Unsure whether you should get supplements for your child? Read on to get the accurate answer!

Parents are understandably concerned when it comes to the well-being of their children. They would try to promote it in all possible ways. One of which, is giving their children supplements.

We asked experts from KK Women's and Children's Hospital (KKH), a member of the SingHealth group, to weigh in on the issue of children’s well-being and the necessity of supplements to that end.

How to complete dietary requirement of children without supplements

Ms Christine Ong, Senior Principal Dietitian, Nutrition and Dietetics DepartmentKKH, says, “With planning and appropriate food choices, it is possible for families (both children and adults) who consume foods bought outside the home to have a balanced diet. For example, if eating out, a family of 2 adults and 2 children can have:

  • Chicken sweet corn soup, steamed fish, stir-fried kailan and mapo tofu at a zhi char outlet

  • Steamed chicken (skin removed), stir-fried dou miao and shrimp dumpling soup with white rice at a chicken rice outlet

  • Grilled chicken or steak with baked potato and salad at a Western food stall

  • Lean non-fried meat, fish, or tofu with stir-fried vegetables and less gravy at a nasi padang or economical rice stall.

  • Plain thosai, chappati or idli with dahl and vegetables cooked without coconut milk

Although it is not easy to meet the recommended number of servings of vegetables when eating out, families can consider ordering vegetables to share, e.g. a dish of salad or stir-fried vegetables at a restaurant or a bowl of vegetable items from the yong tau foo stall at a food court as well as a plate of cut fruits at the end of the meal.”

Physical well-being: A healthy diet with a variety of whole foods is key

Ms Ang Bixia, Principal Dietitian, Nutrition and Dietetics DepartmentKKH, says, “Obtaining good nutrition through food rather than supplements is always encouraged. Hence multi-vitamins are generally not necessary for healthy children who are able to eat a varied diet.

Multi-vitamins may be recommended if a child follows a strict vegan diet or if he/she is not eating well (e.g. fussy eater) and hence does not obtain all the required nutrients from the different food groups.”

Needless to say, children need a wholesome and healthy diet to attain physical growth milestones, to support their immunity against infections, to recover smoothly after an injury or an illness, and to pursue age-appropriate activities.

A wholesome and healthy diet is one that provides the child with carbohydrates and fats (energy foods), protein (building blocks), vitamins and minerals (immunity and growth foods) and fats (brain foods). To be able to obtain these from the diet, a child needs to eat a variety of food items such as whole grains, rice and alternatives (including wholegrains), bread, meat, fish, eggs, nuts, beans and dairy products, fruits and vegetables, oils and nuts, every day.

However, a modern lifestyle and paucity of time means frequent quick-fix meals at home, eating out or takeaways from fast food joints and food courts, which may lead to an inadequate intake of key nutrients. 

To add to this unhealthy trend is the fact that most growing children are picky eaters – they may choose ‘tasty’ over healthy foods, show a preference for salty and fried foods instead of the healthier meal of veggies and lean meats and consume unhealthy amounts of sugary drinks every day.

One multi-vitamin or supplement with calcium, vitamin C and omega 3 (DHA) when needed

The resultant dietary deficiencies in children lead concerned parents to look for solutions. One of the easiest and simplest solutions is supplementing the child’s diet through multi-vitamins that provide almost the whole recommended daily allowance of the essential vitamins A, B, C, D, E and K and minerals such as calcium, magnesium, iron and zinc.

For parents who do not want to go the ‘one-multi-vitamin-a-day’ route, other options include boosting the child’s immunity by giving him vitamin C tablets, pastilles or syrups; promoting the child’s bone and teeth development by giving him calcium tablets; fortifying the child’s health and boosting his brain development by giving emulsions that provide the vital omega-3 (DHA) normally lacking in unbalanced diets. 

Fortified juices, milk and cereals also serve to supplement the diet through food-based choices.

Good eating habits should be cultivated from young

Dr. Han Wee Meng, Head and Senior Principal Dietitian, Nutrition and Dietetics DepartmentKKH, says, “Remember that establishing good eating habits can help your children maintain a healthy weight and normal growth. They are also likely to maintain a healthy lifestyle when they become adults. Furthermore, eating unhealthily sets the children up for an increased risk of obesity and obesity-related conditions such as sleep disorders and metabolic problems such as diabetes, high blood pressure (hypertension) and cardiovascular diseases (heart diseases).

Parents should set a good example for their children by practising good eating habits. Meals should be served at regular times with each meal lasting not more than 30 minutes. Always go for healthier food options when dining out as a family. 

This is because as parents are usually the main decision makers in food choices – what to eat and where to eat; children are great imitators, thus they pick up the eating habits from their family members. 

To cultivate good eating habits and to fulfil the dietary requirements of children, parents should set a role model, in choosing a healthy balanced meal, where there are plenty of vegetables and a selection of non-fried items at each meal. Fresh fruits can also be offered as a snack, in place of calorie-dense tidbits. Healthy eating should be seen as fun and pleasurable to encourage acceptance amongst children.”

Do supplements carry any side-effects?

Ms Christine Ong, Senior Principal Dietitian, Nutrition and Dietetics DepartmentKKH, replied "Some vitamins can be harmful if taken in large doses over a long period of time. For example: 

  • Too much vitamin A can lead to increased intracranial pressure & skeletal abnormalities in infants, as well as hair loss, hepatomegaly (enlarged liver), lethargy, headache, weight loss, vomiting, anorexia (loss of appetite), and skin lesions.

  • Too much vitamin C can cause gastric irritation and diarrhoea and too much iron can affect zinc absorption. However, so long as an age-appropriate supplement is given to your child in the recommended dose, the levels of vitamins and minerals should be within the safe limits."

4 Important advice about supplements for children

It is almost a given that supplements are being used by most parents to fill the nutritional gaps in their child's diet. Whilst it is best to obtain nutrients from food rather than supplements, it is also widely accepted that supplements given in recommended doses to the child do not cause any harm, rather they support and promote the physical well-being of a child.

However, there are certain pitfalls / dangers associated with supplementation and parents need to be mindful of these. These pitfalls are actually associated with supplement misuse and supplement abuse rather than their proper use.

1. Supplements are not magic pills or potions

Supplements cannot work miracles in improving the child's health or immunity overnight. As with anything else, supplements will take time to yield desired results. And they will work best if they are taken regularly, are age-appropriate and in recommended doses.

2. Supplements are not meant to replace meals

It is important to remember that supplements are only, as the name suggests, an add-on to a healthy diet. Supplements are meant to support and complement meals and not replace them. Hence, the emphasis on healthy eating must not wane because the child is taking a multi-vitamin. It is imperative that parents do not over-rely on the use of supplements.

3. Supplements are medicine, not confectionary or candy

The colourful packaging of kid's supplements may inadvertently mislead the consumer (more so children) into thinking that supplements can be consumed at will. It is therefore important to remember and reinforce at home that supplements are medicines and not a confectionary item or snack. Supplements must be treated with caution just like any other medicine. This means keeping supplement bottles away from the reach of children and ensuring that only the correct dosage is given to the child every day. Do not exceed the recommended dose as over-consumption of fat-soluble vitamins can have harmful consequences.

4. Consult a paediatrician before purchasing supplements for your child 

Even though most supplements are available freely over-the counter at pharmacies, it is advisable to consult a paediatrician before starting your child on a regimen of supplements.

Paediatricians can recommend the type of supplement and the dosage that will be most beneficial, discuss the dosage and rule out any possible allergy risks depending on your child's age and growth indicators.

Ref: S13