Parents Must Be Cautious: Pediatric Multivitamins Can Contain Gluten

Abstract

Introduction: Gluten enteropathy, also known as celiac disease, can affect 1 in 100 individuals. Increasingly, diagnoses are made in individuals who are asymptomatic. It has been reported that up to half of children with celiac disease may not be diagnosed. In effort to optimize health, parents often administer vitamins to their children. However, pediatric multivitamins can contain gluten which may adversely affect children with subclinical disease. This study evaluated pediatric multivitamins for gluten at mass market retail stores and a warehouse store. Methods: A survey of multivitamins at two mass market retail stores (Walmart and Target) and a warehouse store (Costco) was conducted. Pediatric multivitamins were identified and ingredients were evaluated. The vitamins were categorized as gluten-free or containing gluten. Vitamins were categorized as cautionary if they contained soy or were manufactured in a facility where there was potential for cross contamination with gluten. Vitamins without gluten containing ingredients, but not labeled as gluten free, were placed in an uncertain category. A database was created using Microsoft Excel. Statistical analysis was performed using the Fisher Exact test, with significance set at p < 0.05. The study was reviewed by the university Institutional Review Board. Results: Target offered 17 pediatric multivitamins, 6 (35.3%) categorized as gluten free, 2 contained gluten, 7 were cautionary and 2 uncertain. Walmart offered 19 pediatric multivitamins, 10 (52.6%) categorized as gluten free, 3 contained gluten, 4 were cautionary and 2 uncertain. Costco offered 3 pediatric multivitamins, 2 (66.7%) categorized as gluten free and 1 contained gluten. There was no significant difference (p=0.3351) in the available gluten free pediatric multivitamins between the retail stores. There was no significant difference in the rate at which Costco had gluten free vitamins compared to Target (p=0.5368) or Walmart (p=1.000). Notably, the pediatric multivitamins containing gluten often had cartoon character labelling. Conclusion: Parents should be aware that pediatric multivitamins with gluten can cause or exacerbate nutritional deficiencies in children with celiac disease. Children with celiac disease can often be asymptomatic, but may react to daily gluten exposure through vitamins. Awareness of vitamin ingredients is important to avoid unintentional gluten ingestion. Parents must be careful when selecting vitamins for their children.