Calcium for Kids: Building Strong Bones

Childhood and adolescence are the critical window for building bone mass—by early adulthood, your child will have built about 90% of their peak bone density. Getting enough calcium now sets the foundation for lifelong bone health.

This guide covers calcium requirements, best food sources, and strategies when dairy isn't an option.

What You Need to Know AAP

Daily calcium requirements:

• Ages 1-3: 700 mg/day
• Ages 4-8: 1,000 mg/day
• Ages 9-18: 1,300 mg/day (highest requirement!)

Why childhood calcium matters:

• Building bone mass is most effective during childhood/adolescence
• Peak bone mass reached by early 20s
• Adequate childhood calcium reduces osteoporosis risk later
• Bones are constantly remodeling—calcium is essential

The concern:

• Many children don't meet calcium requirements
• Teens are especially likely to fall short
• Soft drinks often replace milk
• Dairy avoidance is increasing

Calcium needs vitamin D:

• Vitamin D helps body absorb calcium
• Both nutrients work together for bone health
• Many children are also low in vitamin D
• Consider both nutrients together AAP

Best Sources of Calcium

Dairy sources (highest calcium per serving):

• Milk (1 cup): 300 mg
• Yogurt (1 cup): 300-450 mg
• Cheese (1.5 oz): 300 mg
• Cottage cheese (1 cup): 138 mg
• Pudding made with milk: 150 mg

Non-dairy sources:

• Fortified orange juice (1 cup): 300 mg
• Fortified non-dairy milk (1 cup): 300 mg (varies—check label)
• Tofu made with calcium sulfate (½ cup): 250-400 mg
• Fortified cereal: varies, check label
• Canned salmon with bones (3 oz): 180 mg
• White beans (1 cup): 160 mg
• Almonds (1 oz): 75 mg
• Broccoli (1 cup cooked): 60 mg
• Kale (1 cup cooked): 95 mg

Getting to daily goals:

*For ages 4-8 (1,000 mg):*

• 2 cups milk = 600 mg
• 1 yogurt = 300 mg
• Small amount cheese = 100 mg
• Total: 1,000 mg ✓

*For ages 9-18 (1,300 mg):*

• 3 cups milk = 900 mg
• 1 yogurt = 300 mg
• 1 oz cheese = 200 mg
• Total: 1,400 mg ✓

When Dairy Isn't an Option

For milk allergy:

• Use calcium-fortified non-dairy milk
• Choose tofu made with calcium
• Include other calcium-rich foods
• May need supplement—discuss with pediatrician
• Work with dietitian if needed

For lactose intolerance:

• Lactose-free milk has same calcium
• Yogurt and cheese often tolerated (lower lactose)
• Hard cheeses have very little lactose
• Lactase supplements can help with dairy

For families who don't consume dairy:

• Fortified non-dairy milks vary widely—check labels
• Soy milk typically closest to cow's milk nutritionally
• Multiple non-dairy calcium sources daily
• Consider calcium supplement if diet falls short
• Discuss with pediatrician AAP

Best non-dairy milks for calcium:

• Fortified soy milk (usually 300mg/cup)
• Some fortified oat, almond, rice milks
• ALWAYS check nutrition label—not all are fortified

Strategies for Milk-Resistant Kids

If they won't drink plain milk:

• Add small amount of chocolate (still better than no milk)
• Use milk in smoothies
• Serve in fun cup or with straw
• Warm or cold—find their preference
• Model drinking milk yourself

Alternative calcium delivery:

• Cheese in meals (pizza, quesadillas, pasta)
• Yogurt (even flavored provides calcium)
• Pudding and custards
• Milk-based soups (cream of tomato, chowders)
• Smoothies with yogurt and milk

When they refuse all dairy:

• Focus on fortified foods
• Include non-dairy calcium sources at each meal
• Discuss supplement with pediatrician
• Track intake for a few days to assess adequacy

Calcium and Your Child's Day

Building calcium into meals:

*Breakfast:*

• Cereal with milk
• Yogurt parfait
• Smoothie with milk/yogurt
• Cheese omelet

*Lunch:*

• Milk or calcium-fortified juice
• Cheese sandwich
• Yogurt
• Pudding cup

*Dinner:*

• Milk with meal
• Cheese on vegetables or pasta
• Calcium-set tofu stir fry
• Salmon with bones

*Snacks:*

• String cheese
• Yogurt
• Smoothie
• Cheese and crackers

Factors Affecting Calcium Absorption

Things that help:

• Vitamin D (essential for absorption)
• Spreading intake throughout day
• Lactose (actually helps absorption)
• Adequate protein

Things that interfere:

• Very high fiber intake
• Excess caffeine
• High sodium diets
• Oxalates in some vegetables (spinach, rhubarb)
• Phytates in some grains and beans

Practical takeaway:

• Don't worry excessively about absorption factors
• Focus on adequate intake from varied sources
• Ensure vitamin D is adequate
• Very high fiber/caffeine unlikely in most children

Common Questions Parents Ask

Q: Does my child need a calcium supplement?
A: Most children can meet calcium needs through food. Supplements may be needed if dairy-free, extremely picky, or diagnosed deficient. Food sources are generally preferred. Discuss specific needs with your pediatrician. AAP

Q: Is calcium from supplements as good as from food?
A: Food sources are preferred because they come with other nutrients. Supplements can fill gaps but shouldn't replace dietary calcium entirely. If supplementing, split dose throughout day for better absorption.

Q: My teen drinks soda instead of milk. How worried should I be?
A: This is concerning for bone health. The teen years are critical for bone building, and soda displaces calcium-rich beverages. Work on gradual change—milk with some meals, water or milk instead of soda at home. AAP

Q: Can you get too much calcium?
A: The upper limit is 2,500-3,000 mg/day for children. Toxicity is rare from food alone but possible with excessive supplementation. Very high calcium can interfere with absorption of other minerals. Stick to recommended amounts.

Q: My child is lactose intolerant. What should I do?
A: Many options exist! Lactose-free milk has the same calcium. Hard cheeses and yogurt are often tolerated. Fortified non-dairy milks can work. Calcium-fortified foods help. Discuss with pediatrician if you're concerned about adequacy.

Warning Signs of Inadequate Calcium

Long-term deficiency may cause:

• Poor bone development
• Increased fracture risk
• Dental problems
• (Note: symptoms often not obvious until problems develop)

Risk factors for inadequacy:

• Dairy-free diet without alternatives
• Very picky eating excluding dairy
• Eating disorders
• Certain medical conditions

When to talk to pediatrician:

• If child consistently avoids dairy without alternatives
• Multiple fractures
• Restricted diet
• Concerns about bone health

The Bottom Line

Calcium is essential for building strong bones during childhood. Meet daily requirements through dairy or fortified alternatives. Combine with adequate vitamin D for best absorption. If dairy isn't an option, be intentional about including calcium-rich foods or discuss supplements with your pediatrician. AAP

Key points:

• Ages 4-8: 1,000 mg daily
• Ages 9-18: 1,300 mg daily
• Dairy is most efficient source
• Non-dairy alternatives can work
• Vitamin D needed for absorption
• Build into meals throughout day

Clara is here to help you ensure your child gets adequate calcium.