How Much Calcium and Vitamin D Does My Child Need?
An endocrinologist has the answer
By Joel Steelman, M.D., Endocrinologist at Cook Children's Health Care System
Calcium is one of the most important minerals in the body.
Bones are 70 percent calcium, and it is minerals such as calcium which give bones their hardness for protection and support. What most people may not know is that bones also serve as the calcium bank of the body. There are daily deposits and withdrawals of calcium from bones. Calcium is vitally important in other organs in the body – mainly muscles. Without enough calcium, a person’s heart may beat out of rhythm or even stop! The release of calcium from bones prevents dangerously low calcium levels in the body.
Most people recognize strong relationship between calcium and vitamin D. The job of vitamin D is bringing calcium from foods eaten into the body for use. It also helps bone store calcium.
There are two prime time periods in a child’s life requiring enough calcium and vitamin D. Rapid growth happens in both of these periods which are infancy/early childhood and adolescences.
Rickets is the consequence of not enough calcium delivered into the body during infancy/early childhood. Bones are soft without enough calcium and can bow/deform or even break. Low calcium levels lead to muscle weakness and irritability.
The signs/symptoms of not enough calcium or vitamin are much harder to see in adolescence. Osteoporosis and easily breaking bones is possible in severe cases. However, most teens will have no symptoms. However, the worry is that teens without enough calcium in their bones risk osteoporosis or other bone problems occurring earlier in adulthood.
Bone health is even more important in medically complicated children such as those followed at Cook Children’s Bone Health clinic. Children such as those with childhood cancer, digestive disorders, rheumatoid arthritis, cerebral palsy, or osteogenesis imperfecta (brittle bone disease) are at high risk for bone breaks and daily bone pain. They often require other treatments in addition to supplemental calcium and vitamin.
The beginning of good bone health for otherwise healthy children begins with a good diet with enough calcium and vitamin D. It is sometimes hard, however, to know how much calcium or vitamin D is needed or if a child should take a supplement.
Recommended Intake
Recommendations for Age |
Calcium mg/day |
Vitamin D IU/Day |
Birth to 6 months |
200mg |
400 IU |
6 months – 1 year |
260mg |
400 IU |
1-3 years |
500 - 700mg |
600 IU |
4-8 years |
800 - 1,000mg |
600 IU |
9-18 years |
1,100 - 1,300mg |
600 IU |
19-50 years |
800 - 1,000mg |
600 IU |
>50 years |
1,000 - 1,200mg |
600 IU |
Pregnant & Lactating |
800 - 1,100mg |
600 IU |
Dietary Reference Intakes – Recommended Dietary Allowances (meet needs of 98% of the population) IU= International Unit
Eat and drink low-fat or fat-free dairy (best source of calcium)
2-8 years: 2-3 servings per day 9-18 years: 3-4 servings per day
Sources of Calcium and Vitamin D in the diet
Calcium (Ca) Food Sources |
Vitamin D Food Sources |
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Milk (Cow’s, soy, almond and rice) |
8fl oz. |
300mg |
Cod Liver Oil |
1 Tbsp. |
1360 IU |
Carnation Instant Breakfast, powder |
8fl oz. |
300mg |
Swordfish or Salmon |
3oz |
500 IU |
Cheese- Cheddar, Mozzarella, Ricotta (excludes cream cheese) |
1oz |
200mg |
Tuna, canned |
3oz |
150 IU |
Cereals, fortified with Ca |
½ Cup |
200-600mg |
OJ, fortified |
8fl oz. |
140 IU |
Tofu, fortified with Ca |
¼ Cup |
215mg |
All Fortified Milks |
1 Cup |
100+ IU |
Yogurt |
1 Cup |
275-450mg |
Yogurt, fortified |
6oz |
80 IU |
OJ, fortified with Ca |
½ Cup |
200mg |
Margarine, fortified |
1 Tbsp. |
60 IU |
Cheese- American, Blue, Parmesan |
1oz |
150mg |
Egg |
1 Large |
40 IU |
Soybeans |
½ Cup |
130mg |
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Dark Greens, cooked |
½ Cup |
100mg |
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Broccoli, cooked |
1 Cup |
100mg |
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Canned Salmon or Sardines |
1oz |
100mg |
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Ice Cream, Frozen Yogurt, Milk Pudding or Cottage Cheese |
½ Cup |
100mg |
Calcium or Vitamin D supplementation?
Calcium supplements may be the best way for you to get enough calcium if you cannot meet the recommendations. Dairy sources of calcium are better absorbed than non-dairy sources so individuals with milk protein allergy or lactose intolerance may have trouble meeting their needs. When using supplements be careful of high intakes of calcium as it can lower absorption of other minerals like iron.
Due to low availability of Vitamin D from foods, supplementation may need to be considered even when a deficiency is not present.
For more information on finding the right supplement visit www.FDA.gov or www.usp.org.
Get to know Joel Steelman, M.D.
Dr. Steelman is an endocrinologist at Cook Children's. He trained in endocrinology at the University of Colorado Children’s Hospital in Denver, where the magnificent setting turned Dr. Steelman into a lifelong outdoor sport enthusiast, with a strong desire to lead a healthy life. On his rare days off, he could be found skiing, mountain biking and trail running. He loves to go back to the Rockies as often as possible, and just a few years ago, he ran the Pike’s Peak ascent half marathon. He continues to run for exercise regularly. Click here to learn more about Dr. Steelman. For about about scheduling a patient, click here or call 682-7960.