By Dr. Nguyễn Hữu Lĩnh*

Vitamins and minerals are very important elements of a child’s total nutritional requirements. Because the human body is unable to produce adequate amounts of many vitamins on its own, some must be obtained from our diet. It is very important to understand that the body needs only tiny amounts of vitamins and minerals – and with a balanced diet, there are usually sufficient quantities present in our food. So for the average child, supplements are rarely needed.

When do we need to supplement a child’s diet? A paediatrician may recommend daily supplements for children with a poor appetite or who are picky eaters, if an examination suggests they may be lacking in sufficient vitamins or minerals. They may also be recommended in case a child wants to follow a vegetarian diet – it’s rare, but some children are disturbed to learn their food comes from animals and refuse meat. Such compassionate children may need to source their vitamin complement from supplements.

Supplements are generally safe, but don’t forget that they are drugs! So if taken in excessive amounts – especially fat-soluble vitamins A, D, E and K – they can be toxic. Even Vitamin C – which is very good for increasing resistance to infection, strengthening muscles, and improving healing – can cause diarrhoea, headaches, nausea, or cramps if taken in excessive amounts.

The most toxic mineral supplement is iron. When a child has anemia, we may prescribe iron supplements to bring the hemoglobin concentration back to normal. But if a child consumes a lot of iron, it can cause many symptoms – such as nausea, vomiting, gastrointestinal hemorrhage, liver failure, and heart and lung poisoning. It can even cause seizures and death.

Doctors who prescribe iron-containing supplements to children will often ask for a parent’s signature to acknowledge that they have been informed of the potential toxicity of excessive amounts of iron. They should agree to keep it out of reach of children, and always give the medication personally rather than a nanny or teacher. Doctors sometimes need to reassure parents who are worried they might accidentally miss a day – it’s no problem to skip the medicine, as it’s a supplement, not a treatment.

Gummy vitamins are a very common form of vitamin supplement for children. In the US, they account for 70 per cent of multivitamin sales. They’re also popular in Việt Nam, where they are often imported from the US, Canada, or Australia.

Paediatricians sometimes prescribe gummy vitamins when a child needs supplementation but has difficulty taking a regular pill or liquid – for example, if they find a pill difficult to swallow, or don’t like the taste. Gummy vitamins have a great advantage because children find them delicious and so consume them willingly.

The downside is that children are far more likely to overdose on gummy vitamins, because they are candy-like. Like any multivitamin, they are toxic in high quantities. Some children are given a large amount of gummy vitamins by parents who believe they are healthy because they contain vitamins. Others sometimes eat a whole jar of multivitamins when parents are not looking.

There have been many cases where a child has eaten a large number of gummy vitamins and then been admitted to hospital due to poisoning. Some have even died from gummy multivitamin overdose.

A balanced diet almost always contains sufficient quantities of vitamins and minerals to make supplements totally unnecessary. Try to maximise the vitamins your child receives in his or her regular meals only use supplements on the advice of a paediatrician. If you do keep multivitamin supplements in the house, don’t leave them on the table – try to store them out of sight so your children can't find them.

Remember that vitamin and mineral supplements are usually only prescribed for a limited time. Taking vitamins daily for months or even years is considered an unhealthy practice. It’s far better for a child to follow a healthy diet and receive all the necessary vitamins and minerals naturally.

*Dr. Nguyễn Hữu Lĩnh’s studies in France and the US gave him a broad experience base in treating a range of paediatric illnesses. He takes particular care in the co-operation, communication and education of parents to ensure a better treatment environment for children.

Family Medical Practice was the first foreign-owned primary healthcare provider in Việt Nam, and has consistently remained at the forefront of international-standard medicine since 1995. It offers extensive healthcare and emergency medical services nationwide to Vietnamese, expatriate and corporate customers.

For more advice on any medical topics, visit Family Medical Practice Hanoi at: 298 I Kim Mã, Ba Đình. Tel: (024) 3843 0748.  E: hanoi@vietnammedicalpractice.com.

FMP’s downtown Hồ Chí Minh location is: Diamond Plaza, 34 Lê Duẩn, District 1; 95 Thảo Điền, District 2. Tel: (028) 38227848. E: hcmc@vietnammedicalpractice.com

FMP Đà Nẵng is located at 96-98 Nguyễn Văn Linh, Hải Châu District, Đà Nẵng. Tel: (0236) 3582 699. E: danang@vietnammedicalpractice.com