If you provide your child with selections from each of the four basic food groups and let her experiment with a wide variety of tastes, colors, and textures, she should be eating a balanced diet with plenty of vitamins. Some vitamins, such as the fat-soluble vitamins (A and D), may even pose risks; they’re stored in the tissues when consumed in excess, and at very high levels could make your child sick. High doses of minerals such as zinc and iron taken over an extended time can have negative effects, as well.
Supplementation for Some Children
For some children, however, supplementation may be important. Your child may need some vitamin and/or mineral supplementation if your family’s dietary practices limit the food groups available to her. For example, if your household is strictly vegetarian, with no eggs or dairy products (which is not a diet recommended for children), she may need supplements of vitamins B12 and D as well as riboflavin and calcium. Rickets, for example, is a disease in which the bones soften, and it is associated with inadequate vitamin D intake and decreased exposure to sunlight; although uncommon in the United States, it continues to be reported especially in children with darker-pigmented skin. Consult your pediatrician about which supplements are needed and the amounts.
Iron deficiency does occur among some young children and can lead to anemia (a condition that limits the ability of the blood to carry oxygen). In some cases the problem is dietary. Toddlers need to receive at least 15 milligrams of iron a day in their food, but many fail to do so. Drinking large quantities of milk may lead to iron deficiency anemia, as the child will be less interested in other foods, some of which are potential sources of iron.
Too Much Milk?
If your child is drinking 24 to 32 ounces (720–960 ml) of milk or less each day, there’s little cause for concern. If she drinks much more than that and you can’t get her to eat more iron-rich foods, consult your pediatrician about adding an iron supplement to her diet. In the meantime, decrease her milk intake and keep offering her a wide variety of iron-rich foods so that, eventually, supplementation won’t be necessary.