When should I worry about nutritional deficiencies?

Vanessa Millovich DCN RDN LDN

A child with a nutritional deficiency can put him/her at risk for other nutrition related problems, since their little bodies require all of these nutrients to continue to grow their brain, to grow taller, and to grow stronger.

When dealing with a picky eater, it can feel incredibly overwhelming if we stop and think about our child possibly having a nutritional deficiency as a result.

There are a handful of ways to know when it is time to talk with your child’s doctor or dietitian about a serious nutritional deficiency. Luckily, since the 1920s, multiple items in our pre-packaged food supply has been fortified with nutrients like iodine, vitamin D, and calcium for several decades, which has helped to prevent more widespread nutritional deficiencies in most of the US population.

If you have a selective eater, below are some areas you may want to play closer attention to your child’s diet to know if you should be worried about nutritional deficiencies.



With nutritional deficiencies, a child can have a long-term deficiency or a short-term deficiency. We worry most about long-term deficiencies. A long-term deficiency in calories (energy) can cause the child to not gain the expected amount of weight for age, which can cause the child to not grow as tall as they would’ve had they had sufficient calorie intake long-term. You can ask your child’s doctor for growth charts at each visit, which can show you if they are following their growth curve for weight and height, based on their age and gender.



Long-term deficiencies of vitamins and/or minerals from a limited diet may cause easy-to-spot symptoms that can help you know when to worry. For example, if your child’s diet doesn’t contain any meat (beef, pork, chicken, turkey) and your child is not on a multivitamin supplement of any kind, they could be at risk for an iron-deficiency. This risk could be higher, if your child was or is breastfed. Iron is found in plant-foods as well and in dried fruits, but this type of iron is different, and therefore may not be enough iron to prevent a deficiency if your child is also working to improve picky/decreased eating.

Symptoms of iron deficiency may include fatigue, poor appetite, poor growth, unusual cravings for things like dirt, or frequent infections.


Vitamin C, E, B12 and Folate

Another deficiency could be from B12, if your child doesn’t eat any meat or eggs and is not on any formula or vitamin/mineral supplement. If they don’t love eating fruits or vegetables, they might be deficient in Vitamin C or folate. Lastly, those that avoid leafy green vegetables and nuts could be deficient in Vitamin E. It is very rare for your child to develop deficiencies severe enough to show signs and symptoms from picky eating. However, a good tip is to check changes in your child’s skin, hair, and general behavior. Easier bleeding and bruising can also be worrisome. These could be signs of a problem beyond typical picky eating. Read more about understanding what counts as beyond picky eating here.


The Bottom Line

You can help to prevent vitamin and mineral nutritional deficiencies by providing an “insurance policy” to your child’s daily routine through a child’s multivitamin/mineral supplement. Check with your doctor or dietitian about which multivitamin/mineral supplement would be appropriate for your child, as some may contain iron and others do not.

Overall, if your child is acting differently than usual, and your mom instincts tell you that something isn’t right, it is always good to double check with your child’s healthcare provider to make sure and to help you find ways to minimize the risk.


Up Next: How to prevent nutritional deficiencies from picky eating

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