. Half a cup of firm tofu made with calcium sulfate, 253 mg.
• Vitamin D (per the CDC): salmon, light canned tuna, and fortified cow's milk from 12 months.
• Iron: see our iron deficiency in children guide for signs and foods.

Multivitamins often hold only small amounts of some nutrients, such as calcium, so the NIH says to check labels. A multivitamin plus other supplements plus fortified foods might push a nutrient over its upper limit.

The AAP says your pediatrician can help troubleshoot and make sure your child gets what they need, so bring a food diary to the checkup. Our guide on whether your toddler is getting enough nutrients goes deeper.

If your pediatrician says yes: keep it safe

• Store every vitamin like medicine, out of reach and out of sight. Poison Control warns that toddlers can open child-resistant caps given time.
• Iron is the big risk. The FDA-required label calls accidental iron overdose a leading cause of fatal poisoning in children under 6. Adult and prenatal pills hold a lot of iron per tablet, so a small child can reach a toxic dose fast. Kids' gummies usually carry little or no iron.
• Kids' vitamins look and taste like candy, a Children's Health pediatrician notes. Never call them candy, says Johns Hopkins. Follow the label directions.
• Very high levels of vitamins A and D, or high doses of zinc and iron over time, can harm a child, per the AAP.
• Do not give two products with the same active ingredient, and tell the doctor about every vitamin, per the CDC.
• The FDA does not approve supplements for safety or effectiveness before they are sold.

When to call the pediatrician

• Before starting any supplement.
• Your baby is breastfed: vitamin D from shortly after birth, and iron from 4 months.
• Your family eats vegan.
• Your child has a diagnosed condition that affects eating or absorption.
• Your child eats only a handful of foods, has dropped whole food groups, is not gaining weight well, or is distressed around eating.
• Your child drinks a lot of milk and skips iron foods.
• Your child swallowed vitamins or iron: call Poison Control at 1-800-222-1222 right away.

Frequently asked questions

Are gummy vitamins safe for kids?

The main worry is that they look and taste like candy, so a child may eat a lot at once. Kids' gummies usually carry little or no iron, while adult and prenatal pills carry much more. Store every vitamin like medicine, follow the label, never call vitamins candy, and ask your pediatrician before starting one.

Does my child still need vitamin D after age 1?

The need continues: 600 IU a day from age 1. The CDC says a supplement can be used if the diet falls short. The NIH, citing the Dietary Guidelines, says young children might need to keep taking one after 12 months. Ask your pediatrician whether your child should continue drops.

Will a multivitamin fix picky eating?

No guidance we read says it does. A multivitamin cannot take the place of the variety of foods in a healthy diet, per the NIH. Picky eating is common in toddlers and often fades by about age 5. Keep offering foods without pressure, and ask your pediatrician if you are worried.

Sources

• AAP, Where We Stand: Vitamins
• AAP, Vitamin and Iron Supplements for Babies
• AAP, Dietary Supplements for Toddlers
• AAP, A Vitamin a Day
• AAP, Picky Eaters
• AAP, Anemia and Your Child
• NIH ODS, Vitamin D
• NIH ODS, Calcium
• NIH ODS, Iron
• NIH ODS, Vitamin B12
• NIH ODS, Multivitamin/mineral Supplements
• CDC, Vitamin D
• CDC, Iron
• CDC, Picky Eaters
• CDC, Medication Safety
• eCFR, 21 CFR 101.17 Iron warning
• FDA 101: Dietary Supplements
• Poison Control, Iron Poisoning
• Children's Health, Do I Need to Give My Child a Multivitamin?
• Johns Hopkins Medicine, Do Kids Need Vitamin Supplements?
• Vanderbilt Health, Do Kids Need a Multivitamin?
• UPMC, Does My Child Need to Take Vitamins?
• Boston Children's Hospital, ARFID Program
• Silvers and Erlich, The Nurse Practitioner (2023), picky eating and ARFID