Pediatric ER doctors need to query vitamin use in children: UBC researcher

Pediatric emergency physicians should check children’s vitamin intake to avoid potential adverse drug reactions and negative interactions with over-the-counter or prescription medication, says a researcher at the University of British Columbia and the Child and Family Research Institute (CFRI).

Dr. Ran Goldman is senior investigator of a study that is the first to identify vitamin use among a large pediatric emergency population and to compare medical and socio-demographic characteristics of families and children using and not using vitamins. The study was recently published online in Fundamental & Clinical Pharmacology.

“Vitamins are usually safe but they can cause harm through adverse interactions with drugs, including some painkillers and anti-inflammatory medications,” says Goldman. “We recommend that ER pediatricians, nurses and parents talk about vitamin use and discuss potential adverse reactions to prescribed or over-the-counter medications. This will help patients and their parents make more informed and safer choices about vitamin use.”

For example, vitamin C can increase blood levels and possibly toxicity of acetaminophen, intensify the absorption of iron and increase adverse effects of antacids containing aluminum.

Goldman is a senior associate clinician scientist at CFRI, a UBC associate professor of Pediatrics, and the Medical Director of Emergency at BC Children’s Hospital, an agency of the Provincial Health Services Authority.

Goldman, together with Ontario researcher Dr. Alex Rogovik and Alberta investigator Dr. Sunita Vohra, interviewed families at The Hospital for Sick Children (SickKids) in Toronto. They compared characteristics of two groups of families and children up to age 18: those who used vitamins in the three months prior to the interview and those not using vitamins during the same period. Researchers found that a third of more than 1,800 families interviewed reported vitamin use, with the majority using multivitamins. Almost half of children in families interviewed were taking vitamins daily. Socio-demographic characteristics included a greater likelihood of children to use vitamins if they were older, had a chronic illness, had completed immunizations or were concurrently using prescribed medications. In addition, use of vitamins was also higher among families where parents were older, had higher education and where the family spoke English as a primary language.

The researchers noted that actual amounts of vitamins in multivitamin compositions can significantly exceed values found on labels because U.S. legislation requires that the amount of a vitamin must be equal to, or greater than, the container label declaration. Also, children who eat a lot of vitamin-fortified foods may exceed recommended vitamin dosages noted on labels.

At the time of the study, Goldman was a staff physician in the Emergency Dept. at SickKids and associate professor of Paediatrics at the University of Toronto. The study was funded by the SickKids Foundation.

NB. A PDF of the paper is available upon request.

The Child & Family Research Institute conducts discovery, clinical and applied research to benefit the health of children and families. It is the largest institute of its kind in Western Canada. CFRI works in close partnership with UBC; BC Children’s Hospital and Sunny Hill Health Centre for Children, BC Women’s Hospital & Health Centre, agencies of the Provincial Health Services Authority, and BC Children’s Hospital Foundation. CFRI has additional important relationships with BC’s five regional health authorities and with BC academic institutions Simon Fraser University, the University of Victoria, the University of Northern British Columbia, and the British Columbia Institute of Technology. For more information, visit www.cfri.ca.

BC Children’s Hospital, an agency of the Provincial Health Services Authority, provides expert care for the province’s most seriously ill or injured children, including newborns and adolescents. BC Children’s is an academic health centre affiliated with the University of British Columbia, Simon Fraser University, and the Child & Family Research Institute. For more information, please visit www.bcchildrens.ca.

The Hospital for Sick Children (SickKids) is recognized as one of the world’s foremost paediatric health-care institutions and is Canada’s leading centre dedicated to advancing children’s health through the integration of patient care, research and education. Founded in 1875 and affiliated with the University of Toronto, SickKids is one of Canada’s most research-intensive hospitals and has generated discoveries that have helped children globally. Its mission is to provide the best in complex and specialized family-centred care; pioneer scientific and clinical advancements; share expertise; foster an academic environment that nurtures health-care professionals; and champion an accessible, comprehensive and sustainable child health system. SickKids is proud of its vision of Healthier Children. A Better World.™ For more information, please visit www.sickkids.ca.

Contact

Stephanie Dunn
CFRI
Tel : 604.875.3885
Email : sdunn@cw.bc.ca

Suzanne Gold
The Hospital for Sick Children
Tel; 416.813.7654. ext. 2059
Email : suzanne.gold@sickkids.ca