The profusion of children's vitamins on store shelves might make a parent wonder if Mary Poppins has gone corporate: A spoonful of sugar apparently does help the medicine go down.
Chewable Wilmas and Bamm-Bamms are being elbowed for display space by gummy worms, caramels, jelly beans and gumballs in vivid colors and kiddie flavors.
They look like candy. They taste like candy. But if he chomps on one of these gumballs or gelatinous action heroes, a kid gets his vitamins and minerals for the day, the packaging promises.
Minus the tantrum.
"The truth is, vitamins are vitamins. If you can create a new brand, then you can sell more," says Phil Johnson, director of pharmacy at H. Lee Moffitt Cancer Center & Research Institute in Tampa, Fla.
Manufacturers say they've licked the problem of children refusing to take their vitamin because it tastes bad.
But the assortment also reflects companies' pursuit of a lucrative market: More than 6 percent of the U.S. population purchased children's supplements in the past three months, according to National Marketing Institute. Sales of children's vitamins and minerals jumped almost 19 percent in 2003 compared with 2002, to $14.4 million, at natural food stores, and almost 9 percent, to $98.3 million, at grocery, drug and discount stores, reports SPINS, a San Francisco consulting company.
"Some items that are doing well for children have been around a number of years. The media coverage that taking a multivitamin for adults is good is trickling down to their children," says David Browne, SPINS operations director.
Researchers at Harvard Medical School recommend adults take a daily multivitamin. Seniors may need two. Pediatricians typically recommend a children's multivitamin for those 4 and older. After 12, they can safely take adult vitamins.
"If you eat a balanced diet, you don't need them. A lot of these nutrients are so readily available in foods," says Pat Hare, director of nutritional services at All Children's Hospital in St. Petersburg, Fla.
Hare, a specialist in pediatric nutrition, says supplements for children remain controversial. Traditionally, children were thought to acquire all needed nutrients from foods and beverages. Today, nutritionists know "kids can get adequate calories without getting enough vitamins," she says.
She is not enthusiastic about vitamins pitched like candy.
"We're sending a confusing message. Medicine isn't candy. There's a reason we take it," Hare says. The mother of one of her patients brought in gumball vitamins to show her, "and I was not particularly happy. I think it's not a safe situation."
She and others worry that medicine in the guise of candy could prove risky. A child too young to understand the difference might take extras and overdose. Children old enough to make the distinction still are being programmed to view pharmaceuticals and supplements, all of which carry side effects and risks, to be as harmless as popping a chocolate.
"It's rare for an overdose of vitamins to be toxic," Kendra Grande, director of the University of Wyoming Drug Information Center, says on the college's Web site. "The bigger concern is creating confusion ... between the concept of medicine and the concept of candy."
Alternative medicine and health-food retailers also market kid-friendly supplements, touting theirs as preferable because they do not contain artificial sweeteners or colors. From gummy dolphin vitamins to herbal lollipops formulated for everything from the immune system (echinacea) to mental agility (ginkgo biloba), they're marketed to children 4 and older.
"Every parent knows that half the battle is getting your children to take their medicine," says the Web site for Pure-le Natural, a Canadian herbal company that offers five flavors of "way cool and yummy" lollipops. "Simply replace your child's morning, lunch or evening treat with a KIDZ lollipop and they'll never know the difference."
Vitaball, the gumball vitamin, debuted about three years ago, and sales have climbed 146 percent since its first year, reports SPINS. By comparison, sales of more traditional chewables are flat or declining.
Supplementation can be too much of a good thing, particularly for very young children. Most multivitamins contain iron. A safe dose for young children is about 15 to 18 milligrams. The 60 to 100 milligrams found in adult vitamins can eat through the lining of a child's stomach or cause systemic poisoning as it moves through the bloodstream, according to toxicologist and pharmacist Dr. Vincent Speranza.
Medications are one of the most common causes of accidental poisonings. Most multivitamins are packaged in child-proof containers and, like all medicines and supplements, should be stored out of children's reach and administered by an adult.