Ok to give multi-vitamins for 1-yr-olds? And formula?

[esta_837]

I have a skinny 1 yr old. I now only breastfeed her once at night (bedtime), and offer her formula for breakfast and afternoon tea (afternoon snack), and after dinner.

Multivitamins exist for 1 year olds onwards, I even bought one on impulse. Haven't given it to her yet though.

Is it ok to give a multivitamin if she's also having formula? Vitamins are also in the formula but the thing is she doesn't drink much formula, say 120mls in the morning & 50mls for afternoon tea. Dinner also 50mls only.

Would there be an overdose on the vitamins? I noticed iron was not present in the multivitamin.

 

[meiteoh]

My friend who is also my paed nutritionist (she specialises in paed nutrition) informed me that supplements and formula should be reserved for sick children as oversupplementation (yes, she mentioned that it is possible to OD on supplements) can lead to kidney and liver issues - kidney and liver has to work harder to get rid of waste. If you're concerned about whether she's getting a balanced meal, instead of attempting over-the-counter or DIY treatment, my friend suggests that you speak to a proper nutritionist and not your paed or gynae as they do not specialise in nutrition (they take it as just one subject in their five year study) and can sometimes be as ignorant as a layman.

 

[sunburst]

Please do not give supplements to your 1 yr old kid. If I remember correctly supplements should only be given only if recommend by the PD.

Yes I do think your child is taking too little milk, but as long as a good variety of solid food is given & child is alert, active and growing well... It should be alright. How about introducing some food mixed with milk. For example, for breakfast... Quacker oats with milk, make pancakes using fm.

 

[apollo]

my pd is not very supportive in supplements. he only gave ds multivit when he was on both food and milk strike but told me to stop giving aft his appetite recovers or max finish tt bottle and stop cos he feels tt if aft finishing tt bottle his appetite still v bad means multivit doesnt help, no point taking it anymore. ds is eating quite lil nowadays and his pd refuse to give him any forms of sup to bring his appetite bk, he said unless his appetite is really very bad.

as for the milk part, u can try giving her fresh milk and see if he is interested? maybe she prefers 'blander' milk? or give her more cheese and yogurt. =)

 

[candy_ian]

In my opinion I think wt has size has got nothing to do with health status, it mayb genes or it mayb the child is active so hardly any extra for storage.. If milestone is reached with no issues then y intro supplements? The vitamins n minerals into supplements can b taken from daily diet. Instead of choosing supplements mayb intro your child to more variety of food for the vitamins n minerals intake? It wld b so much betta than taking supplement.

 

[Mummy to Baby V]

If child is on formula milk and varied diet, then supplements do not seem necessary.

In my boy's case, he was weaned off from breastmilk to whole milk. Eats a vegetarian diet except for a few servings of fish weekly. He has a good appetite and weighs above average. Our home-visit nurse recommended supplementing with a multi-vitamin. I showed her my choice and she cleared it. Our journey has also been shared at this article: Which Milk is Better for Toddler? (Part 1) | Mummy's Reviews

Seek professional advice and get several opinions before deciding.

 

[Frenchkitty]

I do give my 18mth old multi-vit supps, about 2-3x/week because he is sometimes a fussy eater and doesnt finish his meals in one sitting.

But be careful what you are giving. Avoid those chewies that are sugar-coated.

And also, it is perfectly OK to give water-soluble vits such as Vit C, as any unabsorbed amount will be flushed out by the body in urine.
Vits A, D, E, K are classed under fat-soluble vitamins which means when not all are absorbed by the body, the "waste" goes to the liver, therefore these are to be taken in minimal - moderation.

 

[meiteoh]

Actually, just because it's water soluble, it doesn't mean it's okay to take in huge quantities. This is because your kidney and liver which act as a filter for ALL vitamins and minerals will have to work doubly hard. Moderation is key.

 

[Ting]

imo, if your child is reaching mildstones, not falling sick often, no need to give supplements.
your girl might be skinny due to genes, n not bcos of she doesnt hv enuf vits. perhaps like candy ian suggested, offer more variety of food (more fruits n veggies) into her diet for the vits rather than supplements. for me, so far im only giving pin colostrum (since 1 mth plus 2mths ago) as she gets a cough/phelgm frequently due to (over)snacking . other than that, she gets her vits from her daily dose of fruits n veggies.

 

[esta_837]

wow thanks for all of your replies! Yes I haven't given the multi-v. I did notice added vitamins & minerals in some of the foods I offer, such as bread had iron & calcium in it too. 5 weeks ago she was still able to finish off 1.5 slices of toast for afternoon tea! But now she can barely eat half a slice...

I'm just really worried because she's skinny. She's really active, now she doesn't seem to eat enough to replace the calories burnt (which makes me think I may not have fed her enough milk when she was smaller). 12 months now, still can't walk unsupported (but cruising from 10months) nor talk. Not sick before. Still can't sleep through the night, so i've now been giving her formula once in the middle of the night, every night for the past 2 weeks, but still doesn't have much effect on her weight. She has a lot of variety of food, but eating lesser & lesser every day and sometimes just doesn't want to eat at all. I ruled out teething because I've been regularly putting teething gel on her gums until I've nearly gone through 1 tube of bonjela (btw did anyone notice bonjela contains alcohol??).

I wonder if it's because of the formula feed in the middle of the night that she's not eating her solids? It's really hard to stop that feed in the middle of the night now because she seems to wake less after having it. I find it even weird-er that she is still skinny after having formula 3-4 times a day. She used to be able to finish a small bowl of food + finger food when she was having formula only once a day. Now it's like only the finger food she can finish. I just know that she can eat more than she's eating, but I also don't know why she's not eating. Especially with her flat tummy. It used to become full after she eat until cannot eat already, but now....still flat every time and yet refusing to eat.

By the way, I'm still using step 2 formula as I notice on the step 3 packs, it says to feed only 2 times a day. Not sure if step 3 will make her completely off her solids. Oh and she's now drinking SLIGHTLY more formula from my 1st post - say 150mls morning, 60-75mls afternoon tea, 70-100mls after dinner, and gulping down another 80mls in the middle of the night.

 

[meiteoh]

Have you ever considered seeing a paed nutritionist? Don't consult your paed as they are not specialist in infant nutrition. A paed nutritionist may offer you some suggestions or insights as to why your daughter is either the way she is.

Hm, I can buzz my friend and ask her about your case - she's a paed nutritionist based in Australia with three young kids of her own. Hopefully she'll be free to give you an answer.

 

[esta_837]

oooh which part of australia is your friend in? I'm in Perth. It's really hard to find quality healthcare providers. All the child health nurses just take a look at her and say, Nope. She's fine, look how active she is. And say to cut her milk and give more solids. No one reallly listens.

 

[meiteoh]

Actually, they are right. Toddlers should be taking only a max of 400 to 500ml, lower if they are taking other dairy foods like yogurt and cheese. It is only in our Asian communities that we feel that a lot of milk is good. In fact, it is harmful as too much calcium can lead to iron deficiency which then impacts on growth, brain development, immunity and so forth.

At 12 mths, she should be having three meals a day plus two snacks (morning and afternoon). Your daughter is doing fine really. Chances are she's distracted with all the activity so much so that she has "forgotten" to eat. Also, the midnight feed could be because she's not eating enough during the day.

To share my experience, Eva didn't start walking until she was 13-14 mths and within one month, she went from starting to walk to walking on her own and now running/brisk walking. She went through a bout of fussy eating too - refusing to eat certain foods and etc. Only wanted snacks but I was firm - no snacks in replacement of main meals. After a while, she went back to normal. Looking back, it was her testing boundaries, to see if she could get away with not having to eat stuff she didn't like. Gloria, my friend, mentioned that toddlers will not starve themselves. When they refuse food for no particular reason and opt for snacks instead, it is because they are testing boundaries. If you give in and offer a snack in an attempt to get them to eat (most parents, she mentioned, are scared that their children will starve - THEY WON'T!), you're telling them that normal food is bad, snacks are good. If you want your child to eat certain foods like veg, etc, she says you need to be firm and disciplined. Feeding a toddler is about discipline and setting limits. Offer the food you want your child to eat and nothing else, not even milk. If she doesn't want it, then put aside and wait. When she's hungry, she'll eat it. Before you think that this is cruel, trust me when I tell you that it works each time! My babysitter who has been in this line for 22 years tell me that this works - whenever her charge doesn't want to eat food that mum provides or that she cooks, she'll wait till they are hungry. Then they'll eat it.

For me, I have a house rule - "No such thing as dont't like means dont't eat. At least must finish half a bowl." I went through this on Monday - yes, Eva loves to test boundaries all the time. She would wail and wail as if I was feeding her rat poison and most people (like my mother) would cave in and give her something else that she likes but me? No blardy way. After five to ten minutes of wailing, she gave up and ate whatever was in front of her. After half a bowl, she started fussing but this time, I told her okay, since you were good and finished half a bowl, we'll have dessert now.

You know how I was convinced that she was testing me? Yesterday, she had fish + tomato + rice for dinner and she happily finished everything. When I went "Oh, today you finish everything happily but yesterday, cry and refuse to eat as if I feed you rat poison, eh?" She looked at me, nod up and down and gave me a big grin!!!! @.@

Anyway, I'll see what my friend says. I think she's based in Adelaide.

 

[meiteoh]

Esta, here's my friend's reply:

Judging from what she shared, I would say lose the night bottle. Children above 12 months need not have a night feed. It sounds like mom is using the night feed more as a way to get bubs to sleep at night and also as "an insurance" to soothe mom's fear that bubs' not eating/drinking enuf.

Few things to emphasise:
1) There is no hard and fast rule for when children can sleep thru night. Some do it as young as during infancy and some will still wake up during the night when they are 5-6 years old. All comes down to child's internal traits and sleep schedule. As long as the child has 10-13 hours of sleep + nap(s) per day and the child seems otherwise happy and active (not easily tire), there is no reason to worry about the child waking up at night. He or she will sleep thru in his/her own time.

2) Mom seems concerned about child's weight/growth... keep emphasising that her child is skinny. Define skinny. Is it skinny compared to other kids? If this is the case, stop comparing. Each child is born with their own genetic propensity inherited from parents or even grandparents/uncles/aunties. If mom is worried re the child's growth, there are a few things she can do to:

- plot the child's weight and length/height: keep monitoring the growth (weight + height) for every 2-3 months and see if the child's growth crosses percentiles (eg: continuously falling or not gaining any weight for a certain period of time). it is important to emphasise that if the child is born small or "light" and continues to track the same percentile (eg: born in the 5th percentile and growing according to the 5th percentile), the child is fine.. he or she is just tracking her own genetic trait.

- get a full blood test done: test for any genetic anomalies as well as for nutrient deficiencies, eg: iron deficiency etc. If it's nutrient def, it is easy enuf to treat, all you need is just to give the child the nutrient supplement for a certain period of time and he or she'll be back on the right track. If it is genetic illnesses (eg: coeliac - which by the way is not common amongst children of asian decent), then at least you'll know that there is a reason for the poor appetite. you'll find that most times, child is doing fine with no deficiencies etc or just a minor def like iron def which is common amongst children with poor appetite and children who rely too much on milk. Again, if it's iron def, it is easy enuf to treat.

Without having the family and child's med history in front of me, I cannot say much. The best advice for any mom who is worried re their child's growth is GET IT CHECKED. Do the growth monitoring and take the blood test. Address thsoe worries and if everything comes back negative, at least the mom can have the peace of mind that the child's normal and it's just a behaviour thingy.

After 12 months, children will go thru a period of poor appetite-good appetite-poor appetite.... that's because during toddlerhood, their growth slows down and they do not need to put on as much weight as when during infancy. It is perfectly common that children will eat or drink less when compared to their infancy time because they are just regulating their appetite according to the physiological requirement of their bodies.

The worst thing a parent can do is to compare their children against the growth and performance of other children. I understand that she has some worries re the development of her child (the talking and walking) and again, there is no hard and fast rule when children achieve those milestones - some faster, some slower- and the developmental age range in the 1st 2 years is pretty subjective.. one of the reason why pediatricians and health professionals hesitate to formally assess the development of children below the age of 2.

So, that is my best advice: GET IT CHECKED.

 

[esta_837]

Awesome. I can't thank you enough for replying & going through the trouble of asking your friend. Regarding your friend's reply, I will come back to it later (in a few hours or days as I got to attend to her now & settle other things). Actually I started the 3 main meals and morning & afternoon snack at 8 months. That's when I dropped all night feeds and started her on a routine, just because the nurses said to feed milk only 3 times a day (I didn't quite believe her as it was only 8 months then and breastfed) AND to feed solids first before milk. So by 9 months, she was having milk only 3 times a day - once upon waking up at 6.30am, then no milk at all until afternoon tea. I was giving her pureed fruit and water only for morning snack. Afternoon tea was milk and toast. Then dinner, then breastfeed upon bedtime shortly after dinner. In bed by 7.30pm. She always woke up twice in the middle of the night at around the same times 11pm & 2am, and I just put her back to sleep without giving anything to eat/drink. This continued till I realised she wasn't gaining much weight, she was 10 months+ by that time, and my routine just went haywire from then on, when I sometimes offered milk in the middle of the night and sometimes didn't. 7.30pm to 6.30am is a very long time, thus I kept getting confused if she was hungry or not.

Something else happened when she was even smaller, around 3.5-4.5 months, she would sleep only 1/2hr each time and wake up crying. In the first 1/2-1hr she was burping, so I linked that with her just being windy, so I put her back to sleep. Then she would wake again in 1/2hr, and again I would put her back to sleep without feeding her thinking she was still windy. Now I admit THIS is my fault for not feeding her subsequent wakings at that time as I look back now and realised that she was just hungry again and having a growth spurt (which I didn't know at that time). She didn't gain any weight at all in that 1month.

So I gather This + That = results today? It's too late to fix the past.

gtg attend to her now..back later

 

[bringuplittleones]

Can I just say that I second what your friend replied? I'm a dietitian myself, although I do not specialise in paed nutrition, but I hae a pair of twins myself so I feel for the parents as well as applying the professional knowledge. My son is also a skinny boy who is 1.5kg lighter than my girl, but is extremely active. He's on the 25th percentile and so I'm giving him a different milk from his sister. Although he's skinny, he's super active. So I'm not too worried, and tries my best not to compare him with his sister. (I know this is hard, but do try please) Comparing our kids with other children is also not ideal as they have different genetic make-up, as well as every child grows at their own pace, specifically those below two. The growth spurt below 2s are like a yo-yo.

 

[Mummy to Baby V]

I agree with meiteoh that toddlers try pushing limits all the time.
Already I'm blessed with a foodie boy who eats almost any bland / bitter vegetables offered to him. (Else how to raise a vegetarian?!?)
But we have challenging days like today when he spat out his usual favourite prunes. As long as he tries to be funny only near the end of the meal, I'm fine. And certainly, hungry kids will eat. No replacement with extra milk or snacks for meals.

Drinking too much milk can spoil the appetite for toddlers. I know a 4-Yr old who drinks 3-4 bottles of milk a day, fusses over meal times, hates vegetables and doesn't grow much. But some parents try to feed more formula milk when the child is picky. I believe this makes things worse.

 

[bringuplittleones]

I agree with meiteoh that toddlers try pushing limits all the time.
No replacement with extra milk or snacks for meals. Drinking too much milk can spoil the appetite for toddlers. I know a 4-Yr old who drinks 3-4 bottles of milk a day, fusses over meal times, hates vegetables and doesn't grow much. But some parents try to feed more formula milk when the child is picky. I believe this makes things worse.

I totally agree. it seems to be a norm with many parents to offer milk when the kid refuses food. I think it creates a very bad habit, and encourages the child to be lazy (cos its easier to jus drink then to chew) or quickly get over a meal so they can get back to playing. Parents with caregivers, please make sure you let your caregiver know that you DO NOT want meal replacement for ur children (esp grandparents?). If they're hungry, they'll definitely come over for food.

 

[esta_837]

Esta, here's my friend's reply:

Got it checked. Took her to a GP, the doc didn't want to do any blood test as it would be "invasive", we only had her stool and urine test done and the results came back to have signs of lactose intolerance (1% reducing substances present in stool). Actually, I suspected she might be lactose intolerant a while back but still continued with the toddler formula as it has the vitamins, etc specifically for her age group. I also gave yoghurt & cheese, which my daughter has enjoyed eating. It's a big disappointment and disheartening to deal with it, and if I already guessed it but didn't want to believe it, I must have done a fair bit of damage to not only her poor little tummy but to her overall development as she had always been windy and unable to have good long sleeps. I've gone through 2 tins of lactose-free formula now and she seems to be improving although very slowly. Think I delayed her growth as she really is a bit skinny and does tire easily.
I wonder if there's still something else she's intolerant to....
Doesn't that mean no ice-creams, cake, chocolate in the future....
Have begun to look for dairy-free receipes.......

 

[meiteoh]

I could check with my friend and see what she thinks about this diagnosis.