Top Nutrient Supplements for Healthy Children

Ensuring a healthy start with optimal nutrition 
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Infancy and early childhood are critical times in development. Establishing strong nutritional habits is essential for optimizing health during early life and beyond. Both the World Health Organization and the Canadian and American Pediatric Societies recommend that infants be exclusively fed with breast milk for the first six months of their lives, which should then be complemented and eventually replaced by a wide variety of whole foods. Healthy term infants are largely able to meet their nutritional requirements from breast milk alone, with the exception of vitamin D. Similarly, a diverse diet containing a broad array of fruits and vegetables, healthy fats, whole grains, and proteins should provide nearly everything a growing child needs. However, some children may benefit from additional supplemental nutrients starting at six months of life. This article contains a brief summary of the most commonly prescribed supplements for otherwise healthy infants and children, their benefits, and recommended doses.

Vitamin D 

In addition to preventing rickets, vitamin D has an array of other benefits. Insufficient levels of vitamin D have been linked to lowered immune function, asthma, autism, obesity, and cancer. Children who live in Canada and the northern United States are at a particularly high risk of low vitamin D levels due to decreased sun exposure in the winter and the strongly encouraged use of sun protection in the summer. Breast milk is a poor source of the nutrient since most Canadians and many Americans are already deficient in vitamin D.

Vitamin D dosing 

Infants who are partially or exclusively breastfed should be given a supplement of at least 400 International Units (IU) of vitamin D daily to prevent deficiency. Once solids have been introduced, children can be offered natural dietary sources of vitamin D such as fatty fish (wild salmon, sardines, tuna), cod liver oil, and egg yolk, while continuing to take at least 400 IU per day. After their first birthday, a child's supplemental vitamin D should be increased to at least 600 IU per day, although depending on the age of the child, up to 4000 IU per day may be safe and necessary to attain optimal vitamin D status.

Vitamin D recommendations based on age

Age Recommended Dietary Allowance (RDA) per day

Tolerable Upper Intake Level        (UL) per day

Infants 0-6 months 400 IU (10 mcg) 1000 IU (25 mcg)
Infants 7-12 months 400 IU (10 mcg) 1500 IU (38 mcg)
Children 1-3 years 600 IU (15 mcg) 2500 IU (63 mcg)
Children 4-8 years 600 IU (15 mcg) 3000 IU (75 mcg)

Children and Adults 9-70 years

600 IU (15 mcg) 4000 IU (100 mcg)


Omega-3 fatty acids

At birth a child’s brain is only about 50% of the size of their adult brain. Essential omega-3 fatty acids aid in ensuring proper structure and function of the developing human brain. Omega-3 fatty acids also aid in the regulation of inflammatory pathways, critical in the prevention and treatment of conditions of particular concern in the pediatric population such as eczema, asthma and depression. These good fats also contribute to lifelong prevention of cardiovascular, metabolic, and other chronic diseases, most of which have their origins in childhood. The human body is inefficient at converting plant sources of omega-3 fatty acids into the more useful forms, EPA and DHA, which are most typically found in fish. Low levels of fish consumption contribute to omega-3 fatty acid deficiencies in North Americans, and excessive amounts of other kinds of oils and fats in the diet further create an imbalance of fatty acids in the body. Pregnant and breastfeeding mothers should consume plenty of foods high in EPA and DHA such as wild salmon, mackerel, anchovies, sardines, and herring (check your local fish advisory to avoid the risk of heavy metal toxicity from seafood). Pregnant or breastfeeding women, as well as children who follow a vegan or vegetarian diet should consume a variety of plant-based sources of omega-3 fatty acids such as algae, seaweed, flaxseeds, and walnuts. Talk to your naturopathic doctor to ensure your child is getting enough!

Omega-3 dosing

Once solid foods have been introduced, consider a meal of fatty fish two to three times a week (again, checking local advisories), or a daily dose of fish oil with at least 500 mg of mixed EPA and DHA to ensure children are consuming an adequate amount. Child-friendly chewable omega-3 supplements typically do not provide adequate amounts; a liquid form is best.

Probiotics

There are over five hundred species of microorganisms that line and interact with the human digestive tract. Collectively referred to as the “microbiome,” these beneficial bacteria are essential to the health and regulation of the gastrointestinal system, reducing colic and reflux in infants, and gas, bloating, diarrhea, and constipation in older children and adults. Probiotics also play a critical role in the regulation of the immune system, and have a profound impact on brain health. A healthy microbiome can reduce the risk of developing allergies, eczema, autoimmune conditions, obesity, mood disorders, and autism. The use of antibiotics early in life, chronic stress, low-fiber diets, and c-sections have all been connected to a disruption of the healthy bacteria that reside in the gut of a child. Breast milk nourishes healthy gut bacteria in babies, providing yet another compelling reason to breastfeed. Incorporating fermented foods like cultured vegetables (sauerkraut, kimchi), kefir, and yogurt (ideally plain, full-fat, and homemade if possible!) into baby's first solids can foster a healthy microbial population. Fibre-rich foods are also critical to a healthy microbiome, acting as “pre-biotics”, foods that feed and nourish the population of beneficial bacteria.

Probiotic dosing

Children who may be at higher risk of an imbalanced gut microbiome due to factors discussed above may benefit from consuming a supplement containing multiple probiotic strains ranging in dose from 5 – 10 billion Colony Forming Units (CFU). Probiotic supplementation may not be necessary or appropriate for every infant. Consult your naturopathic doctor prior to initiating a probiotic.

Iron

Iron is an essential mineral for the developing brain and blood cells of an infant and child. Children who are deficient in iron struggle to grow adequately and learn effectively. The majority of healthy term infants are born with sufficient iron to last four to six months after birth due to stores accumulated in utero and the highly bioavailable form of iron in breast milk. Premature and low birth weight infants are at an increased risk of low iron levels. Beyond six months infants require additional iron due to their rapid growth and development, their diminished stores, and the declining supply from breast milk. Iron-deficiency is relatively common among older infants and children. Meat, blackstrap molasses, spinach, raisins, prunes, lentils, and whole grain oats are all great sources of this mineral and should be included in baby’s first foods. Cooking in a cast iron pan can also increase the amount of iron in your child’s diet. An infant or child consuming a vegetarian diet requires nearly twice this amount due to the decreased bioavailability of iron coming from plant sources. Adding foods that are high in vitamin C, such as citrus fruit, peppers or kiwis, will help with the absorption of iron from plant sources. These children, and other infants or children at higher risk of iron deficiency may need supportive iron supplementation over and above consuming iron-rich foods to achieve these daily intakes. Liquid supplements are a simple and effective way to get iron into a child’s diet, but iron toxicity poses a threat to infants and children. Ask your doctor if your child is at risk of iron-deficiency before deciding to supplement; a simple blood test will assess this.

Iron dosing 

Current recommendations are 11 mg of dietary iron daily for children throughout their first year of life, with minimally decreased requirements during early childhood.

Iron Recommendations Based on Age

Age Recommended Dietary Allowance (RDA) per day Tolerable Upper Intake Level  (UL) per day
Infants 0-6 months 0.27 mg 40 mg
Infants 7-12 months 11 mg 40 mg
Children 1-3 years 7 mg 40 mg
Children 4-8 years 10 mg 40 mg

(As per Health Canada)

To supplement or not to supplement?

Supplemental vitamin D is essential for all children, and fish oil should be strongly considered. Vitamin D should be supplemented to the mother before and during pregnancy, and directly to the child from birth onwards. Fish oil should be a regular part of pregnancy and a breastfeeding mother’s regime, and included in the child’s diet once solids have been introduced. Probiotics and iron are often indicated, sometimes from birth, although they are not necessary for all children, and carry the risk of adverse effects. Discuss with your family or naturopathic doctor prior to beginning supplementation.

Homemade nutrient-rich treats!

Goodies full of goodness that your kids will go for!

Iron Kid Energy Bites

Ingredients

  • 1/4 c unsalted raw almonds

  • 1/4 c raw sesame seeds

  • 1/2 c. whole rolled oats

  • 1/2 c. organic dried apricots

  • 1Tbsp fair-trade cocoa

  • 1Tbsp blackstrap molasses (optional; molasses adds a strong flavour)

  • 1 Tbsp water

Instructions

Grind the almonds and sesame seeds in a food processor until in very small pieces (important to avoid a choking hazard in small children); add dried apricots, molasses and cocoa powder, and blend until well combined.  Add water as needed to achieve a workable consistency.  Roll the mixture into small, bite-sized balls and freeze or refrigerate.  Enjoy with strawberries, kiwis, oranges or another vitamin-C-rich food for a quick hit of absorbable iron! 

Make-your-own Yogurt

Heat 1L (4 cups) of full-fat, organic milk over medium heat to approximately 180F, or just below the boiling point. Stir constantly to prevent scorching. Let cool to 120F, or just warm enough to comfortably touch.

Pour some of the warm milk into a bowl containing ½ cup of “starter”—this may be store-bought plain yogurt, or a serving of a previous homemade batch. Whisk the starter into the milk so that it is fully distributed; pour the mixture back into the large pot and stir well.

Pour warm milk into a yogurt incubator OR into a clean, warm, glass dish and cover securely. Reserve ½-1 cup in a smaller glass container with a lid to act as your next starter.

Turn on the incubator OR wrap the containers securely with a thick towel and place in a warm but turned-off oven for approximately 12 hours. Try experimenting with cow, goat, almond or coconut milks.