Children's nutrients

The vast majority of healthy children who have a balanced daily diet and whose growth curve is within the normal range do not need to supplement nutrients at all; only children with clear intake deficiencies, malabsorption, or diseases or special developmental stages need targeted supplementation of corresponding nutrients under the guidance of a pediatrician or clinical nutritionist.

I met a mother in the outpatient clinic a while ago. She took out half a bag of bottles and cans from her canvas bag, including DHA, calcium citrate, lutein gummies, multivitamins, and zinc supplement oral liquid. She counted 7 types. She said that all the kids of the same age in the community were eating them. "Other people's babies are getting supplementary care. What if my family doesn't provide supplementary supplementation and will not be able to grow taller or keep up with their studies?" This kind of anxiety is really too common. The first thing many relatives and friends around me ask me is "My baby is 3 years old, what should I supplement?"

In fact, regarding the supplementation of children's nutrients, no matter in the parent circle or in the professional field, there has never been a completely unified conclusion. One group of people holds the view of "prevention first" and believes that it is too common for children to be picky eaters now. In addition, the nutrient density of food grown in greenhouses is not as good as before. Supplementing low-dose nutrients is equivalent to "priming", even if it is useless. There is no harm. The other group insists that "natural food is the best solution" and believes that the absorption rate of additional nutrients is far less than that obtained from food. Long-term supplementation will increase the metabolic burden of children's liver and kidneys, and even lead to the risk of overdose poisoning. In fact, both views have their own truths. There is no absolute right or wrong. The core still depends on the specific situation of the child.

I have been doing child health care for 11 years, and I have dealt with at least 7,000 to 8,000 children. The proportion of children who really need extra nutrients is really less than 10%. I was particularly impressed by a 4-year-old allergic child who was allergic to milk protein, eggs, and nuts. He usually refused to eat dark green vegetables. He was found to have low bone density six months ago and his serum calcium was only at the lower limit of the standard value. So we asked him to take a daily supplement of 300 mg of calcium citrate with vitamin D. After three months of supplementation, he returned to normal levels. After that, he stopped and just relied on diet to maintain it.

There is also vitamin D that everyone knows. This is the only consensus among domestic and foreign nutrition circles that it needs to be supplemented regularly starting from the 15th day of life: exclusively breastfed babies need 400IU per day. Babies who drink formula milk must also make up the difference if their daily milk volume is less than 1000ml. After one year old, it is increased to 600IU, at least until puberty. This is really necessary. After all, the vitamin D content in food is very small, and relying on sun exposure can easily damage your baby's delicate skin.

As for DHA, lutein, iron and zinc supplements, which are very popular nowadays, they are really not necessary options. Let’s just talk about DHA. It is indeed good for the development of children’s optic nerve and nervous system. But if you can feed your baby two or three times a week of deep-sea fish, such as salmon and cod, about a palm-sized piece each time, or eat one egg every day, then the DHA intake will be enough for your baby, and there is no need to buy extra DHA soft capsules that cost hundreds of dollars a bottle. Previously, a mother bought a product without DHA for her baby. After eating it for half a month, her baby developed an allergy and developed a rash. After sending it for testing, it was discovered that the content of EPA in it exceeded the standard, which caused trouble for the baby.

There is also lutein. Many businesses say that "supplementing lutein can prevent myopia", which is purely a sneaky concept. Lutein can indeed relieve visual fatigue, but the core of preventing myopia is to spend more than 2 hours outdoors every day and watch less electronic products. If your child can eat half a pound of dark green vegetables every day, such as spinach, broccoli, and lettuce, the lutein obtained will be more effective than eating ten bottles of gummy candies. Of course, if your child really refuses to touch a bite of green vegetables and spends more than 4 hours a day taking online classes and reading picture books, then there is no problem in supplementing with a low dose of lutein. There is no need to think of paying an IQ tax.

Oh, by the way, there is also the highly controversial multivitamin. Some clinicians think that if the child is often picky about food and does not eat enough fruits and vegetables for a day or two, supplementing with a low-dose multivitamin is equivalent to "checking for leaks and filling the gap", which is fine. However, there are also many experts in the field of public health who do not recommend that healthy children eat it regularly. The ratio of many commercially available multivitamins is based on the dietary structure of European and American children. Asian children eat more cereals on a daily basis. The original intake of B vitamins is sufficient, but supplementing too much will increase the metabolic burden. On the other hand, relying on supplements for a long time can easily cause parents to ignore dietary adjustments and instead indulge their children's picky eating habits. My sister's baby just entered kindergarten last year. During that time, she was very picky about food. She was so anxious that she bought a popular multivitamin gummy candy and gave her 2 capsules a day. The baby found it sweet and asked for it every day. Sometimes she secretly took out more gummies and ate more. Within half a month of eating, she became constipated. When she went to check, she found out that the vitamin A content was high and the baby couldn't metabolize it. After stopping, she adjusted her diet and it was fine within two weeks.

In fact, there is really no “standard answer” to supplementing nutrients for babies, and there is no need to follow other people’s lists. If you are really not sure whether your baby is deficient, keep a food diary for three days, ask a nutritionist for a dietary assessment, and do a serum nutrient test if necessary. Make up for whatever is missing, and don’t make up for it if it is not lacking. After all, compared to the nutrients in bottles and jars, eating well, running more, jumping more, and getting enough sleep are the core of a healthy baby's body.