Most parents believe that they are failing their children if they don’t do something to ‘fatten’ them. This flawed reasoning is driving numerous parents to feed children dietary supplements such as vitamins and minerals which do more harm than good – Dr. Gita Mathai

It’s quite common to hear middle class parents and grandparents expressing dissatisfaction about their children’s physical growth and development. Many tend to be unhappy with their children’s height and weight — they are either too fat or thin — their body mass index (weight divided by height in meters squared) is not the ideal 23, or they seem to lack energy and stamina.

However, such fears about children’s physical development are mostly unwarranted, especially in the first year of an infant’s life. For instance the birth weight of a newborn should ideally double by the end of the fifth month and triple by the end of the first year. An infant who was born prematurely may weigh 2 kg or less at birth. That means her weight should be 4 kg at five months and 6 kg on the first birthday. Another mother may have delivered a baby that was 3.5 kg at birth, 7 kg at the end of the fifth month and 10.5 kg on the first birthday.

When these two children meet, although both have gained weight proportionately and are growing normally, the 10 kg child may seem much healthier than the 6 kg one. Inevitably, this prompts comparisons and heartburn among parents and family members who begin comparing diets and worry whether the latter child should be administered dietary supplements to accelerate her physical development.

Unfortunately, even educated parents tend to be unaware that every child follows her own individual linear growth curve. Enhanced diets are unlikely to boost a child’s physical progression. For example after the age of one, a child needs only 400 ml of milk per day. Increasing the quantity of milk consumption to increase weight/height is likely to prove counterproductive. Intake of large quantities of milk bloats the stomach and is likely to cause abdominal distress in young children.

Ideally, if a child eats a balanced, home-cooked meals (not instant noodles and other fast food) for breakfast, lunch and dinner, supplemented with a homemade snack of fruits or nuts at 10 a.m and 5 p.m, she will be on a healthy growth trajectory.

Snacking on ready-to-eat, nutritionally sub-standard packaged foods should be discouraged. The common refrain of most middle class Indian parents is that their children have poor appetites and don’t eat enough. A child who exercises for at least an hour and has her meals at fixed times is likely to have a good appetite.

Yet despite reassurances from paediatricians, parents tend to doubt their children are developing optimally. They believe that they are failing their children if they don’t do something to ‘fatten’ them. This flawed reasoning is driving a growing number of parents to feed children dietary supplements such as vitamins and minerals which do more harm than good.

The consequence is the growth of an unregulated health supplements industry valued at billions of dollars. This industry capitalises on the anxiety of parents, the elderly, and fears and aspirations of sportspersons and fitness enthusiasts who swallow supplements — dietary, nutritional, health, sports and body-building — to attain the promised ideal health and physical characteristics.

Most health supplements claim to be ‘natural’ products free of chemicals and side effects. Usually these are misrepresentations. Natural/herbal supplements may contain harmful heavy metals or unpurified plant chemicals which mimic hormones. The common public perception is that mega doses of vitamin supplements boost immunity. The plain truth is that no health supplement can compensate for a balanced diet and healthy lifestyle including regular physical exercise.

Natural foods are always better for health than packaged nutritional supplements because they contain trace minerals and antioxidants. A case in point is breast milk. Despite years of research and experimentation, none of the packaged ‘formula milk’ multinationals has come anywhere close to replicating the nutritional and immunological content of breast milk.

Health supplements are usually sold as powders that dissolve in milk/water, capsules, and now increasingly as bottled smoothies and health shakes. These are best avoided. The better option is to prepare smoothies at home. Breakfast cereals are also highly processed. A more nutritious breakfast option is to powder a combination of millets and nuts at home and add them to porridge.

Vitamin supplements for children are also being formulated and sold as chewable tablets which look and taste like candy. They contain added sugar (usually 3 gm per tablet), colouring and flavouring. It is possible that children may overdose on them because they like the taste and demand it as a treat. Parents need to be aware of the dangers of these vitamin supplements targeted at children. Many of them contain excess fat-soluble vitamins, especially vitamin A and D. They can cause nausea, vomiting, liver and kidney damage and increase calcium deposits in the body. However water-soluble vitamins (B and C) are harmlessly excreted by children.

Also read: Importance of good gut health

I strongly advise parents to carefully study the content labels of health supplements. Food supplements drunk as beverages are enriched with minerals, vitamins and calcium. If children take them in pill form, there’s the danger of overdosing. Similarly, if children or adults are on alternative (herbal, homoeopathy, ayurveda) medication, please note the same vitamin and mineral ingredients present in these concoctions are usually available in a natural food. Weight loss tonics and pills contain ephedrine or thyroid extracts. On the other hand weight gain formulations may contain steroids. Exact concentrations are difficult to determine and seldom specified on product labels. It’s also important to check the expiry date of dietary supplements, vitamins and tonics.

In sum, avoid health and dietary supplements for children because the promised nutritional benefits can be derived by altering family diets and physical exercise regimens.

(Dr. Gita Mathai is a Vellore-based paedritician and author of Staying Healthy in Modern India.)