Q: My 6-year-old daughter is a very picky eater and refuses to eat anything that even resembles a fruit or vegetable. I'm worried that she's missing out on some key nutrients. Should I start her on a multivitamin?

A: Most children, picky eaters or not, can benefit from taking a complete pediatric multivitamin supplement, and most can be found over the counter at local drug and grocery stores. Generally, children ages 1 to 3 years old should take one tablet and children 4 years of age or older should take one to two tablets daily. But it's always best to speak with your dietitian, pharmacist, or doctor and follow their recommendations.

When choosing a multivitamin, look for a well-known and trusted brand, and check the nutrition label to be sure the nutrients provided are within the established reference standards. Generally, this is given in a percentage of the recommended daily values. Avoid products that give mega-doses (more than 100 percent of the daily value).

Vitamins and minerals are important to the body because they help it to carry out all its necessary functions. While taking a multivitamin is a great safety net for making sure that the body is getting many of the smaller micronutrients that it needs, they should be combined with a well-balanced diet. As such, it's important that children have access to and eat a variety of foods from all five of the food groups.

Developing healthy eating behaviors in "picky eaters" can be challenging and frustrating for both parent and child. The role of the parent is to provide a balanced and healthy variety of foods for the child to choose fromeven those they have chosen not to eat in the past. The role of the child, of course, is to eat the foods provided.

To ease this process, here are some guidelines:

Set times for meals and snacks. This provides the child with structure and predictability, much like a bedtime routine. This also decreases the amount of "grazing" or frequent snacking between mealtimes, which can have a negative effect on appetite.
Offer only water between meals and snacks, and keep juice to a minimum.
Involve the child in planning meals and snacks and offer healthier options to choose between. For example: "Would you like an apple or a yogurt for a snack?" "Would you like carrots or green beans with dinner?"
Keep mealtimes calm, relaxed, and fun. Encourage the child to try new foods, but never force a child to eat anything he or she does not want.
Make the same meal for everyone in household.
Allow your child to determine when she or he has had enough to eat.

Carly D.G. Lion, M.S., R.D., C.D./L.D.N., is a clinical dietitian in the Gastroenterology Center at Children's Hospital of Wisconsin, one of the top-rated children's hospitals in the nation. The Gastroenterology Center, which treats children with feeding, swallowing, overweight, and many other GI-related diseases and conditions, serves as a national and international referral source for treatment and management of both complex and common GI problems.