Back when we were children, our parents made sure we took our multivitamin and mineral supplements every day. It was generally deemed good practice: Vitamins and minerals are believed essential for life, and deficiency in one or more may lead to various ailments.

Today’s parents still hold to this belief, but a growing number of them are realizing that just because a little bit of something is good for their kids does not mean that a lot of it is better.

The recent market recall of Sangobion Kids Syrup, a formulation containing iron plus vitamin B complex, should remind parents to be very careful of what they give their children.

The product was recalled because it was thought to contain excessive amounts of ethylene glycol—a possible manufacturing error as only a select batch originating from the product’s manufacturer in Indonesia was affected.

Ethylene glycol is one of the raw materials used in the preparation of the syrup, according to the Philippines’ Food and Drug Administration. But its presence in the final product should not exceed 0.1% because a higher dose may result in abdominal pain, vomiting, diarrhea, inability to pass urine, headache, altered mental state, and even acute kidney injury that may lead to death in kids.

But even without excessive ethylene glycol, parents should make sure that their kids are not taking high doses of iron supplements, especially on an empty stomach, as these can cause similar symptoms: upset stomach, constipation, nausea, abdominal pain, vomiting, and diarrhea, according to the United States’ National Institutes of Health. While it is extremely rare for ingestion of vitamins to cause fatalities in children, overdosing can make them sick. For example, taking too much Vitamin B3 can be harmful to the liver and may cause stomach ulcers.

Out of kids’ reach

“First of all,” says Dr. Jocelyn Y. Agonoy, pediatric consultant at ACE Medical Center Quezon City and Bocaue Specialists Medical Center, bottles of vitamins and mineral supplements should be kept out of children’s reach always. 

“Parents should be the ones directly giving their kids the correct amount to prevent accidental overdosing and mistakes. They should explain to their children that although these vitamins and minerals look and taste like candy, it is very dangerous to take more than the necessary daily amount,” she says.

In fact, iron and vitamin B complex products like Sangobion Kids Syrup should only be prescribed to children diagnosed with iron deficiency anemia (a common type of anemia in which the blood lacks adequate healthy red blood cells), latent insufficiency of iron and vitamin B during the growth period, and iron deficiency after loss of blood. The product, however, may also be used by children as a supplement during conditions of chronic illnesses and during periods of recovery.

As for other supplements, parents should bear in mind that excessive doses of vitamin A can cause dizziness, nausea and headache; too much vitamin C and zinc can cause diarrhea and stomach cramps; too much vitamin D can lead to constipation and muscle weakness; and excessive vitamins E and K nay lead to bleeding. 

While excess vitamin C can be flushed out of the body during urination, others, like vitamin A, are not excreted and can build up in the liver, potentially leading to long-term consequences.

Overdosing on minerals such as calcium may cause irregular heartbeat,

‘The best way’

“A healthy, variety-filled diet is still the best way for kids to get the nutrients that they need,” Dr. Agonoy says. 

She warns that certain vitamins and minerals can interact with a child’s prescribed or over-the-counter medication, such as: vitamin K (taken to help in blood clotting), zinc (to boost immunity), and omega-3s (to thin the blood). 

Says Dr. Agonoy: “We remind parents that if your child eats or drinks food with added vitamins and minerals, read the labels. Make sure the total amount of those nutrients does not go over the safe limit for your child’s age. Moreover, parents should always share with their pediatrician and pharmacist a list of any supplements that their child is currently taking, to prevent negative interactions.” 

If sudden symptoms occur in your child and you suspect that the child consumed something of concern, including more than one multivitamin or mineral, immediately proceed to a clinic or hospital. The doctor, preferably a pediatrician, will sometimes recommend observation for at least 48 hours as laboratory workups must be done to test the child’s liver, kidneys and metabolism.

“Doctors may recommend a number of lab tests,” says Dr. Agonoy. She lists these tests as: complete blood count with actual platelet count; thromboplastin time and partial thromboplastin time tests to determine bleeding; test to measure sodium, potassium and chloride; blood urea nitrogen and creatinine test; test to measure SGPT (serum glutamic-pyruvic transaminase) and SGOT (serum glutamic-oxaloacetic transaminase), which are enzymes produced by the liver and its cells; urinalysis; and test to measure arterial blood gas (to determine the oxygen and carbon dioxide levels in the blood). 

Every parent wants to ensure that their kids are getting the proper vitamins and minerals. But before you grab a bottle at the drugstore or supermarket, it’s best to consult your pediatrician first. Your doctor can offer guidance and assistance on what to get for your children according to their specific needs.