Vitamin and mineral supplement needs in normal children in the United States.

The last 50 yeas have witnessed a steadily increasing understanding of the biochemistry of vitamins and trace minerals and their role in human nutrition and intermediary metabolism.’7 There also has been a growing public awareness of the sometimes dramatic clinical impact of vitamin and mineral administration in deficiency states. As nutritional needs became more clearly defined, essential vitamins and minerals were incorporated into processed formulas with the aim of providing an essentially complete food for infants; specific nutrients likely to be lacking in the diet of older infants and children were also used to fortify certain food products, such as infant cereal. Supplemental vitamin and mineral drops or tablets continued to be used, probably to a greater extent than necessary considering the more extensive fortification of food. Vitamin and/or mineral supplements are relatively inexpensive and available without prescription; therefore, it is understandable that they are used by a substantial portion of the population. The widespread consumption of these products is also fostered by a combination of advertising pressure and concern about dietary adequacy. Many individuals regard vitamin and/or mineral supplements as a reliable method of ensuring that real or imagined dietary shortcomings are corrected. Others, on far less rational grounds, have come to regard supplements in a wide range of doses as the philosopher’s stone for good health or as treatment for a wide array of ailments from mental retardation to the common cold. As a result, vitamin and mineral supplements are widely abused by the general public, occasionally to the point of toxicity. This statement will review the usual need for supplements in normal infants and children in the United States. In addition, the special needs of preterm and low-birth-weight infants and those of infants whose mothers are inadequately nourished will be reviewed. This statement will not consider the special requirements of infants and children with overt nutritional deficiencies, malabsorptive and other chronic diseases, rae vitamin dependency conditions, inborn errors of vitamin or mineral metabolism, or deficiencies related to the intake of drugs. Many children with these disorders may require pharmacologic doses of vitamins, which should be individually prescribed by the physician.