Children's Health: A Parent's Guide to Nutrition, Immunity, Sleep, Screens and Supplements

Why children's health looks different today

Parents ask me which vitamin to buy for their kids far more often than they ask what their kids eat for breakfast. The question is understandable; the order is wrong.

The Centers for Disease Control and Prevention puts obesity prevalence in children and adolescents aged 2 to 19 at about 19.7 percent, roughly 14.7 million kids 1. The American Academy of Pediatrics now treats childhood obesity as a chronic disease that deserves early evaluation and family-based treatment rather than watchful waiting 2. And a 2021 analysis of national dietary data found the share of calories American youths get from ultra-processed foods climbed from 61.4 percent in 1999 to 67 percent in 2018, while minimally processed food fell to 23.5 percent 3.

If you remember one number, make it that one. Two thirds of what your child's classmates eat is manufactured rather than grown or raised. A child's health looks like a medical question, but for most families it behaves more like a household routine. The levers are food, sleep, movement and screens, and the medical layer sits on top of those four and catches what they miss.

Nutrition for growth: what kids need by age

Per pound of body weight, kids need more of nearly everything, and iron is the clearest example. The AAP's clinical report notes that iron deficiency in infancy and early childhood, even without anemia, can have long-lasting effects on neurodevelopment 4. Iron needs by age, from the National Institutes of Health, run 11 milligrams a day for infants 7 to 12 months, 7 milligrams for ages 1 to 3, 10 milligrams for ages 4 to 8, 8 milligrams for ages 9 to 13, and 11 milligrams for teen boys and 15 for teen girls 5.

Bone is the second big story. The AAP sets calcium at 700 milligrams a day for ages 1 to 3, 1,000 milligrams for ages 4 to 8 and 1,300 milligrams for ages 9 to 18, and it is explicit that routine calcium supplements are not recommended for healthy children; you meet those numbers with food 6. Vitamin D is the partner nutrient. The AAP set a minimum of 400 IU a day for all infants, including breastfed babies, in 2008 7, and it now endorses the higher Institute of Medicine allowance of 600 IU a day from age 1 through 18 6. Those two figures do not conflict. One is the infant supplement dose; the other is the daily allowance from the first birthday on.

The Dietary Guidelines for Americans single out calcium, vitamin D, potassium and fiber as nutrients worth extra attention in children's diets 8.

Daily targets for the nutrients kids most often miss. Figures from the AAP, the NIH Office of Dietary Supplements and the Dietary Guidelines for Americans, cited in the text above. Ask your pediatrician about your own child.

The plate to build for a growing kid

My position has not changed: food comes first. Nutrient-dense, real, whole foods before supplements, before anything. For a child that means a plate built the same way every time: a protein, a fat, a fiber-rich carbohydrate, and a color.

1. Protein at every meal. Eggs, wild fish, pasture-raised chicken, grass-fed beef, Greek yogurt, lentils. It builds muscle, antibodies and enzymes, and keeps a kid full through a morning of school.

2. Real fat. Avocado, olive oil, grass-fed butter, nut and seed butters, full-fat dairy where tolerated. Fat carries vitamins A, D, E and K and feeds a growing brain.

3. Fiber that grows in the ground. Beans, berries, oats, sweet potato, pears with the skin on. This is where you close most of the fiber gap.

4. Something colorful. Peppers, carrots, blueberries, spinach in a smoothie. The color is phytonutrient content, which a vitamin pill cannot copy.

A savory, protein breakfast matters more for kids than for anyone else in your house. The research on breakfast and school performance mostly covers short-term attention and behavior, with the strongest signal in undernourished kids 9, but dyed cereal and juice is still the wrong way to start a day that includes math. For meal-by-meal ideas, see the guide to nutrition for kids, and if a growth curve worries you, nutrition for children's growth.

Children who share three or more family meals a week have 12 percent lower odds of overweight and 35 percent lower odds of disordered eating in a pooled analysis 10. That is an association rather than proof of cause. It is still one of the cheapest things you can do.

Sugar, juice and the drinks problem

Excess sugar behaves like a toxin in a child's body. The American Heart Association found added sugars associated with higher blood pressure, worse lipids, insulin resistance, fatty liver and obesity in children at intakes far below what most kids eat. Its recommendation is no more than 25 grams of added sugar a day, about six teaspoons, and none before age 2 11. A single flavored yogurt or a small soda can use up that whole budget.

Sugary drinks add calories without fullness. In cohort studies each extra daily serving was associated with a rise in children's BMI, and trials that cut sugary drinks moved BMI gain in the right direction, though the pooled effect in kids was modest and not statistically firm 12. Juice is the special case, because it looks like fruit. The AAP now says no fruit juice in the first year, then a cap of 4 ounces a day for ages 1 to 3, 4 to 6 ounces for ages 4 to 6 and 8 ounces for older kids, with whole fruit preferred every time 13. Water and milk are the drinks I keep in the house.

How to build a child's immune system

Young children get sick often, and much of that is normal. Their immune systems are meeting viruses for the first time, and every cold is a lesson. What you can do is keep the system well supplied and well rested, so each lesson is short, and you can stop treating every sniffle as a failure.

Start with the gut, because a large share of the immune system lives along it. Fermented foods, prebiotic fiber and a wide variety of vegetables, fruits, meats and fats build the microbial diversity that regulates immune responses, which is why I introduce a wide range of foods early and in small amounts with my own kids. The evidence on early allergen introduction supports the instinct. In the LEAP trial, infants at high risk for peanut allergy who ate peanut regularly from early infancy had a 1.9 percent rate of peanut allergy at age 5, against 13.7 percent in the avoidance group 14. The AAP's 2019 report finds no evidence that delaying allergenic foods prevents allergy and recommends early peanut introduction timed to the child's risk 15. A baby with severe eczema or an egg allergy gets peanut with a pediatrician or allergist, never on your own.

Then the unglamorous habits:

1. Handwashing. A meta-analysis of 30 community studies found hand-hygiene programs cut gastrointestinal illness by 31 percent and respiratory illness by 21 percent, and plain soap did as well as antibacterial soap 16. Before meals, after the bathroom, after school.

2. Sleep, the most underrated immune input in a child's day, covered below.

3. Movement outside. The federal guidelines call for at least 60 minutes of moderate-to-vigorous activity a day for children 6 to 17, with bone- and muscle-strengthening play three days a week, and for preschoolers to be active throughout the day 17.

4. Protein and zinc at every meal. Antibodies are proteins.

Vitamin C, vitamin D and zinc: what the evidence says for kids

The marketing around kids' immune products is far louder than the data, so you deserve the honest size of the effects.

Vitamin C helps children, modestly. The Cochrane review found regular vitamin C did not prevent colds in the general population, but it shortened cold duration by about 14 percent in children, and by 18 percent in trials that used 1 to 2 grams a day 18. A 2023 meta-analysis found it cut overall cold severity by about 15 percent, mostly on severe symptoms 19. The catch is that those doses sit well above the NIH upper limits for young children, 400 milligrams for ages 1 to 3, 650 for ages 4 to 8 and 1,200 for ages 9 to 13 20, so the trial dose is not a dosing suggestion. Give vitamin C as food instead: an orange, a red pepper, strawberries, kiwi and broccoli cover it, and you never approach the limit.

Vitamin D is the one you should take most seriously, and the evidence supports a measured view. A 2021 meta-analysis of 46 randomized trials found vitamin D supplementation reduced the risk of acute respiratory infection compared with placebo, but the overall effect was small, with 61.3 percent of supplemented participants getting at least one infection against 62.3 percent on placebo. Protection was clearest with ordinary daily doses of 400 to 1,000 IU and in children aged 1 to 16 21. That argues for meeting the 600 IU allowance through a northern winter, not for large doses. The NIH sets upper limits at 2,500 IU a day for ages 1 to 3, 3,000 IU for ages 4 to 8 and 4,000 IU from age 9 22. The adult vitamin D doses you will see elsewhere on this site do not apply to children.

Zinc is where the gap between adult evidence and kids' products is widest. The 2024 Cochrane review found zinc lozenges may shorten a cold slightly, with low certainty, showed no clear prevention benefit, and commonly caused nausea and taste disturbance 23. Treatment doses in those trials ran 45 to 276 milligrams a day, mostly in adults, many times the child upper limits of 7 milligrams for ages 1 to 3, 12 milligrams for ages 4 to 8 and 23 milligrams for ages 9 to 13 24. Zinc for kids comes from beef, chicken, pumpkin seeds, beans and yogurt. Lozenges are an adult tool, and you can leave them on the shelf.

How much sleep do kids need?

Sleep is where growth hormone is released, the day's learning is filed and the immune system does its maintenance, and it is the first thing families give up when evenings get busy. The American Academy of Sleep Medicine consensus figures, endorsed by the AAP, are the ones you want 25.

Recommended sleep per 24 hours by age, from the American Academy of Sleep Medicine consensus statement cited above. Infant and toddler figures include naps.

The cost of missing those numbers is more than a cranky morning. In a meta-analysis of longitudinal studies, children with short sleep had about twice the odds of later overweight or obesity, an association that is consistent across studies 26. The AAP's report on adolescent sleep ties chronic sleep loss in teens to depression, higher obesity risk and drowsy-driving crashes, names electronic media and caffeine as two main causes, and supports later school start times 27.

What you can do is simple, and it is what I do at home. Bedtime is early and the same every night, the room is dark and cool, and screens leave the bedroom an hour before lights out; a child who needs help winding down gets an audiobook. Sleep loss hits dopamine signaling, which is one reason a tired kid looks like an inattentive kid, so if you have a child who struggles with focus, sleep is the first thing to fix. If the problem is the sleep itself, the guide to night terrors covers what helps, and the sleep hygiene habits apply to a 7-year-old as well as to you.

Screen time for kids: what the AAP says

Screens are the newest input into children's health and the least studied, but what we know is consistent. A systematic review of 67 studies found screen time linked to worse sleep, mainly shorter duration and later bedtimes, in 90 percent of them 28. The authors say causation is not proven. You do not need a perfect trial to keep a phone out of a 10-year-old's bedroom.

The AAP's guidance comes in two statements. For children up to 5 the rules are specific: no screens other than video chat under 18 months, high-quality programming watched together from 18 to 24 months, and one hour a day of quality content for ages 2 to 5 29. For ages 5 through 18, the AAP deliberately declines to set a single hour cap and instead asks you to build a Family Media Use Plan that keeps screens out of bedrooms, off the table at meals and off before bed 30. If someone tells you the AAP has a two-hour rule for school-age kids, they are quoting an older statement.

The best experiment on screens going down is a Danish cluster trial that cut family recreational screen use to three hours a week or less for two weeks. Children in those families gained about 45 minutes a day of light-to-vigorous activity compared with controls 31. The same trial did not show a meaningful change in sleep over that short window; the sleep benefit shows up in observational data and needs longer to appear in an experiment, if it appears at all.

Outdoor time carries a bonus. In a meta-analysis of 25 studies, most in children, more time outdoors was associated with about 2 percent lower odds of developing nearsightedness per extra hour a week, though it did not clearly slow progression in kids already nearsighted 32. An hour outside after school protects eyes, sleep, mood and weight at once.

My own rules run stricter than the AAP's: no phones or tablets in bedrooms at any age, screens off an hour before bed and during meals, weekend mornings outside before anything glows. The digital detox approach works for kids with a few adjustments, and it works better when your kids see you follow it.

Supplements for kids: what is reasonable and what is not

About a third of American children and teens take a dietary supplement, most often a multivitamin 33. If you are one of the parents buying them, you deserve my position and the evidence side by side, because they do not line up perfectly.

Where I stand. If a child could only have two supplements, I would choose a food-based multivitamin and a probiotic. Some kids benefit from an omega-3, and a child who lives up north and rarely gets outside may need vitamin D; in my experience vitamin D without magnesium can constipate small children, so I pair them. Zinc and vitamin D shortfalls were the most common ones in the children I worked with. That is my clinical position, on the record, and you should know my own young children take a probiotic.

Where the evidence stands. The AAP's public guidance is that healthy children eating a varied diet generally do not need a multivitamin, and that large doses of vitamins A, C or D can be harmful 34. On probiotics, the biggest pediatric trial to date, 971 children with acute gastroenteritis, found Lactobacillus rhamnosus GG did nothing measurable compared with placebo 35, and the AAP has declined to endorse routine probiotics even in preterm infants, citing product quality and safety 36. On omega-3, trials in children with ADHD show a small but real improvement in symptoms, clearest with higher EPA content and modest next to medication 37 38; there is no comparable evidence for children without ADHD.

How I reconcile them. The evidence says the general child does not need a pill, and I agree. My position is about the specific child: the picky eater, the kid on repeated antibiotics, the child with a diagnosed deficiency. For those kids a targeted, conservative supplement makes sense, and the way you find out whether yours is one of them is your pediatrician and, where it matters, a blood test. Fermented foods deliver probiotics without the product-quality question.

What is reasonable, with your pediatrician

1. Vitamin D, at the AAP amount. Four hundred IU a day for infants, including breastfed babies, starting soon after birth 7, and 600 IU a day from age 1 6, staying under the age-specific upper limits 22. This is the one supplement with both an AAP recommendation and a plausible immune benefit behind it.

2. Iron, only when a test says so. The AAP recommends screening at 12 months and supplementing exclusively breastfed infants from 4 months until iron-rich foods take over 4. Beyond infancy you give iron only on a pediatrician's advice after testing, because accidental overdose of iron-containing products is a leading cause of fatal poisoning in children under 6 5.

3. A food-based multivitamin for a restricted eater. A vegan diet, severe food aversions, or recovery from illness. Choose one made from foods, at the child dose, and tell your pediatrician.

4. Omega-3 for a child with ADHD, as an adjunct. The evidence is real and modest 37. It sits alongside whatever plan the child's doctor has built, never in place of it. Fatty fish twice a week is the food-first version; the article on omega-3 supplements and ADHD walks through the trials.

5. Probiotics, food first. Yogurt, kefir, sauerkraut. If you and your pediatrician choose a supplement, give it a start date and an end date.

What is not reasonable

1. Megadoses of anything. Child upper limits are far lower than adult limits, and vitamins A and D accumulate. More is not better in a body that weighs 40 pounds.

2. Adult products at a fraction of the dose. Adult formulas often carry iron, herbs and other ingredients never studied in children.

3. Melatonin without a pediatrician. Pediatric melatonin ingestions reported to U.S. poison centers rose 530 percent from 2012 to 2021, to more than 260,000 cases, most unintentional in children under 5, with more than 4,000 hospitalizations and two deaths 39. When researchers tested 25 melatonin gummy products sold in the United States, 22 were inaccurately labeled, with actual melatonin from 74 to 347 percent of the label, and one contained CBD 40. Melatonin has legitimate uses in specific pediatric sleep disorders under medical care. As a nightly shortcut for a child on a tablet until 9 p.m., it is the wrong tool, and you lock it away like any medicine.

4. Zinc lozenges. Adult doses, adult evidence, and side effects children tolerate poorly 23.

5. Immune gummies treated as candy. A child who can reach the bottle will eat the bottle. Store every supplement out of reach.

6. Anything sold to you without a reason. This page recommends no products, on purpose.

A parent's quick reference for common kids' supplements. Evidence and dose figures are cited in the sections above. Every row assumes a pediatrician is in the loop.

School lunches, food dyes and the ultra-processed problem

On the food supply, the numbers are not in dispute. Two thirds of the calories American youths eat come from ultra-processed foods, and the fastest-growing category is ready-to-heat and ready-to-eat mixed dishes, which went from 2.2 percent of calories to 11.2 percent over two decades 3. That analysis measures what kids eat, not what it does to them. What I have found on school lunch menus, reading the ingredient lists, is sugar, artificial dyes and refined oils in nearly every item, five days a week. The articles on childhood obesity and school lunches and what schools get wrong about school lunch cover the policy side.

On food dyes, the evidence is real but smaller than the internet says. The Southampton trial gave 3-year-olds and 8- to 9-year-olds drinks containing artificial colors plus the preservative sodium benzoate, and found increased hyperactivity compared with placebo in both age groups, with small effect sizes 41. A 2012 meta-analysis found restriction diets reduced ADHD symptoms with a small effect, that the food-color effect was small and mainly seen in parent ratings, that teacher ratings did not reach significance, and that the effect did not hold in studies limited to FDA-approved colors 42. My reading is that a subset of children react to dyes, parents are the ones who notice, and removing dyes costs you nothing. The Southampton mixes also included benzoate, so the color alone was never isolated. Neither caveat makes me want dyes in a lunchbox; both stop me from telling you dyes cause ADHD.

Added sugar is the more consistent culprit, and the AHA put a number on it 11. A packed lunch built from real food solves both problems: leftover chicken and rice, a hard-boiled egg, cheese and apple slices, hummus with carrots. The list of healthy snacks for kids is the page I send parents to.

When to call the pediatrician

Everything on this page sits alongside medical care, never instead of it. Several colds a year in a preschooler is ordinary, and teething is loud and mostly harmless, as the guide to teething symptoms explains. A few patterns deserve a same-day call.

1. Fever in an infant under 3 months, or a fever with a stiff neck, a rash that does not fade under pressure, or a child who is hard to wake.

2. Breathing trouble. Fast breathing, ribs pulling in, or lips that look blue.

3. Dehydration. No wet diaper in eight hours, no tears, or a child who cannot keep fluids down.

4. A growth curve that stalls. Weight or height that flattens or drops across percentiles is the reason the well-child schedule exists.

5. A child who is always sick. Infections that are unusually frequent, unusually severe or slow to clear can signal something a pediatrician needs to see.

6. Persistent tiredness, pallor, poor appetite, or a change in mood, sleep or school performance that lasts more than a couple of weeks.

Vaccination decisions, screening tests and the well-child schedule itself belong in that same conversation with your child's doctor. This page covers the food, sleep, movement and screen habits that surround that care.

My take: fix the kitchen and the bedroom before the medicine cabinet

Too many families spend real money on children's supplements while the child's breakfast comes out of a box with a cartoon on it, and if that is you, you are not alone. The order is backwards, and reversing it costs less than the supplements did.

Here is what you can take from this page. Real food built around protein, fat, fiber and color will cover the nutrients most kids miss. Sleep at the AASM numbers, an hour outside and screens on a written plan will do more for immunity, weight, mood and attention than any product. Vitamin D at the AAP amount is reasonable for nearly every child, and a short list of other supplements is reasonable for specific children with a pediatrician's agreement.

Here is what you should not take from it. A probiotic will not reliably stop a stomach bug, because the best trial says it will not. Food dyes do not cause ADHD; the studies show a small effect in some children. And no supplement, at any dose, substitutes for a pediatrician who has examined your child. Where my clinical position runs ahead of the trials, you have been told so, and you can weigh it for yourself.

Food comes first. Nutrient-dense, real, whole foods before supplements, before anything. That is my position on the record, and it applies to my own children before it applies to yours.

The bottom line

Frequently asked questions

References

1. Centers for Disease Control and Prevention. Childhood Obesity Facts.
2. Hampl SE, Hassink SG, Skinner AC, et al. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity. Pediatrics. 2023;151(2).
3. Wang L, Martínez Steele E, Du M, et al. Trends in Consumption of Ultraprocessed Foods Among US Youths Aged 2-19 Years, 1999-2018. JAMA. 2021;326(6):519-530.
4. Baker RD, Greer FR, Committee on Nutrition American Academy of Pediatrics. Diagnosis and prevention of iron deficiency and iron-deficiency anemia in infants and young children (0-3 years of age). Pediatrics. 2010;126(5):1040-50.
5. National Institutes of Health, Office of Dietary Supplements. Iron: Fact Sheet for Health Professionals.
6. Golden NH, Abrams SA, Committee on Nutrition. Optimizing bone health in children and adolescents. Pediatrics. 2014;134(4):e1229-43.
7. Wagner CL, Greer FR, American Academy of Pediatrics Section on Breastfeeding, American Academy of Pediatrics Committee on Nutrition. Prevention of rickets and vitamin D deficiency in infants, children, and adolescents. Pediatrics. 2008;122(5):1142-52.
8. U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020-2025.
9. Adolphus K, Lawton CL, Dye L. The effects of breakfast on behavior and academic performance in children and adolescents. Front Hum Neurosci. 2013;7():425.
10. Hammons AJ, Fiese BH. Is frequency of shared family meals related to the nutritional health of children and adolescents? Pediatrics. 2011;127(6):e1565-74.
11. Vos MB, Kaar JL, Welsh JA, et al. Added Sugars and Cardiovascular Disease Risk in Children: A Scientific Statement From the American Heart Association. Circulation. 2017;135(19):e1017-e1034.
12. Malik VS, Pan A, Willett WC, Hu FB. Sugar-sweetened beverages and weight gain in children and adults: a systematic review and meta-analysis. Am J Clin Nutr. 2013;98(4):1084-102.
13. Heyman MB, Abrams SA, SECTION ON GASTROENTEROLOGY, HEPATOLOGY, AND NUTRITION, COMMITTEE ON NUTRITION. Fruit Juice in Infants, Children, and Adolescents: Current Recommendations. Pediatrics. 2017;139(6).
14. Du Toit G, Roberts G, Sayre PH, et al. Randomized trial of peanut consumption in infants at risk for peanut allergy. N Engl J Med. 2015;372(9):803-13.
15. Greer FR, Sicherer SH, Burks AW, COMMITTEE ON NUTRITION, SECTION ON ALLERGY AND IMMUNOLOGY. The Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Hydrolyzed Formulas, and Timing of Introduction of Allergenic Complementary Foods. Pediatrics. 2019;143(4).
16. Aiello AE, Coulborn RM, Perez V, Larson EL. Effect of hand hygiene on infectious disease risk in the community setting: a meta-analysis. Am J Public Health. 2008;98(8):1372-81.
17. Piercy KL, Troiano RP, Ballard RM, et al. The Physical Activity Guidelines for Americans. JAMA. 2018;320(19):2020-2028.
18. Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013;2013(1):CD000980.
19. Hemilä H, Chalker E. Vitamin C reduces the severity of common colds: a meta-analysis. BMC Public Health. 2023;23(1):2468.
20. National Institutes of Health, Office of Dietary Supplements. Vitamin C: Fact Sheet for Health Professionals.
21. Jolliffe DA, Camargo CA Jr, Sluyter JD, et al. Vitamin D supplementation to prevent acute respiratory infections: a systematic review and meta-analysis of aggregate data from randomised controlled trials. Lancet Diabetes Endocrinol. 2021;9(5):276-292.
22. National Institutes of Health, Office of Dietary Supplements. Vitamin D: Fact Sheet for Health Professionals.
23. Nault D, Machingo TA, Shipper AG, et al. Zinc for prevention and treatment of the common cold. Cochrane Database Syst Rev. 2024;5(5):CD014914.
24. National Institutes of Health, Office of Dietary Supplements. Zinc: Fact Sheet for Health Professionals.
25. Paruthi S, Brooks LJ, D'Ambrosio C, et al. Recommended Amount of Sleep for Pediatric Populations: A Consensus Statement of the American Academy of Sleep Medicine. J Clin Sleep Med. 2016;12(6):785-6.
26. Fatima Y, Doi SA, Mamun AA. Longitudinal impact of sleep on overweight and obesity in children and adolescents: a systematic review and bias-adjusted meta-analysis. Obes Rev. 2015;16(2):137-49.
27. Owens J, Adolescent Sleep Working Group, Committee on Adolescence. Insufficient sleep in adolescents and young adults: an update on causes and consequences. Pediatrics. 2014;134(3):e921-32.
28. Hale L, Guan S. Screen time and sleep among school-aged children and adolescents: a systematic literature review. Sleep Med Rev. 2015;21():50-8.
29. Media and Young Minds. American Academy of Pediatrics Council on Communications and Media. Pediatrics. 2016;138(5):e20162591.
30. Media Use in School-Aged Children and Adolescents. American Academy of Pediatrics Council on Communications and Media. Pediatrics. 2016;138(5):e20162592.
31. Pedersen J, Rasmussen MGB, Sørensen SO, et al. Effects of Limiting Recreational Screen Media Use on Physical Activity and Sleep in Families With Children: A Cluster Randomized Clinical Trial. JAMA Pediatr. 2022;176(8):741-749.
32. Xiong S, Sankaridurg P, Naduvilath T, et al. Time spent in outdoor activities in relation to myopia prevention and control: a meta-analysis and systematic review. Acta Ophthalmol. 2017;95(6):551-566.
33. Qato DM, Alexander GC, Guadamuz JS, Lindau ST. Prevalence of Dietary Supplement Use in US Children and Adolescents, 2003-2014. JAMA Pediatr. 2018;172(8):780-782.
34. American Academy of Pediatrics. Where We Stand: Vitamins. HealthyChildren.org.
35. Schnadower D, Tarr PI, Casper TC, et al. Lactobacillus rhamnosus GG versus Placebo for Acute Gastroenteritis in Children. N Engl J Med. 2018;379(21):2002-2014.
36. Poindexter B, COMMITTEE ON FETUS AND NEWBORN. Use of Probiotics in Preterm Infants. Pediatrics. 2021;147(6).
37. Bloch MH, Qawasmi A. Omega-3 fatty acid supplementation for the treatment of children with attention-deficit/hyperactivity disorder symptomatology: systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry. 2011;50(10):991-1000.
38. Chang JP, Su KP, Mondelli V, Pariante CM. Omega-3 Polyunsaturated Fatty Acids in Youths with Attention Deficit Hyperactivity Disorder: a Systematic Review and Meta-Analysis of Clinical Trials and Biological Studies. Neuropsychopharmacology. 2018;43(3):534-545.
39. Lelak K, Vohra V, Neuman MI, Toce MS, Sethuraman U. Pediatric Melatonin Ingestions - United States, 2012-2021. MMWR Morb Mortal Wkly Rep. 2022;71(22):725-729.
40. Cohen PA, Avula B, Wang YH, Katragunta K, Khan I. Quantity of Melatonin and CBD in Melatonin Gummies Sold in the US. JAMA. 2023;329(16):1401-1402.
41. McCann D, Barrett A, Cooper A, et al. Food additives and hyperactive behaviour in 3-year-old and 8/9-year-old children in the community: a randomised, double-blinded, placebo-controlled trial. Lancet. 2007;370(9598):1560-7.
42. Nigg JT, Lewis K, Edinger T, Falk M. Meta-analysis of attention-deficit/hyperactivity disorder or attention-deficit/hyperactivity disorder symptoms, restriction diet, and synthetic food color additives. J Am Acad Child Adolesc Psychiatry. 2012;51(1):86-97.e8.

This article is for educational purposes and is not a substitute for medical advice, diagnosis or treatment from your child's pediatrician. Pediatric supplement doses, iron and melatonin in particular, should be decided with a doctor who knows your child. If your child has trouble breathing, a fever under 3 months of age or signs of dehydration, seek medical care promptly. The habits described here work alongside, never instead of, medical care.