Tag: vitamin K

Which Vitamins Should My Kids Take?

All kids need vitamins.

So which vitamins or supplements should you give them?

“The American Academy of Pediatrics believes that healthy children receiving a normal, well-balanced diet do not need vitamin supplementation over and above the recommended dietary allowances, which includes 400 IU (International Units) of vitamin D a day in infants less than 1 year of age and 600 units/day for children over 1 year of age.”

AAP on Where We Stand: Vitamins

It depends. Most kids don’t actually need to take any extra vitamins.

Which Vitamins Should My Kids Take?

Follow the My Plate guidelines to make sure your kids are getting enough vitamins and minerals.
Follow the My Plate guidelines to make sure your kids are getting enough vitamins and minerals.

Wait, if all kids need vitamins, then why don’t you need to give them extra vitamins?

That’s easy. Most kids should get enough vitamins from the foods they eat.

Are your kids missing out on something? Then that would be a clue on which vitamins and minerals they would need to take.

Does your child have a chronic medical condition?

Are they on a special or restrictive diet?

Even if they are a little picky or don’t eat as much as you like, do they eat some foods from each food group, leading to a balanced diet by the end of the week?

In general, to see what your child might need, focus on your child’s intake of:

  • iron – can be low (anemia) in preterm babies, when infants are exclusively breastfeeding and not eating foods with iron, toddlers and preschoolers who are drinking excessive amounts of cow’s milk and not eating foods with iron, other kids who don’t eat many foods with iron, and teen girls who have heavy periods
  • vitamin D – can be low when infants are exclusively breastfeeding and don’t take a daily vitamin D supplement and older children who don’t eat or drink enough foods with vitamin D, including milk, cheese, yogurt, and orange juice
  • calcium – can be low when children don’t eat or drink enough foods with calcium, including milk, cheese, yogurt, and orange juice
  • fluoride – can be deficient when children mainly drink bottled water, soda, and juices, but since too much fluoride can lead to tooth staining, it is best to get fluoride from drinking fluoridated water – offer it daily once your child is about six months old
  • vitamin B12 and folate – can become classically low in vegans (who don’t take a supplement) and kids who drink goat milk that’s not fortified with vitamin B12 and folate
  • vitamin C – rarely low, which would cause scurvy, as most fruits and fruit juices are high in vitamin C

What other things do parents think about supplementing?

  • protein – while many parents worry that their kids aren’t getting enough protein in their diets, protein is rarely the thing that they are missing out on, as only about 20 percent of our calories need to come from protein.
  • calories – if your child is a picky eater, you might think that they aren’t getting enough calories and might think of supplementing them with a shake or two to boost their calories, but keep in mind that these typically end up replacing meals, leading kids to eat even less food and teach them to just drink their calories
  • vitamin K – typically only a problem for breastfeeding newborns who didn’t get a vitamin K shot, as vitamin K is found in many foods
  • vitamin A – since milk and many other foods are fortified with vitamin A, this is rarely a vitamin that we worry about being low. Supplements are also a concern, because too much vitamin A can be toxic.
  • potassium – few people worry about their potassium intake, but maybe they should. Most of us don’t eat enough foods with potassium.
  • magnesium – since magnesium is so easily absorbed, this is rarely a mineral that we get concerned about being low.
  • vitamin E – most kids get enough vitamin E in their diet, so a supplement probably isn’t necessary unless your child has a malabsorption problem or abetalipoproteinemia
  • iodine – most kids get enough iodine thanks to salt iodization, but extra iodine is recommended for pregnant and breastfeeding mothers
  • zinc – many foods contain zinc, so zinc deficiency is rare
  • fiber – giving kids extra fiber can be a good idea if your kids don’t eat enough high fiber foods, especially if they are having stomach issues
  • probiotics – although taking probiotics is one of the latest fads, there is little evidence that probiotics are helpful for much of anything in healthy kids
  • fish oil – another fad, there is likely no benefit to giving your kids omega 3 fatty acids

So which vitamins and supplements do your kids need?

Best Vitamins and Supplements for Kids

Once you figure out which vitamins and minerals your kids need, you have to figure out the best way to make sure they get them, understanding that the answer isn’t always going to be a gummy vitamin.

You also will likely need a different supplement if you are actually treating a deficiency vs if you are just trying to prevent your child from developing a deficiency in the first place.

So the best supplement(s) might be:

  • a multivitamin with iron – keeping in mine that gummy vitamins typically don’t contain iron, so if your main concern is that your child isn’t getting enough iron, then you should give your child an iron vitamin or a multivitamin with iron. Also low in calcium. Either liquid (infants), chewable, or tablets.
  • a multivitamin without iron – keeping in mine that in addition to not containing iron, these types of multivitamins also often don’t contain very much calcium. Often available as liquid (infants), gummies, chewables, and tablets.
  • a vitamin D supplement – was your child’s vitamin D level low or do you just think that he doesn’t get enough vitamin D in his diet? These are typically available as liquid, gummies, chewables, and tablets.
  • a calcium supplement – These are typically available as gummies, chewables, and tablets.
  • a vitamin D supplement combined with calcium – These are typically available as gummies, chewables, and tablets.
  • an iron supplement – if  your child’s iron was low, then they will likely need an iron supplement, like Feosol, Niferex, or Fer-In-Sol. Either liquid or tablets.
  • a fluoride supplement – do you live in an area where the water isn’t fluoridated? Do you use a reverse osmosis system that filters out fluoride? Usually available as a prescription only. Or you can buy ‘baby water’ with added fluoride.

Again, remember that unless your child has already been diagnosed with a deficiency, you can often work to get your kids to eat more foods with these nutrients instead of giving them an extra supplement, including vitamin fortified foods.

Look to you pediatrician and a registered dietician if you need extra help.

More on Which Vitamins Should My Kids Take

 

Don’t Skip Your Baby’s Vitamin K Shot

Most parents understand and expect that their baby will get a vitamin K shot when they are born and before they leave the hospital.

It helps prevent bleeding from vitamin K deficiency.

Vitamin K for Babies

Leave the formula samples at the hospital, but don't leave without your baby's vitamin K shot.
Leave the formula samples at the hospital, but don’t leave without your baby’s vitamin K shot.

Newborns have been routinely getting vitamin K shots since at least since 1961.

While it was well known that newborns could suffer from hemorrhagic disease of the newborn (the old name for vitamin K deficiency bleeding) since 1894 (thanks to Dr. Charles Townsend), it wasn’t until later that it was connected to a temporary lack of vitamin K in newborns and younger infants. This occurs because:

  • vitamin K doesn’t pass through the placenta well, so your baby doesn’t build up a good supply during pregnancy
  • breast milk is a poor source of vitamin K, even if the breastfeeding mother eats well and takes supplements, so your baby isn’t able to quickly build up a good supply after she is born
  • babies have a mostly sterile gut and are not born with the bacteria in their intestines that can make vitamin K
  • some clotting factors need vitamin K to work

Although vitamin K deficiency bleeding was never very common, before newborns began it get vitamin K shots, it did affect from 1.7% (classic onset disease) to 7 in 100,000 newborns (late onset disease).

Since many of these bleeds were fatal, even though they were rare, no one thought that there was a benefit to being low in vitamin K and getting a vitamin K shot wasn’t controversial. At least not until a 1992 paper suggested that vitamin K shots could be associated with childhood cancer. That soon led some parents to refuse their babies vitamin K shots for a short time, at least until the link was refuted.

In 1996, a student called for the ‘End of the Vitamin K Brouhaha:’

“Because hemorrhagic disease of the newborn can be life-threatening but preventable, the studies by von Kries et al and Ansell et al should allay our fears and doubts about the dangers of administering intramuscular vitamin K immediately after birth. It seems that hemorrhagic disease of the newborn can be completely eradicated without the threat of leukemia and childhood cancer as a side effect.”

And the vitamin K brouhaha did seem to end.

The Vitamin K Controversy

It came back though.

In addition to holistic and natural parenting groups, there are some who are against vaccines who are also against vitamin K shots.

This is surprising to many people, as those who oppose giving babies vitamin K are often the same folks who push many other types of vitamins, including megadoses of vitamin C, vitamin B12 shots, and extra vitamin D.

Vitamin K Misinformation

So why do some parents skip giving their new baby a vitamin K shot?

It is possible that in doing their research, they have been mislead by some of the misinformation about vitamin K that you commonly find on the internet.

This includes claims that:

  • there is mercury and other toxic ingredients in the vitamin K shots (the truth is that neither mercury or thimerosal nor any other heavy metals are used as a preservative in vitamin K shots and all of the other ingredients are safe too)
  • vitamin K shots cause cancer (the truth is that they don’t and an early study that suggested they did was later refuted many times)
  • babies don’t need extra vitamin K (the truth is that some do though and it is typically impossible to identify them, except maybe for babies born to mothers taking certain medications, mostly seizure medicines, that put them at extra risk of early vitamin K deficiency bleeding)
  • babies start making enough vitamin K when they are 8 days old (the truth is that some babies don’t, especially those with liver disease and other disorders that might interfere with the absorption of fat soluble vitamins)
  • babies did fine before we started giving them vitamin K shots (the truth is that some died, which is why we started giving vitamin K in the first place)
  • you can just give babies oral vitamin K instead of a vitamin K shot (the truth is that oral vitamin K doesn’t work to prevent all cases of late onset vitamin K deficiency, which is also deadly)
  • only boys who get a circumcision need vitamin K (the truth is that we don’t know why some infants with vitamin K deficiency bleeding develop bleeding in their brains, as it isn’t usually any kind of big trauma, so it doesn’t have to be something like a circumcision or a fall or whether you delivered vaginally or by C-section, etc. In fact, late onset bleeding can occur up to 12 weeks, and sometimes as long as 6 months, after a baby is born!)
  • there must be a benefit to having low vitamin K levels when we are born, otherwise God wouldn’t have made us this way (even if this were somehow true, it doesn’t negate the fact that some babies die from their low vitamin K levels…)

Just as with vaccine preventable diseases, since vitamin K deficiency is now rare (because most parents make sure their babies get a vitamin K shot), it is easy for parents to be misled by this type of misinformation.

Bad Advice about Vitamin K

According to the American Academy of Pediatrics, vitamin K deficiency bleeding “is most effectively prevented by parenteral administration of vitamin K.”

That’s the vitamin K shot.

While early (birth to 2 weeks) vitamin K deficiency bleeding can be prevented with either oral vitamin K or a vitamin K shot, late onset (2 to 12 weeks) vitamin K deficiency bleeding is best prevented with a vitamin K shot.

Some people didn’t get the message though, advising parents to skip the vitamin K shot against all standard medical advice:

  • Dr. Mercola still warns parents about the ‘jab with a syringe full of vitamin K.’
  • Sarah Pope at the Health Home Economist tells parents to ‘Skip that Newborn Vitamin K Shot’
  • 28 percent of parents who delivered at local private birthing centers in Tennessee had recently declined the vitamin K shot

So what are the consequences of this kind of non-standard, non-evidence based advice?

They are much as you would expect when dealing with a potentially life-threatening condition – a rise in vitamin K deficiency bleeding in newborns and infants.

Among the recent cases of early and late vitamin K deficiency bleeding include:

  • seven babies over eight months in  2013 at Monroe Carell Jr. Children’s Hospital at Vanderbilt University in Nashville, including three who required surgery to remove clots “out of their head” and who may “have issues with seizure disorders and will have long-term neurological symptoms related to seizures and developmental delays.”
  • a 5-week-old in Florida with late onset vitamin K dependent bleeding. The youngest of 6 children, none of whom had been given vitamin K, the baby had a seizure and stopped breathing after developing two brain hemorrhages.
  • a 3-week-old in Indiana with late onset vitamin K dependent bleeding who was born in a birthing center and whose “parents signed a waiver to forego vaccination and prophylactic therapies,” and required an emergency craniotomy to evacuate braining bleeding, prolonged intubation, and difficult to control seizures
  • a 6-week-old in Illinois with late onset vitamin K dependent bleeding who never received vitamin K prophylaxis at birth and developed brain bleeding and swelling, seizures, a DVT, and who was hospitalized for 10 days
  • a 6-week-old in South Texas with late onset vitamin K dependent bleeding who never received vitamin K prophylaxis at birth and died after developing brain bleeding and seizures
  • an infant in Australia who had not been given a vitamin K shot as per her mother’s birth plan and  died of late vitamin K deficiency bleeding (at 33 days of life)
  • another infant in Australia who is in critical condition after his parents refused a vitamin K shot
  • infants in Germany, Switzerland, Denmark, and the Netherlands who have suffered from vitamin K deficiency bleeding while receiving oral vitamin K, often because their parents refused a vitamin K shot

Tragically, most parents who refuse vitamin K shots also refuse other potentially life-saving medical interventions, including getting a hepatitis B vaccine and even getting erythromycin eye ointment. And many go on to refuse all childhood vaccines.

On the bright side, the great majority of parents do allow their newborn babies to receive vitamin K when they are born. One study found that only 0.3% of parents refused vitamin K.

What To Know About Vitamin K Shots for Babies

The bottom line is that vitamin K shots are a safe way to prevent vitamin K deficiency bleeding. This is no good reason to skip this shot for your baby.

More Information About Vitamin K Shots for Babies

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