Children with certain health conditions, chronic illness, or poor dietary habits may require nutritional supplementation. These cases should be referred to a pediatrician. In general, a healthy child >1 year consuming a well-balanced diet does not need vitamin supplementation. Parents considering OTC vitamin supplementation should be advised to have their children adhere to a healthy diet and to consult their pediatrician if they have specific nutritional concerns.1
OTC vitamin supplementation aims to fill in the nutritional gaps in a child's diet. Most preparations contain a combination of vitamins A, B1, B2, B6, B12, C, D, and E. Many products contain additional ingredients, including minerals such as calcium or iron; nutrients such as niacin, biotin, or folic acid; or dietary supplements such as echinacea (Table). Because products vary by brand, the pharmacist should remind parents to check each product for manufacturer-specific dosing.
An assortment of fruit flavors helps to increase children's compliance. Most pediatric vitamin supplements are chewable, but parents should be reminded to crush tablets if the child is unable to chew them completely. The crushed tablet can be mixed in any soft food, such as applesauce or yogurt, or mixed into juice or water and swallowed entirely.
Dr. Holmberg is a pharmacist with Phoenix Children's Hospital, Phoenix, Ariz.
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One study linked multiple pregnancies to an increased risk of developing atrial fibrillation later in life, and another investigated the association between premature delivery and cardiovascular disease.
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