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Bone Health

May 13, 2010

By Dr. Elizabeth Walenz with Methodist Physicians Clinic

One of the most important topics that I focus on at well child is nutrition. It is important to make sure that the child’s intake is adequate for optimal growth and development. Conversely, I want to make sure the intake is not overabundant with unnecessary calories. One of the major focuses I have is on bone health.

It is important to think about bone health from the first day of a child’s life. The AAP recently made recommendations regarding Vitamin D supplementation. Vitamin D does not travel through breast milk. If a child is exclusively breastfed or feeding less than 1 Liter of formula daily¸ the child needs Vitamin D supplementation. The AAP recommends that children need 400 IU of vitamin D which can be given as 1 mL of a liquid multivitamin (such as poly vi sol).

The other important consideration in healthy bones for kids is calcium. Calcium is so important. I talk about milk intake at every visit starting at the 2 week visit. Children under the age of 8 need 500-800 mg of calcium every day. Boys and girls over 8 need 1300 mg of calcium daily.

Where do we find calcium? The obvious answer is milk and dairy products. An 8 oz glass of milk contains 300 mg of calcium. A slice of American cheese contains 250 mg. Six ounces of yogurt has 250 mg of calcium.

It is not uncommon for me to encounter adolescent girls who no longer “like the taste of milk” and are low on their calcium intake. Adolescence is one of the most important times in a person’s life for calcium intake and bone health. The majority of bone growth occurs from adolescence until a person becomes 30. Many studies have looked at the amount of calcium in a child’s diet in the adolescent years and the relation to osteoporosis later in life. If calcium intake is low, I often will recommend yogurt smoothies. Many everyday foods are fortified with calcium such as bread, juices, waffles, granola bars and pizza. If a child cannot tolerate milk products, I will recommend 2 plain Tums daily or the Viactiv chews.

It is also important to be active. Giving your bones a good workout daily helps to increase bone strength. Taking evening walks, jogging, playing soccer or team sports are excellent work outs for your bones!

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