Clinical Reference Systems: Pediatric Advisor 10.0
Milk and Calcium
Milk is good for most children. A few children cannot
digest milk or are allergic to it and shouldn't drink it.
Most children, though, can drink milk.
Milk provides important amounts of protein and it is many
people's main source of calcium and vitamin D. Sometimes
you may hear that milk is bad for people. These rumors are
simply wrong. Until they get to adolescence, children need
between 2 and 3 cups of milk every day.
If your child is drinking much more than 3 cups of milk a
day, she may be filling up on milk and not leaving enough
room for the other foods she needs. Then you might consider
limiting the amount of milk she drinks and offering water
If your child doesn't drink enough milk, she may not get the
calcium she needs to develop strong bones. To help her get
enough calcium, use more dairy products or calcium-rich
foods in your cooking.
Amounts of Calcium in Foods
Children from age 1 to 3 years need 500 milligrams (mg) of
calcium a day. Children 4 to 8 years old need 800 mg of
calcium a day. Children 9 to 18 years need 1300 mg a day.
The following chart shows how much calcium is in various
FOOD AMOUNT CALCIUM (mg)
Milk, liquid 1 cup 300
Milk, powdered 1 Tbsp 60
Cheese, natural or
processed 1 ounce 200
Cottage cheese 1/4 cup 60
Yogurt 1 cup 300
Ice cream 1/2 cup 110
Cream cheese 1 Tbsp 10
Meat and other protein sources:
Meat, poultry, fish 3 ounces 10 to 20
Canned fish with bones 3 ounces 250
Egg 1 egg 30
Cooked dried beans 1/2 cup 70
Nuts and seeds 2 Tbsp 20 to 40
Peanut butter 2 Tbsp 20
Bread, cereal, pasta:
Bread 1 slice 25
Biscuits, rolls 1 roll 25
Corn tortilla 1 tortilla 60
Cooked and dry cereals 1 serving 15
Noodles, macaroni 1/2 cup 15
Vegetables and fruits:
Vegetables, average 1/2 cup 20 to 40
Green, leafy vegetables,
average 1/2 cup 100
Fruits, average 1/2 cup 20 to 40
orange juice 1/2 cup 160
Ways to Include Calcium in the Diet
- Encourage your child to drink milk.
You can make milk the only mealtime beverage except for
water. You can drink it yourself. You can give your
child a gentle reminder: "Don't forget about your
You mustn't insist, "You have to drink your milk." And
you mustn't use leverage: "You have to drink your milk
before you can have more spaghetti." Also, you
shouldn't play games: "I bet I can drink my milk faster
than you can." These tactics give children the clear
message that they shouldn't like milk. Children reason,
"If it's so good, how come they have to do all that to
get me to drink it?"
Most children go through a stage when they don't drink
milk. For many, it is when they first are weaned from
the nipple. Don't panic and put your child back on the
bottle. Just wait. She will start to drink milk
You can use the suggestions given below for including
calcium in the diet by preparing special foods, but try
to be low-key. The harder you work to make special
foods, the more pressure you may put on your child to
eat them. When children feel pressured to eat, they
generally react by eating less.
See Eating Basics: Helping Your Child Eat Well.
- Use dairy products in different ways.
Make fortified milk: Combine 2 cups of liquid milk and
1/3 cup of powdered milk. Cool in refrigerator before
using. Substitute for regular milk. One cup of
fortified milk contains the calcium and other nutrients
of 1 and 1/2 cups of regular milk.
Add flavorings to milk: strawberry, chocolate, soft
drink powders. Make eggnog, cocoa, and milkshakes.
Make a "smoothie": Blend milk with fruit to make a
beverage much like a milkshake.
Use milk in some cooking instead of water; for example,
in cooked cereal, soups, and gravies.
Use powdered milk when you bake. Add 2 tablespoons of
powdered milk to each cup of flour. Store and use for
Add powdered milk to other cooking:
- Ground beef: Add 1/2 cup powdered milk for each
pound of beef. Add water.
- Casseroles: Add 2 tablespoons of powdered milk for
each cup of casserole.
- Vegetables: Make a cream sauce using powdered milk.
Make desserts with fortified milk; for example, custard,
pudding, rice pudding, pumpkin custard, and cheesecake.
Use cheese in cooking; for example, macaroni and cheese,
lasagna, tacos, grilled cheese sandwich, cheeseburgers,
- Use vegetables high in calcium.
Use beans and peas; for example, bean or split pea soup,
chili, three-bean salad, pea-pickle-cheese salad, and
kidney beans with cheese.
Use leafy, green vegetables in salads, soups, and
Calcium Supplements for Children Who Don't Eat Milk
You can give calcium supplements to make up for a lack of
milk, but it is usually better to first try substituting
other calcium-rich foods. There are different types of
calcium supplements. Some are better absorbed by the body
than others. Supplements may be tablets, wafers, or
chewables. Supplements in the form of calcium lactate or
calcium carbonate are reasonably well absorbed. Avoid bone
meal and dolomite. They contain lead and other trace
elements that are not good for your child.
The dosage varies. If you need to give your child several
tablets, spread them throughout the day so your child's body
can better absorb the calcium.
Calcium supplements come with or without vitamin D. Which
you should use depends on whether your child is getting
enough vitamin D from other sources. (The recommended daily
allowance for vitamin D is 400 IU per day.)
Calcium-supplemented orange juice gives a lot of calcium.
However, it does not contain vitamin D, nor does it give the
protein that milk does. To get a whole day's supply of
calcium, your child would need to drink 2 and 1/2 cups of
calcium-supplemented orange juice a day.
Call Your Child's Physician During Office Hours If:
- It looks like your child is getting less than 200
milligrams of calcium a day.
- You suspect your child cannot digest milk or is allergic