Supplements in Pediatrics: Challenges and Inappropriate Prescriptions

Optimal nutrition is a cornerstone of pediatric growth, cognitive development, immune competence, and long-term health. Despite sufficient dietary intake in most children, the use of dietary supplements is increasingly prevalent, sometimes without clear clinical justification. Five commonly supplemented nutrients-omega-۳ fatty acids, amino acids, vitamin C, vitamin E, and magnesium have well-established physiological roles but are generally unnecessary in healthy pediatric populations. Omega-۳ fatty acids, particularly DHA and EPA, support neurodevelopment, retinal maturation, and immunomodulation, with supplementation primarily indicated for preterm infants or children with inadequate dietary intake. Amino acids, essential for protein synthesis, energy metabolism, and neurotransmitter production, are indicated in inherited metabolic disorders, chronic kidney disease, or critically ill children. Vitamin C, a water-soluble antioxidant crucial for collagen synthesis, iron absorption, and immune defense, is typically sufficient from diet, with supplementation reserved for deficiency or high-risk conditions. Vitamin E, a lipid-soluble antioxidant, preserves cellular membranes, supports neurological function, and regulates immunity, with supplementation indicated in fat malabsorption syndromes or prematurity. Magnesium, a cofactor in enzymatic reactions and critical for neuromuscular, cardiovascular, and skeletal function, is generally adequate from a balanced diet, with supplementation limited to confirmed deficiency or specific clinical contexts. Clinical guidelines emphasize prioritizing dietary sources, precise dosing when supplementation is required, and monitoring for potential adverse effects, including bleeding, renal complications, or gastrointestinal intolerance. Conclusion: Routine supplementation of these five nutrients is not indicated in healthy children with adequate nutrition. Decisions regarding supplementation should be guided by individualized nutritional assessment, laboratory-confirmed deficiencies, and specific clinical indications, with dietary diversity remaining the foundation of pediatric health.

کلیدواژه ها:

pediatric nutrition ، supplementation ، omega-۳ ، amino acids ، vitamin C ، vitamin E ، magnesium