Supplements and Kids: How Pediatricians Can Stop this Potentially Dangerous Duo

A growing number of children are taking dietary supplements that have no proven health benefits and pose potential health risks. Given the explosion of supplement consumption among adults, many pediatricians are not surprised by this trend.

According to a report from the business consulting group, McKinsey & Company - Cashing in on the Booming Market for Dietary Supplements -  “Over the last decade, sales of vitamins, minerals, and nutritional and herbal supplements have surged and many new companies have entered the space. Globally, the market is now valued at $82 billion, with roughly 28 percent of that in the U.S., where sales increased by approximately $6 billion between 2007 and 2012. Growth is expected to remain strong through 2017 – between 5 and 6 percent a year both globally and in the U.S.”  

Apparently, these consumers - especially those who are mothers and fathers - are encouraging their children to get on the “supplement bandwagon.” According to analysis published in JAMA Pediatrics, the rate of children taking alternative or herbal supplements nearly doubled, to 6.3 percent from 3.7 percent, between 2003 and 2014.

The increase was fueled by melatonin, a hormone used to aid sleep, and omega-3 fatty acids, or fish-oil supplements, which are often given to children with attention-deficit/hyperactivity disorder and autism, despite little evidence that they help. One-third of children and adolescents in the U.S. take loosely regulated dietary supplements, the analysis found, largely reflecting the use of multivitamins. That rate has held steady over a decade, while the use of alternative supplements has jumped.

While this increase in consumption may be good news for the supplement industry, it is bad news for children, according to the American Academy of Pediatrics (AAP). The organization has noted 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".

It adds that megadoses of vitamins—for example, large amounts of vitamins A, C, or D—can produce toxic symptoms, ranging from nausea to rashes to headaches and sometimes to even more severe adverse effects.

What’s the Problem?

Many current parents grew up taking a daily multivitamin, some of which were designed to look like popular cartoon characters. These parents see little or no health risks to continuing this practice with their own children. Plus, since popular media extoll the benefits of such supplements as melatonin or omega 3, many adults are motivated to share these perceived “benefits” with their children.

Unfortunately, there are 3 potential problems with this approach.

1. The quality of these supplements is uncertain.

Unlike prescription drugs, supplements are not tightly regulated by the U.S. Food and Drug Administration (FDA). Supplement manufacturers are not required to demonstrate safety or effectiveness to the FDA. Unfortunately, great packaging is often more important than quality control of these products.

2. Supplements should not replace good nutrition.

According to several sources, including this article, almost 1 in 3 children in the U.S. is overweight or obese. While wanting the best health for their children, parents often look for a “quick fix” in the form of vitamins or other supplements, rather than investing the time and energy in proper nutrition.

3. Some supplements can present health hazards to children.

Young men and women who compete in athletics are sometimes tempted to use over-the-counter supplements to build body bulk or strength. Bodybuilding supplements, used by 3 percent of boys and 1.3 percent of girls, are a concern because, in some cases, they have been linked to cardiac problems.

What Can a Pediatrician Do About Supplement Abuse?

In the pediatric toolbox, there is no more powerful tool for combating misinformation than well-child visits. Among other things, during these regularly scheduled check-ups, the practitioner can observe physical growth and wellness in each patient, compare it to the national norms and counsel parents on the remedial actions that are needed. Having a pediatric-focused electronic health records (EHR) platform such as the PCC system, can greatly enhance these well-child visits.

Here’s why.

The objective of a study conducted in 2014 was to assess whether rates of preventive counseling delivered at well-child visits differ for practices with basic, fully functional, or no EHR. Practices with fully functional EHRs documented delivery of 34 percent more counseling topics than those without an EHR. Plus, those well-child visits with a fully functional EHR lasted 3.5 more minutes than those with a basic EHR. Overall, for each additional 10 min, 12 percent more topics were covered.

“With more time and better organized counseling information found in a well-designed EHR, more preventive health information can be delivered,” said Chip Hart, the Director of PCC’s Pediatric Solutions consulting group and author of the popular blog Confessions of a Pediatric Practice Consultant.

“This includes information on the benefits versus the risks of supplements."

Hart continues, “Having a pediatric-focused EHR can make a big difference in the efficiency of well-child visits. The Bright Futures guidelines, which are loaded into the PCC platform, along with other AAP policies for nutrition and supplement use can allow the pediatrician the opportunity to give these issues the attention they deserve.”  

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Tags: nutrition, AAP Bright Futures, patient advocacy, pediatric ehr