Paediatric Nutrition

supporting wellbeing with nutrition education

Tag: vitamin D deficiency

good sources of calcium

Infants and children need good sources of calcium in their diets on a daily basis. Calcium absorption in the gut is variable and ranges from 25-50%, increasing when intake is low and reducing when intake is high. Plenty of foods rich in calcium are especially important throughout infancy to support the rapid bone growth and bone mineralisation that occurs at this time. The uptake of calcium by bones is then regulated by Vitamin D, with Vitamin D deficiency limiting bone mineralisation even in the presence of adequate calcium.  Growth spurts during infancy and childhood, from a surge in growth hormone provides a boost to calcium absorption, which further strengthens bone mineralisation. Absorption of calcium from breast milk is very efficient at around 66% and from formula milk around 40%.   For all infants and young children offer them calcium rich foods every day.

  • Dairy products like milk, cheese and yoghurt are the UK’s best sources of calcium for infants and young children
  • Calcium is also found in tinned fish, nut butters, tahini or sesame seed pulp, hummus, figs, dates, and green vegetables
  • White wheat flour is fortified in the UK with 120mg Calcium per 100g
  • Water in areas of hard water like Cambridge contains 120mg calcium per litre
  • For all children with cow’s milk allergy, take care to offer calcium enriched products, checking sources of other valuable nutrients such as protein, iodine, Vitamin D as well as overall calories
  • Prolonged poor calcium intake will lead to brittle bones that break more easily, both in childhood and in later adulthood
  • Exercise and weight bearing activity will also strengthen bone
  • Have a quick check on recommended intakes to check if your child is getting enough calcium
  • Download the portions of calcium rich foods below
  • Infants and young children need a Vitamin D supplement containing a minimum of 10ug daily until 5 years and thereafter for a minimum of the 6 Winter/Spring months to maintain good levels

Recommended Intakes

  • Daily calcium needs during infancy are 525mg 
  • 5-600mls formula provides the majority of calcium during infancy
  • Breast fed infants depend on mum’s diet, and a calcium and vitamin D is advisable for mum
  • Daily calcium needs during early years are 350-450mg; provided by 3-4 portions of calcium rich foods
  • Daily calcium needs during primary school are 450-700mg; provided by 4-5 portions of calcium rich foods
  • For all children with cow’s milk allergy, take care to offer calcium enriched products, checking sources of other valuable nutrients such as protein, iodine, Vitamin D as well as overall calories.


does my child need a vitamin D supplement?

metabolism of vitamin DThis is a question many parents ask me. Multivitamin and mineral supplements should not be needed as nutrient deficiencies are rare in the UK. Provided your child is eating a variety from the 5 food groups, they are unlikely to need a vitamin supplement. The exception for this is a Vitamin D supplement. Rickets, a condition where growing bones are misshapen, is caused by Vitamin D deficiency in childhood.  It was prevalent in UK children in the early 1900’s, and is being seen increasingly in the UK again.  The reasons are multi-factorial and include less time playing outside in the sunshine, the use of sun-block because of worries about skin cancer and declining oily fish consumption.  Oily fish is the only significant dietary source of Vitamin D. More than 90% of our Vitamin D needs are met by the action of UV sun rays on the skin. Recent guidance on the need for a Vitamin D supplement from Public Health England (PHE) following a SACN review of the evidence on Vitamin D and Health says

“Children aged 1 to 4 years should have a daily 10 microgram vitamin D supplement. PHE recommends that babies are exclusively breastfed until around 6 months of age. As a precaution, all babies under 1 year should have a daily 8.5 to 10 microgram vitamin D supplement to ensure they get enough. Children who have more than 500ml of infant formula a day do not need any additional vitamin D as formula is already fortified.”

Sure Start vitamins containing Vitamin D are available for all children under 4.  Pregnant and breast feeding mums should also remember to take a Vitamin D supplement containing a minimum of 10ug daily.