Blog: “My Child Has Autism: Should I Give Him a Multivitamin?”

“My Child Has Autism: Should I Give Him a Multivitamin?”

When a parent of a child with autism asks whether their child should take a multivitamin, it's essential to consider the child's overall dietary intake and nutritional needs. While a well-balanced diet rich in nutrient-dense foods should ideally provide most of the necessary vitamins and minerals, some children with autism may have extreme dietary restrictions, selective eating habits, or nutrient deficiencies that could benefit from supplementation.

Here are some key points to consider when addressing this question:

1. Assess the Child's Diet: Start by evaluating the child's dietary intake to determine if they are meeting their nutritional requirements through food alone. If the child has a varied diet that includes a wide range of nutrient-rich foods such as fruits, vegetables, whole grains, lean proteins, and dairy or dairy alternatives, they may not need a multivitamin. A simple way to ask this question is, “tell me about the foods he/she typically eats for breakfast, lunch and dinner.” If the child is consuming less than 20 different foods, a multivitamin might fill in the gaps. 
2. Are entire food groups eliminated? If the parent says the child refuses all foods from a food group, for example NO meat or absolutely NO vegetables, a multivitamin might be beneficial. 
3. Many kid-friendly foods are fortified with vitamins like A, C, D, and B. So if the child consumes milk, yogurt, nut milks, orange juice, breads, cereals, and frozen waffles routinely, a multivitamin may not be necessary. 
4. Children’s portion sizes are much smaller than what parents think and they can get the necessary vitamins and minerals from the basic food groups. 

http://www.choosemyplate.gov

A multivitamin can be a useful supplement for children with autism who have extreme dietary restrictions or nutrient deficiencies. It can also be used during a learning period if the child is learning to like new foods. While individual needs may vary, some key micronutrients to focus on include:

1. Omega-3 Fatty Acids: Omega-3 fatty acids, particularly EPA and DHA found in fatty fish like salmon and sardines, play a crucial role in brain development and function. Supplementing with fish oil or incorporating omega-3-rich foods into the diet may support cognitive function and behavior in children with autism. Foods to suggest the family try include:

• Fish and other seafood (especially cold-water fatty fish, such as salmon, mackerel, tuna, herring, and sardines)
• Nuts and seeds (such as flaxseed, chia seeds, and walnuts)
• Plant oils (such as flaxseed oil, soybean oil, and canola oil)
• Fortified foods (such as certain brands of eggs, yogurt, juices, milk, soy beverages, and infant formulas)

Omega-3 dietary supplements include fish oil, krill oil, cod liver oil, and algal oil (a vegetarian source that comes from algae). They provide a wide range of doses and forms of omega-3s.

2. Vitamin D: Adequate vitamin D levels are essential for bone health, immune function, and mood regulation. Children with autism may have a higher risk of vitamin D deficiency due to dietary restrictions or limited sun exposure. Encourage sources of vitamin D such as fortified dairy products, fatty fish, and exposure to sunlight. Children over 1 year of age need 600 IU (15 mcg) of vitamin D daily, either through food or a supplement.

3. Magnesium: Magnesium is involved in over 300 biochemical reactions in the body, including neurotransmitter function and muscle relaxation. Some research suggests that magnesium supplementation may help alleviate certain symptoms associated with autism, such as anxiety and hyperactivity. Include magnesium-rich foods like leafy greens, nuts, seeds, and whole grains in the diet.

4. Zinc: Zinc is important for immune function, sensory processing, and cognitive development. Children with autism may have lower zinc levels or impaired zinc metabolism, making it essential to include zinc-rich foods such as lean meats, shellfish, legumes, nuts, and seeds in their diet.

5. B vitamins: B vitamins, including folate, B6, and B12, play a role in neurotransmitter synthesis and methylation pathways, which are implicated in autism spectrum disorders. Ensure adequate intake of foods rich in B vitamins, such as leafy greens, eggs, poultry, fish, dairy products, and fortified cereals.

6. Antioxidants: Antioxidants like vitamin C, vitamin E, and selenium help protect cells from oxidative stress and inflammation. Including a variety of colorful fruits and vegetables, nuts, seeds, and whole grains in the diet can provide a range of antioxidants to support overall health.

7. Probiotics: Gut health is increasingly recognized as a factor influencing behavior and mood, with some evidence suggesting a link between gut microbiota and autism symptoms. Probiotic-rich foods like yogurt, kefir, sauerkraut, and kimchi can help support a healthy gut microbiome.

If you do recommend a multivitamin, here are a few things to also educate the parent about:

1. Choose a High-Quality Supplement: Look for a high-quality multivitamin specifically formulated for children that provides essential vitamins and minerals at appropriate levels. The Food and Drug Administration (FDA) doesn’t regulate vitamins and other dietary supplements to make sure they are safe or effective. It’s up to manufacturers to follow safety guidelines and accurately label what’s in their product. Look for products that are third-party tested for purity and quality to ensure safety and efficacy. To choose a safer supplement, look for one verified by U.S. Pharmacopeia, ConsumerLab, or the National Sanitation Foundation (NSF). 
2. Follow label directions for use in children. Give only the recommended dietary allowance (RDA) for the child’s age. Most children already get vitamins from their diet, so they may need less than this.
3. Keep all supplements out of a child’s reach, in either a locked cabinet or closet. This can prevent accidental overdose.

While focusing on these micronutrients, it's important to prioritize a balanced and varied diet that meets the child's individual nutritional needs. Consulting with a Registered Dietitian can help develop a personalized nutrition plan tailored to the child's specific requirements and preferences. If you would like more information on nutritional strategies for patient’s with autism, listen to episode 35 | Nutrition for Autism: Manage Mealtime Meltdowns with a Sensory-based Approach on The Exam Room Nutrition Podcast here: https://podcasts.apple.com/us/podcast/35-nutrition-for-autism-manage-mealtime-meltdowns-with/id1696017800?i=1000647380944