Multivitamins for kids … or not?

I feel guilty sometimes because my 12-year-old doesn't take a multivitamin—and she never has. Somewhere on the first-aid/supplement shelf in the kitchen lurks a dusty bottle of fruit-flavored, gummy-chew multivites that's barely used and, I must confess, way past the expiration date. I'll throw it out the next time I clean that shelf—but I don't plan to replace it.

Why? Given the avalanche of vitamin commercials, the supermarket aisle packed with colorful bottles adorned with cartoon characters (Fred and Wilma!  Disney Princesses! Scooby-Doo! Pixar Cars!), and our own "one a day" childhoods (my parents doled out a nasty, brown multivitamin liquid with a medicine dropper every night for years …. yechhh!), it feels like heresy or a lapse in smart parenting not to do the same. But it turns out most kids and teens don't need them.

"This is not an easy topic," registered dietitian Mary Trotter MS RD LDN, of Nemours/Alfred I. duPont Hospital for Children in Wilmington, Del., told me in an email last week. "The American Academy of Pediatrics and the American Academy of Nutrition and Dietetics (formerly American Dietetic Association) agree that children who eat a balanced diet get all the nutrients that they need from food. In fact, no U.S. government health agency, private health group, or health professional organization promotes the regular use of a multivitamin and mineral supplement or individual nutrients without first considering the quality of the child's diet."

One recent study found that one in three American kids take multivitamins—and most of them ate well enough that they didn't need them. And the kids who needed vitamin supplements usually weren't getting them.

So how do you know? Kids who eat a balanced diet—fruit, vegetables, some whole grains, lean protein and 2-3 servings of dairy or a calcium-fortified equivalent (like soy milk) daily probably don't need a multivitamin. If they're munching fortified breakfast cereal, adding a multivitamin could raise their intake of some vitamins and minerals above safe upper limits, Trotter said.

It's worth asking your pediatrician or family doctor about a multivitamin if your child is: A picky eater or skips or skimps on entire food groups, a strict vegetarians or vegan, following a fad diet, dealing with anorexia or another health condition that interferes with eating or the ability to absorb nutrients.  In addition, breast-fed babies under one year old need vitamin D (400 IU per day) til they're weaned and getting enough D from formula or milk, Trotter notes.

What do you think? Do your children take vitamins? Why—or why not? Do you think vitamins are great nutrition insurance policy or a waste of money?