If you owned a store in Perfectville, your customers’ kids would be seduced by ripe, velvet peaches rather than red velvet cake. They’d chug kombucha instead of Coke. And they’d never get sick, tired, depressed, anxious or overweight.

In the real world, the scenario is more grim. Diets rich in processed ingredients and poor in whole foods have spawned childhood obesity, diabetes and behavioral problems. As a result, anxious parents are increasingly turning to supplements to keep their tots hale and happy.

Sales of children’s vitamins increased 79 percent over the last five years, to $170 million, and are expected to rise nearly 50 percent by 2015, according to Chicago-based research firm Mintel. Overall, children’s supplements sales hit $1.1 billion in 2008, according to Nutrition Business Journal’s “Healthy Kids’ Market Report: Supplements 2009,” and are predicted to grow an average of 4 percent a year through 2017.

Even so, Mintel researchers warn that sitting back and waiting for parents to scarf up supplements isn’t the best sales strategy: “Marketers and retailers will have to put greater emphasis on educating parents on how to choose the right vitamin combination for their child,” the researchers write.

To help you out, we asked five children’s supplements experts for their vitamin, mineral, herb, other nutrient and homeopathy recommendations for common kids' health issues, along with their thoughts on multivitamins, delivery systems, age-appropriate doses and special dietary needs. Here are their top choices.

The experts:

Linda White, MD, visiting assistant professor at Metropolitan State College of Denver and coauthor of Kids, Herbs and Health (Interweave Press, 1998)

Jack Challem, author of more than 20 nutrition books, including No More Fatigue (Wiley, 2011)

Carolyn Dean, MD, ND, medical director of the Nutritional Magnesium Association and author of Homeopathic Remedies for Children’s Common Ailments (McGraw-Hill, 1999)

Audra Foster, ND, a Santa Cruz, Calif.-based primary care physician specializing in family health

Tod Cooperman, MD, president of ConsumerLab.com, which independently tests health and nutrition products and reports on their quality 

Top choices for kids' supplements

Think multis, omega-3s and probiotics are all that's available in the kids' supplement category? Think again.

Immunity

Vitamin C. The go-to antioxidant for a healthy immune system. Dose: See chart on the next page.

Vitamin D. Research shows D activates the body’s infection-fighting T cells. Dose: 400 to 1,000 IU.

Zinc. Data is inconclusive on how effectively this mineral relieves colds, but like vitamin D, zinc is needed to activate T cells. Dose: See chart.

Echinacea. Recent studies about this herb’s impact on colds have sparked controversy, but few people disagree that echinacea enhances overall immunity by helping to activate the body’s infection-fighting cells. Dose: For a 50-pound child, steep 15 drops of tincture in hot water or tea, which evaporates the alcohol; work up to 20 to 30 drops. Drink ¾ cup up to four times a day.

Astragalus. This adaptogenic herb can support the body through a number of different illnesses, but is not recommended for fevers. White recommends only using supplements made from Astragalus membranaceus. Dose: Prepare the same way as echinacea.

Elderberry. Research shows this potent antiviral herb is effective for flu and respiratory viruses. Dose: 2 teaspoons a day of Sambucol Black Elderberry Syrup.

N-acetylcysteine. This amino acid is used to battle flu, ear infections and lung disorders like bronchitis. Dose: 1,000 IU for adults. See “dosing” on opposite page to determine kids’ doses.

Probiotics. These healthy bugs can help combat bacterial infections such as ear infections. Dose: In general, adult dosages are safe for children age 3 and up.

Colic

Probiotics. Healthy bacteria can reduce the gas cramps associated with colic. Dose: Foster recommends that caregivers wet the tip of their pinky, dip it in probiotic powder, and have the baby lick the powder off their finger.

Magnesium. Relaxes muscles and reduces cramping. Dose: Make an adult dose of magnesium powder and give the baby a few sips, rub magnesium oil on an infant’s stomach, or add 1 cup of Epsom salts to a warm bath.

Bone health

Calcium. Kids generally get enough from milk, but supplementation is key for those who don’t. Dose: See chart.

Vitamin K. Helps regulate the calcium in blood. Dose: See chart.

Vitamin D. Not only are pediatricians seeing a resurgence of rickets in kids of all ages, but “the research is pretty clear that the vitamin D status of teenage girls impacts bone health 10 to 20 years later,” Challem says. “At that life stage, the body is literally cementing itself together.” The vitamin isn’t quite as critical for teenage boys, he says, perhaps because they tend to be more physically active than adolescent girls. Dose: 400 to 1,000 IU.

Allergies

Digestive enzymes. Help break down proteins in pollen and food before they pass through the gut wall and trigger an allergic response. Dose: Follow label directions; Challem says it’s usually safe to double the dosage.

Quercetin. Research shows this flavonol turns off some of the mast cells involved in allergic responses. Dose: 1,000 mg for adults. See “dosing” below to determine kids’ doses.

Vitamin D.There’s an established association between low D levels and asthma. Dose: 400 to 1,000 IU.

Nettles. This natural antihistamine should be taken as soon as any hay fever symptoms appear. Dose: Half a cup of tea per day for a 50-pound child; gradually increase to three times a day.

Mental and emotional health

Essential fatty acids (fish, flaxseed, borage, black currant and evening primrose oils). Omega-3s and -6s have been shown in many studies to aid in brain development, improve cognition, increase attention span and fight ADHD and ADD. Challem says research also shows omega-6s (gamma-linolenic acid, found in borage, black currant and evening primrose oils) work synergistically with omega-3s (fish and flaxseed oils) to reduce the inflammation that seems to interfere with mood and behavior. Dose: Experts disagree. Some don’t recommend supplemental EFAs for kids under 3, but children who eat fish already may consume more oil than the adult dosage in most supplements. Concerned parents should opt for EFA products made specifically for kids.

Bach Flower Remedies. These flower essences come in children’s dosages and can address a variety of emotional conditions. Dose: See package.

B vitamins.Folic acid, B6 and B12 help create neurotransmitters and serotonin, and all of the Bs are key components in nervous-system development. Shortages can result in low-grade anxiety, depression and insomnia. Also, studies show autistic children don’t properly metabolize B vitamins. Dose: See chart.

Magnesium. Calms the nervous system, reduces irritability and nervous twitches, and helps promote sleep. Dose: 80 to 130 mg once a day, or 1 cup of Epsom salts in a tub full of bathwater.

Chamomile. This calming herb has a mild sedative effect at high doses. Dose: For a 50-pound child, 1 cup of tea twice a day. Double the dose if you see no side effects.

Homeopathic remedies: Aconite helps combat anxiety, gelsemium boosts confidence and nat. mur. can relieve sadness. Dose: Some companies make kids’ formulations, but adult doses are also safe for children.

Obesity

Chromium. Helps regulate blood sugar, which reduces food cravings.
Dose: See chart.

Zinc. Studies show zinc can boost metabolism, although the mechanism is unclear. A 2010 study of 60 obese Iranian children found that those who took 20 mg of zinc daily for eight weeks had significant weight loss and reduced body mass index. Dose: See chart.

Vitamin D.A 2010 University of Michigan study of nearly 500 children ages 5 to 12 showed that those with low vitamin D levels gained weight more rapidly than kids with adequate levels. Dose: 400 to 1,000 IU.

Vitamin B12. Supports the adrenal glands and combats stress, which can cause high blood sugar levels. Dose: See chart.  

Dosing, delivery systems and diet restrictions

The chart below lists the latest Institute of Medicine dietary reference intakes for children. Take into account that many natural health practitioners believe DRIs tend to be low and that levels can be increased safely, although Challem says to be careful with some fat-soluble vitamins. “For pure vitamin A—retinol, not beta-carotene—there’s some potential for toxicity because little kids’ livers are not as functional as adults’ at flushing out the excess,” he says. “For vitamin D, 1,000 IU is generally considered safe for kids.”

For nutrients without a DRI, your customers can use Clark’s Rule, a mathematical formula that determines dosages for kids age 2 to 17. Begin by assuming that a supplement’s standard dose is for a 150-pound adult. Then divide the child’s weight by 150 to calculate the percentage of the dosage that should be used. For example, if the child weighs 50 pounds, divide 50 pounds by 150, which equals 33 percent, meaning the child should take one-third of the adult dosage.

Age appropriate

There are many theories as to which age to begin giving supplements, but Foster says the conservative recommendation is to wait until the child is 3 before dosing with vitamins or minerals. “Prior to that, the digestive system is still developing and is not prepared for putting dense nutrients into the body,” she says. The exception is vitamin D. The American Academy of Pediatrics recommends at least 400 IU of the sunshine vitamin for all children, including breastfed newborns, to prevent rickets.

White says kids shouldn’t take herbal supplements before they’re on solid foods—at about 6 months. Introduce one herb at a time to ensure the child isn’t allergic, and use easy-to-digest glycerites or teas for young children. Dean says homeopathic remedies contain such miniscule doses that they’re safe for tots of all ages.

Multivitamins

Most health practitioners agree that multivitamins are an insurance policy for kids with poor diets, but research shows that even veggie-loving tykes may be deficient in key vitamins and minerals. The National Health and Nutrition Examination Survey found that many U.S. children don’t get enough vitamins A, C or E; calcium or magnesium from food.

Starting with toddlers ages 2 to 3 who are no longer breastfed, our experts recommend multivitamins—particularly for picky eaters—which is good news for retailers. Nutrition Business Journal’s “Healthy Kids’ Market Report: Supplements 2009” estimates that multis make up 70 percent of all children’s supps sales.

Delivery systems

As every parent knows, if Junior doesn’t like how something tastes, good luck getting it down the hatch. This holds true for supplements, spurring companies to come up with unique delivery systems and kid-friendly tastes, such as Ferndale, Wash.-based Barlean’s Kid’s Omega Swirl fish oil disguised as a smoothie.

Any children’s supplement that contains B vitamins, which Challem calls “some of the worst-tasting substances on earth,” is likely to be spiked with sugar, which our experts surprisingly don’t think is that bad. “The benefits of getting a kid to take a vitamin outweigh the risks of some extra sugar,” Challem says. Still, recommend that your customers check a product’s label for sugar content—particularly in gummies, which can be overly sweetened—and opt for pure cane sugar, stevia or xylitol. It’s also key to evaluate the DRI levels on gummies, which are notorious for low potency.

Liquid supplements and effervescent powders, which can be mixed in water or juice, are easily absorbed by young tummies, Foster says. “For some kids whose digestive systems are still developing, the stomach acids might not be enough to break down chewables.” Avoid all chewables that contain hard-to-digest binders and fillers.

As for the debate over synthetic versus food-based versus raw supplement ingredients, our experts are noncommittal. “Food-based, synthetic—both can be fine,” Cooperman says. Foster gives a slight edge to synthetics because she believes nutrient amounts are easier to control in lab-based formulations. Adds Challem: “You can’t achieve higher potencies by dehydrating foods and putting them in capsules. There might be greater absorption with raw ingredients, but that’s hard to prove.”

Diet restrictions

Vegetarian and vegan children and adolescents may need to supplement with protein powders or amino acids. “For vegans, you need at least double the recommended daily allowance of protein supplements,” Foster says. Menstruating girls who don’t eat meat most likely need to supplement with iron, Cooperman says, noting that “it’s been shown in adolescent girls that iron can improve mental function and cognition.” Foster recommends starting with a low dose—5 mg—to avoid nausea or constipation, and increasing it if medical tests show iron levels are still low.

Our experts say gluten-intolerant children can get enough of wheat's nutrients from vegetables, but concerned customers might want to supplement with a multivitamin. Dairy-averse tykes should take extra calcium, since most multis don’t contain the recommended daily allowance. 

Recommended daily intakes for additional nutrients