Multivitamins And Asthma In Children
Chester J. Zelasko, Ph.D. | July 17, 2004

Health information by press conference seems to be the norm today, especially when the results appear to be provocative. Such is the case with the recent headlines: "Early Vitamin Use Linked to Asthma, U.S. Study Finds"
– Reuters

"Vitamins may give kids asthma, allergies"
– CTV, Canada

In this edition of the Newsletter, we'll examine the research for answers to whether supplementation at early ages contributes to immunological dysfunction.

The premise for the study referenced in the news stories was test-tube studies (in vitro) that demonstrated an effect of vitamins on specific immune cells (T-helper cells) in culture. That means the researchers extracted T-helper cells from animals, bathed them in the vitamin, and then examined how those cells developed. This is the way basic research is conducted; it may be relevant in the real world or it may not. The next step would be to take this approach to an animal model to see if the results could be replicated in a living system. That wasn't done.

Instead, the researchers chose to use data from two large questionnaire and interview studies: the National Center for Health Statistics 1988 National Maternal-Infant Services Survey and the 1991 Longitudinal Follow-Up Study. They analyzed the responses to survey questions that asked about the use of supplemental vitamins and immunological diseases such as asthma and allergies (1). They specifically wanted to examine the timing of vitamin supplements to see if that had an impact on these immune-system diseases.

Based on the headlines, the researchers claimed to find an association between the use of multivitamin supplements taken in the first six months of life and asthma in black infants, and an association between early infant multivitamin intake and food allergies in formula-fed infants. But is that what the data really said? And more important, what does that mean in the real world? Let's focus on asthma.

In the abstract (summary) of the study, the researchers stated that vitamin use in the first 6 months of life was associated with a higher risk of asthma for black infants. That's what showed up in the media. But that's not exactly what the results showed. The use of multivitamins at 3 months and at 3 years was not associated with asthma. The only time multivitamin use was statistically significant was 6 months. That raises the question of why did vitamins have an effect during months 3 through 6, but not before or after? The numbers may support the researchers' theory that there is a specific time when exposure to vitamins affects immune function--or it could be random error and thus meaningless. While the researchers responsibly stated that this is really only an indication that further research is necessary, their results still became headlines questioning the use of vitamins in both dietary supplements and formula for infants.

Let's take a look at what the results mean in the real world. The incidence of asthma in the study was 10.5%--not based on a physician's diagnosis but on the mother's response to a survey question. The researchers correctly explained that other respiratory conditions are often misreported as asthma, so the results could not be partitioned out as precisely as they would have liked. Using the numbers that they derived, that means an infant given a multivitamin between the ages of 3 and 6 months had a 27% greater risk of developing asthma than those who weren't given vitamins. In numerical terms, instead of 105 infants out of a 1,000 developing asthma, 133 children out of a 1,000 might develop asthma. Interestingly enough, that is about the national average for children of all ages and races--12.5% (2).

What does it mean for you as a parent? All this study does is raise questions that will take years to answer. It may or may not mean something for a large group of infants, but it can tell you nothing about your particular infant. What it also means is that you should discuss the health of your infant with your pediatrician. The decision to breastfeed, use infant formula, or supplement your infant's diet should be based on the specific needs of your child as an individual, not on headlines. That's the better life way and that is meaningful in your life.


  1. Milner, JD, et al. Early Infant Multivitamin Supplementation Is Associated with Increased Risk for Food Allergy and Asthma. Pediatrics 2004; 114(1):27-32.

  2. Summary Health Statistics for U.S. Children: National Health Interview Survey, 2001. DHHS Publication No. (PHS) 2004-1544. 2003.
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