Introducing a Vitamin or Supplement
A practical, neuroaffirming guide for families
Prepared by
Dr Melissa Bujtor
HCPC Registered Dietitian · AfN Registered Nutritionist (RNutr)
Paediatric Feeding Specialist
Important before you start
Please read first
This guide does not recommend or prescribe a particular vitamin, mineral or nutritional supplement. The right product and dose depend on your child’s age, dietary intake, health, other supplements or medicines, and the reason supplementation is being considered.
If you think your child may have a nutritional deficiency, or you are unsure whether supplementation is needed, seek individual advice rather than treating a suspected deficiency yourself.
Where to seek advice
Is a supplement needed?
For nutritional assessment and advice about whether supplementation is appropriate, contact Dr Melissa Bujtor Specialist Dietetic Practice, another suitably qualified dietitian, or your local GP.
About a specific product?
For questions about dose, interactions, side effects, or whether a tablet or capsule can be altered or a product mixed with food, speak to your pharmacist, local GP or the clinician who prescribed or recommended it.
Always follow the dose, age range and administration instructions for the specific product.
Why might my child need a supplement?
When a child’s diet is restricted, they may be getting enough energy to maintain their weight while still having a low intake of particular vitamins or minerals.
Children and young people with ARFID and other forms of restricted eating can experience nutritional deficiencies without necessarily being underweight. This is why nutritional assessment considers what a child eats as well as their growth, health and development.1
A vitamin or supplement may therefore be recommended to:
- meet routine requirements for a child’s age;
- prevent a likely nutritional shortfall;
- address a gap identified from their dietary intake;
- treat or help correct a confirmed deficiency;
- support nutrition while eating is particularly difficult;
- provide a reliable source of a nutrient that is difficult for the child to obtain from foods they can currently access.
A supplement does not mean that your child, or their eating, has failed.
Nor does it have to be viewed simply as a temporary bridge until your child eats a wider range of foods. For some children supplementation will be short term; for others, taking a supplement for longer may be an appropriate and useful way of meeting their nutritional needs. The aim is to meet your child’s needs in a way that is safe, manageable and appropriate for them.
Some vitamins are recommended routinely
Not every supplement is recommended because a child has restricted eating. Current UK guidance recommends:
- breastfed babies from birth to 6 months receive a daily supplement containing 8.5–10 micrograms of vitamin D;
- from 6–12 months, breastfed babies receive vitamins A, C and D;
- babies under 1 year receiving 500 mL or more of infant formula per day do not usually need additional vitamin supplements, because infant formula is already fortified;
- children aged 1–4 years receive daily supplements containing vitamins A, C and D, including 10 micrograms of vitamin D.2–4
Different recommendations may apply where a child has an identified deficiency, restricted dietary intake, medical condition or another specific nutritional need.
More is not better
Do not assume that giving more is better. Some vitamins and minerals can be harmful in excessive amounts, and different products may contain the same nutrients.3 Before combining supplements, check what each product contains.
Routine supplementation and treating a deficiency are different
Taking a routine age-appropriate vitamin supplement is not the same as treating a suspected or confirmed nutritional deficiency. A deficiency — of iron, vitamin B12, vitamin D or another micronutrient — may require clinical assessment, blood tests and a specific treatment dose.
Treatment doses can be very different from the amounts contained in routine supplements. Do not use high-dose supplements to treat a suspected deficiency without appropriate medical or dietetic advice.
Start with the child, not the product
Before deciding how to give a supplement, think about what taking it actually involves for your child. A supplement can introduce:
For a child with sensory differences, feeding differences, ARFID, anxiety or previous difficult experiences with medicines, any one of these may be significant.
Instead of asking
“How do we get them to take this?”
Try asking
“What part of taking this is difficult, and how can we make that part more accessible?”
That might lead to a very different solution.
Choosing a form that works for your child
Where more than one suitable formulation is available, your child’s preferences and sensory needs should be part of the decision.
Liquids or drops
These may work well for a child who is comfortable with liquid medicines or small volumes. Consider taste, smell, thickness, colour, volume, temperature, aftertaste, and whether an oral syringe, spoon or cup is preferred.
Measuring accurately
Where an exact liquid dose is required, use the measuring device supplied with the product or recommended by your pharmacist. Kitchen teaspoons are not accurate enough for measuring medicines or products requiring a precise dose.5
Sprays
A spray may reduce the amount that needs to be swallowed, but the sensation of a spray in the mouth can itself be difficult. Consider flavour, aftertaste, number of sprays required, where in the mouth it is sprayed, and the sound and sensation of the spray.
A spray is not inherently “easier” or more suitable. It depends on the individual child.
Powders, granules or sprinkles
These may be useful where the specific product is designed to be mixed with food or drink. However, do not assume that every powder or granule can be mixed into any food or drink. Instructions vary between products — some need dissolving in water, some can be mixed with a small amount of soft food, others have specific administration requirements.6
Always follow the instructions for the individual product.
Chewables or gummies
Some children prefer these because the texture or method of taking them is more familiar than swallowing a tablet. Others may find the flavour, chewiness, coating or texture difficult.
Check the nutrient content carefully. Different products contain very different combinations and amounts of vitamins and minerals.
Store them as supplements, not sweets
Store gummies and chewables safely and treat them as supplements rather than sweets. Taking too much of some nutrients can be harmful.3
Tablets and capsules
These may suit children who are comfortable swallowing them. Tablet swallowing is a skill, not something every child can automatically do at a particular age, and some children may benefit from specific support to learn it if it would be useful to them.
Do not alter a product without checking
Do not crush, split or dissolve a tablet, open a capsule, mix a product with food or drink, or otherwise alter how it is given unless the manufacturer’s instructions specifically allow this, or a pharmacist or prescribing clinician has confirmed that it is appropriate.7–10
Some preparations can safely be altered. Others cannot, because doing so may affect how the product works or how the dose is delivered.
Be open about what you are giving
Where possible, avoid secretly adding a supplement to a food or drink without your child’s knowledge.
For a child who depends on predictability around food, discovering that a familiar food tastes different can make that food feel less reliable. This is particularly important where the child has only a small number of foods they can consistently access.
Instead, use language appropriate to your child’s level of understanding. For example:
The aim is not to give a detailed medical explanation a child cannot understand. It is to make what is happening as predictable and understandable as possible.
Be thoughtful about mixing supplements with familiar foods
Sometimes the safest and easiest way of taking a particular product is to mix it with food or drink. That is different from secretly disguising it.
If the individual product can be mixed with food or drink, the points overleaf are worth working through first.
If the individual product can be mixed with food or drink:
- tell your child what is happening in a way they can understand;
- follow the instructions for that specific product;
- use only a small amount of food or fluid where appropriate, so the full dose can realistically be taken;
- consider whether changing the taste, appearance or texture could make an especially important familiar food less accessible;
- where possible, avoid risking one of the child’s few essential foods or drinks;
- prepare and give it exactly as directed.
Some products interact with particular foods or need to be taken in a particular way, so check the individual product rather than assuming mixing is suitable.9,10
If the dose is not finished
If your child does not finish the food or drink containing the full dose, do not automatically give another dose. Check the product guidance or ask a pharmacist or clinician what to do.
Predictability can help
For some children, knowing what will happen makes taking a supplement more manageable. That might mean:
This does not mean every child needs a rigid routine. For some, consistency reduces uncertainty; others may prefer choice or flexibility. Work with what helps your child.
Give meaningful choices where choices are possible
Sometimes a supplement is clinically important and choosing not to address the nutritional need may not be a safe option. Even then, the child can be involved as much as possible in deciding how that need is met.
Depending on the product and available alternatives, that might include:
Offer genuine choices only. Do not present something as optional if it is not.
Choice should support autonomy rather than becoming another way of persuading the child to comply.
If the sensory experience is difficult
First work out what part is difficult. Is it:
The answer matters.
Changing flavour will not solve a problem caused by the sensation of liquid in the mouth. Changing from liquid to a chewable may not help if chewing an unfamiliar texture is more difficult. And repeatedly offering the same product may not help if the formulation itself is inaccessible.
Sometimes changing the form of the supplement is more appropriate than repeatedly asking the child to tolerate a form that is particularly difficult for them.
Becoming familiar with something new
If your child wants or needs time to become familiar with a new supplement or delivery method, this can happen gradually. Depending on the child, they might:
- look at the packaging;
- handle the bottle or device;
- watch how a spray works away from their face;
- practise using an empty medicine spoon;
- practise the method of taking a liquid using an appropriate familiar drink, where suitable;
- learn tablet-swallowing skills separately from taking the actual supplement.
These are possibilities, not a ladder your child must complete. There is no requirement for a child to touch, smell or taste a supplement in a particular sequence before they can take it. The useful question is: what would make this particular experience more predictable or manageable?
Tablet and capsule swallowing
If swallowing is the main barrier, consider whether learning to swallow a tablet or capsule would be useful for your child. This should be approached as learning a skill, rather than as a test of willingness. A child may need clear explanation, appropriate positioning, gradual practice, plenty of time — or a different formulation altogether. Medicines for Children provides specific information for families about giving tablets and capsules.7,8
Seek assessment first
If your child has difficulty swallowing food or drinks generally, coughs or chokes when eating or drinking, or you have concerns about their swallowing safety, seek professional assessment rather than practising tablets at home.
Keep communication neutral and supportive
Taking a supplement can quickly become another area in which a child feels watched, evaluated or pressured.
Try to avoid
“Good girl — you took it all!”
“See, that wasn’t so bad.”
“You did it yesterday.”
“Just get it over with.”
“If you take it, you can have a treat.”
“You have to be brave.”
Instead, try
“It’s time for your vitamin. How would you like to take it today?”
“That flavour isn’t working for you. Let’s work out what the difficult part is.”
“You weren’t able to manage that one today. We need another plan.”
“Would something to drink afterwards help?”
“Tell me if something about it feels different today.”
Where the supplement is clinically necessary, avoid pretending that taking it is entirely optional. Equally, necessity does not remove the need to listen to the child’s communication and find the least burdensome way of meeting that nutritional need.
Praise is not required
Some children appreciate acknowledgement. Others find praise draws uncomfortable attention to something that was already difficult. Rather than routinely praising the act of taking the supplement, follow your child’s preference.
Neutral acknowledgement might be:
If your child is following a specific therapeutic programme in which reinforcement has been deliberately agreed, follow that individual plan.
What if my child cannot take it?
Tell the professional who recommended it. Do not assume that your child needs to try harder.
Useful information includes:
Depending on the nutrient and reason for supplementation, there may be:
The aim is not loyalty to a particular product. It is finding a safe and workable way of meeting your child’s nutritional needs.
If your child repeatedly refuses or becomes distressed
Repeated distress is information. Do not simply increase pressure or continue repeating the same attempt indefinitely.
Consider:
Bring this information back to your dietitian, pharmacist, GP or wider clinical team.
Check before combining supplements
More is not necessarily better. Different multivitamins, vitamin drops, gummies, fortified nutritional products and individual nutrient supplements may contain overlapping nutrients. Excessive amounts of some vitamins and minerals can be harmful.3
Before starting an additional product, check what your child is already taking, including:
If you are unsure whether products can safely be combined, ask a pharmacist, your local GP or a suitably qualified dietitian.
Keep supplements safely stored
Store vitamins, gummies, tablets, drops and other supplements out of children’s sight and reach. Follow the manufacturer’s storage instructions and expiry date — some products require particular storage conditions.
If more than the recommended amount may have been taken
If you think your child may have taken more than the recommended amount, seek medical advice promptly rather than waiting for symptoms to develop.11
When to seek medical advice
Contact your local GP, pharmacist or NHS 111 for advice if:
- you are worried about a reaction or side effect;
- your child repeatedly vomits after taking the supplement;
- you are unsure how much of a dose your child has taken;
- your child may have accidentally taken more than the recommended amount;
- you think two or more products may be providing overlapping doses of the same vitamin or mineral;
- you are concerned about a possible nutritional deficiency or deterioration in your child’s health.
Urgent
If you think your child may have swallowed a potentially harmful amount of a vitamin, supplement or medicine, seek medical advice immediately. If you are unsure whether what they have taken could be harmful, NHS 111 can advise. If your child is seriously unwell, call 999 or attend A&E as appropriate.11
Call 999 for a severe allergic reaction, including sudden swelling of the lips, mouth, tongue or throat, significant difficulty breathing, collapse, or a child becoming limp or unresponsive.12
When to seek dietetic advice
Consider a dietetic assessment if:
- your child’s diet is significantly restricted;
- you are unsure whether their current diet is meeting their nutritional needs;
- your child relies on a small number of foods;
- foods or food groups are absent from their diet;
- you are considering supplements because of restricted eating;
- your child is already taking several supplements and you are unsure whether they remain appropriate;
- a supplement has been recommended but you are struggling to find a formulation your child can access;
- you are concerned about growth, nutritional adequacy or possible deficiency.
At Dr Melissa Bujtor Specialist Dietetic Practice, assessment can consider your child’s actual dietary intake, nutritional requirements, growth and development, health, feeding profile and any sensory or neurodevelopmental factors affecting eating.
Where supplementation is indicated, recommendations can then be made around what nutritional need requires addressing, with appropriate liaison with your child’s GP, pharmacist or wider clinical team.
Enquire about specialist paediatric dietetic and feeding support
Keep us in the loop
Finding a workable supplement can involve some adjustment. If you are receiving dietetic support, let your dietitian know:
- what is working;
- what is difficult;
- which forms your child can access;
- flavours or textures that are easier or harder;
- whether a familiar food or drink has changed after using it to give a supplement;
- any possible side effects;
- any doses that are regularly being missed.
The nutritional plan, product, formulation, timing or method may need to change, or input from your GP or pharmacist may be appropriate. A supplement should support your child’s health without creating unnecessary difficulty around eating.
A final thought
Nutrition does not have to come from food alone to count.
For some children, a vitamin or supplement is a straightforward way of meeting a nutritional need. For others, finding a form they can comfortably take requires more thought.
The goal is not to make your child tolerate a particular product, or to use supplementation only until their eating becomes more typical. It is to find a safe, nutritionally appropriate and sustainable way of meeting their needs, while respecting their sensory experience, communication and autonomy.
Important information
This guide provides general educational information only. It does not constitute a prescription, diagnosis or individual medical or dietetic advice, and it does not recommend a particular vitamin, mineral, supplement, product or dose.
Do not self-treat a suspected deficiency
Do not use this guide to treat a suspected nutritional deficiency. If you are concerned about your child’s nutritional intake or think supplementation may be required, seek individual assessment from an appropriately qualified healthcare professional.
For individual nutritional assessment and dietetic advice, you can contact Dr Melissa Bujtor Specialist Dietetic Practice, another suitably qualified dietitian, or your local GP.
For questions about a particular product, dosage, interactions, side effects, altering a formulation or administering a product alongside medicines, speak to a pharmacist, your local GP or the clinician who prescribed or recommended the product.
Always follow the manufacturer’s instructions and recommended age and dose for the specific product unless an appropriately qualified healthcare professional has advised otherwise.
Seek urgent medical advice where overdose, poisoning, a serious reaction or acute illness is suspected.
Prepared by Dr Melissa Bujtor, HCPC Registered Dietitian, AfN Registered Nutritionist (RNutr) and Paediatric Feeding Specialist, for Dr Melissa Bujtor Specialist Dietetic Practice. This guide provides general educational information and is not a substitute for individual clinical assessment or advice.
References
- James RM, O’Shea J, Micali N, Russell SJ, Hudson LD. Physical health complications in children and young people with avoidant restrictive food intake disorder (ARFID): a systematic review and meta-analysis. BMJ Paediatr Open. 2024;8(1):e002595. doi:10.1136/bmjpo-2024-002595.
- National Institute for Health and Care Excellence. Maternal and child nutrition: nutrition and weight management in pregnancy, and nutrition in children up to 5 years. NICE guideline NG247. London: NICE; 2025.
- NHS. Vitamins for children. NHS; current online guidance. Accessed 21 Aug 2026.
- NHS. Your baby’s first solid foods. NHS; current online guidance. Accessed 21 Aug 2026.
- NHS. Medicines for babies and children. NHS; current online guidance. Accessed 21 Aug 2026.
- Medicines for Children. How to give medicines: granules and powders. London: RCPCH, NPPG and WellChild; current online guidance. Accessed 21 Aug 2026.
- Medicines for Children. How to give medicines: tablets. London: RCPCH, NPPG and WellChild; current online guidance. Accessed 21 Aug 2026.
- Medicines for Children. How to give medicines: capsules. London: RCPCH, NPPG and WellChild; current online guidance. Accessed 21 Aug 2026.
- NHS Specialist Pharmacy Service. Why and how medicines are given with soft food or thickened fluid. London: NHS Specialist Pharmacy Service; updated 17 Dec 2024.
- NHS Specialist Pharmacy Service. Checking if medicines can be given with food. London: NHS Specialist Pharmacy Service; updated 6 Feb 2025.
- NHS. Poisoning. NHS; current online guidance. Accessed 21 Aug 2026.
- NHS. Allergies. NHS; current online guidance. Accessed 21 Aug 2026.
Prepared by Dr Melissa Bujtor, HCPC Registered Dietitian, AfN Registered Nutritionist (RNutr) and Paediatric Feeding Specialist, for Dr Melissa Bujtor Specialist Dietetic Practice. This guide provides general educational information and is not a substitute for individual clinical assessment or advice.
About the author
Dr Melissa Bujtor
A HCPC Registered Dietitian and AfN Registered Nutritionist with specialist expertise in paediatric dietetics, feeding development and eating disorders.
Dr Bujtor also holds a British Psychological Society-accredited Master’s degree in Psychology, bringing an understanding of behaviour, cognition and emotional development to her clinical work with children and young people.
She is a published scientist whose work spans research, policy and advocacy, and serves on the Board of Trustees of The Feeding Trust, helping to connect research, policy and clinical practice to improve outcomes for children, young people and families.
Her clinical practice combines evidence-based dietetics with a developmental understanding of feeding — looking beyond what a child eats to understand the factors that may be contributing to their difficulties.
enquiries@drbujtor.com
01732 453956
Clinic
C/o Springbank Clinic Sevenoaks
13 Pembroke Rd, Sevenoaks TN13 1XR
Consultations
In clinic & online telehealth
Monday–Friday, by appointment