For most healthy children, a balanced diet is the best way to ensure that they have all the nutrients they need to grow and develop well. — 123rf
In my paediatric endocrinology clinic, I often meet parents who are doing everything they can to help their children grow well.
Some bring in toddlers who look smaller than their peers, while others come with teenagers who are anxious about their height as classmates shoot up around them.
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Many children are already taking various vitamins, nutrient powders, multivitamin gummies, herbal tonics and “natural growth boosters”.
Most were started with good intentions, based on advice from friends, online reviews or influencer-style claims that promise incredible results.
The desire to give your child every possible advantage is completely understandable.
But with so many supplements available – each marketed so confidently and attractively – it can be challenging to know what is truly helpful, what is unnecessary and what could potentially be harmful.
This column aims to clarify when supplements are actually useful, when they are not and how to approach them safely.
What really influences growth
Before we talk about supplements, it helps to revisit the basics.
Growth is a complex process that depends on:
- Good nutrition
- Regular sleep
- Physical activity
- General health
- Hormones, and
- Genetics (of course!).
These are the real “growth boosters”.
There is no single supplement that can replace them or push a child beyond their natural growth potential.
Natural food is still the best source of essential nutrients.
A well-rounded diet gives children the macronutrients (i.e. proteins, carbohydrates and healthy fats) and micronutrients (i.e. vitamins and minerals) needed to build bone, muscle and tissue in the right proportions.
For most healthy children, this is enough.
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When supplements are needed
While routine supplements aren’t necessary for most children, there are situations where vitamin or mineral supplementation plays an important role in optimising a child’s growth.
This is particularly so when a deficiency is confirmed or when a child is at higher risk of a deficiency.
Here are some common conditions I often see:
Surprisingly, vitamin D deficiency is very common in children, even in sunny countries like Malaysia.
This is because vitamin D comes mainly from sunlight and very little from food.
Babies who are exclusively breastfed, children who spend most of their time indoors and those with darker skin tones are especially at risk.
Vitamin D is essential for helping the body absorb calcium to build strong, healthy bones.
It also plays a role in immunity and various other body functions.
ALSO READ: Ensuring your child gets enough vitamin D
Iron deficiency is common in infants and young children because their need for iron increases rapidly during growth, yet their diets may not provide enough of this mineral.
This is especially so if they drink large amounts of cow’s milk after one year of age, or eat limited iron-rich foods.
It is also frequently seen in adolescent girls with heavy menstrual periods as the more they bleed, the more iron they lose with their blood.
Severe iron deficiency is one of the causes of anaemia.
ALSO READ: A third of Malaysian children lack enough iron for good health
This can be seen in children who avoid dairy products due to allergies, intolerance or personal preference, or those who simply consume too little milk, yoghurt or cheese.
This mostly occurs in children on strict vegetarian or vegan diets, as vitamin B12 is found mainly in animal foods.
This is a likely scenario in very selective eaters or children with chronic medical conditions that affect nutrient absorption.
Children who have chronic illnesses, food allergies or medically-restricted diets, or are underweight, also frequently have some type of deficiency.
In these situations, supplements are important to correct deficiencies and to optimise a child’s growth and well-being.
Diagnosis and treatment
When needed, nutrient levels can be checked through blood tests – this is the most reliable method.
Parents sometimes ask about hair analysis or other alternative tests that claim to assess nutrient levels.
These methods are not medically reliable, can give inconsistent or misleading results, and should not be used to decide which supplements a child needs.
Accurate testing leads to accurate treatment, and avoids unnecessary or excessive supplementation.
If a child is diagnosed with a nutritional deficiency, doctors may prescribe short-term treatment doses.
These are higher than daily requirements and help restore nutrient stores in the body.
But these higher doses are not meant to be continued indefinitely.
Once levels have normalised, the child should switch to maintenance doses that match the recommended daily intake for their age.
Taking large treatment doses unnecessarily for too long can lead to excessively high levels, which may be harmful.
This is why long-term supplement use should always be supervised by a doctor.
Children on vegetarian or vegan diets tend to lack vitamin B12 as it is mainly found in animal foods. — Positive Parenting
Less strictly regulated
In our local Asian communities, herbal or plant-based growth supplements are extremely popular.
They are often marketed as gentle, safe or “traditional”.
But it is important to remember: natural does not automatically mean safe.
Herbal supplements often contain several plant extracts with active ingredients that may influence hormones, metabolism or organ function.
In many cases, the dosage is unclear, and there is little or no research on their effects in children.
Some may interact with medicines.
Others have side effects that only appear after long-term use.
Quality control can also vary widely, meaning that some products may contain contaminants or ingredients not listed on the label.
Children, because they are still growing and developing, are especially sensitive to these uncertainties.
Another common misconception is that supplements are as thoroughly tested as medicines.
They are not.
Medicines must undergo years of research, clinical trials and strict safety checks before they are allowed for use in children.
Supplements, however:
- Do not have to prove effectiveness
- Are rarely tested in children
- May have inconsistent quality
- Can contain undisclosed ingredients
- Only need to avoid making claims that sound like they “treat” diseases.
This does not mean that all supplements are unsafe or without benefits, but it does mean that parents need to choose wisely.
If your child needs a supplement, here are some practical tips:
- Pick reputable brands with clear, transparent labels.
- Avoid products with long ingredient lists, especially herbal blends.
- Make sure doses match your child’s age requirements.
- Check with your paediatrician or doctor before starting long-term supplements.
True growth boosters
The most reliable ways to support growth are simple, everyday habits like:
- A balanced diet with enough protein, calcium, fruits, vegetables and whole grains
- Adequate sleep
- Regular physical activity and outdoor play
- Good management of any chronic health conditions, e.g. allergic rhinitis or asthma
- Supporting emotional well-being and self-esteem
- Routine growth (weight and height) monitoring.
Vitamins and supplements are important for children with deficiencies or who are at risk.
They can be helpful, and indeed, sometimes essential.
But unnecessary long-term use, especially without medical guidance, can carry risks, so do:
- Talk to your doctor first
Before starting any supplement, discuss it with your paediatrician.
We can assess your child’s growth pattern, advise on appropriate vitamins and supplements, and check for deficiencies if necessary.
- Focus on natural food
Prioritise a diverse, nutrient-rich diet.
This remains the gold standard.
- Choose reputable manufacturers
If a supplement is necessary, choose products from reputable manufacturers to ensure quality and accurate labelling.
- Follow recommended doses
Do not exceed the recommended amount for your child’s age without medical advice.
More is not always better and can be harmful.
Dr Jeanne Wong Sze Lyn is a consultant paediatrician and paediatric endocrinologist. For more information, email starhealth@thestar.com.my. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
