Calcium for toddlers: how much and the best sources

Why calcium matters

Calcium helps build bones and keep teeth healthy (NHS). Toddlers are still growing fast, and the US Dietary Guidelines note that calcium needs go up in the second year of life. Calcium works together with vitamin D, which most toddlers need as drops: see vitamins for babies and toddlers.

How much calcium by age

The NIH and the AAP give these daily amounts:

• 0 to 6 months: 200 mg
• 7 to 12 months: 260 mg
• 1 to 3 years: 700 mg
• 4 to 8 years: 1,000 mg

In the first year, breast milk or infant formula is your baby’s main drink and main source of calcium (NHS). Full-fat dairy foods like plain yogurt and pasteurized cheese can be added from around 6 months (NHS). The jump comes at 12 months, when food and other milks take over more of the job.

Milk: enough, but not too much

For most toddlers, milk is the easiest way to get calcium.

• AAP: about 16 oz (480 ml), or 2 cups, of whole milk a day at 12 to 24 months, and 16 to 24 oz (480 to 710 ml) a day from 2 to 5 years. Its milk alternatives page puts the maximum at about 24 oz (710 ml) a day at age 1.
• NHS: at least 350 ml (12 oz) of milk a day, or 2 servings of foods made from milk, such as cheese, yogurt or fromage frais.

A cup (8 oz, 240 ml) of whole milk has about 276 mg of calcium (NIH), so 2 cups give about 550 mg, most of a toddler’s 700 mg. For 2-year-olds, the AAP says 16 oz (480 ml) of low-fat or nonfat milk a day provides most of the calcium they need and still leaves an appetite for other foods, especially those that provide iron.

More milk isn’t better. The AAP says more than 32 oz (960 ml) of milk a day may interfere with iron absorption and raise the risk of iron-deficiency anemia, and milk can fill toddlers up so they eat less. At 12 to 24 months, keep to the AAP’s maximum of about 24 oz (710 ml) of whole milk a day. Offer milk in a cup with meals and snacks, and water in between. See cow’s milk at 12 months and iron deficiency.

Calcium from food

The NIH says milk, yogurt and cheese are rich natural sources of calcium. Good dairy choices for toddlers:

• plain full-fat yogurt (no added sugar)
• pasteurized cheese, grated or thinly sliced, and cottage cheese
• cow’s milk in porridge, sauces and other cooking

Non-dairy sources, from the NIH and the AAP:

• Fortified soy drink. Calcium-fortified soy drink has about the same calcium as cow’s milk (NIH). Choose unsweetened.
• Tofu made with calcium. Tofu set with calcium sulfate is a good source (NIH). Check the label for “calcium sulfate” or “calcium-set”.
• Canned fish with soft bones. Canned sardines and salmon with their bones contain calcium (NIH). Lift out the backbone and larger bones and mash the rest completely flat, as each food page shows.
• Green vegetables. Kale, broccoli and bok choy, cooked soft and chopped (NIH).
• Other foods. Fortified breakfast cereals (choose ones with no added sugar), pinto beans and other beans, mashed or squashed, and ground chia seeds soaked into porridge or yogurt add smaller amounts (NIH).

Spinach is a poor source. It contains calcium, but the NIH says the body absorbs only about 5% of it, compared with about 27% from milk, because of compounds called oxalates. Spinach is still a good vegetable; just don’t count on it for calcium.

If your toddler doesn’t drink milk

Some toddlers don’t like milk, and some can’t have it. What helps depends on why.

• Cow’s milk allergy. This is not the same as lactose intolerance (ACAAI). Yogurt, cheese and lactose-free milk are all made from cow’s milk, so none of them is a safe swap. Talk to your pediatrician, health visitor or GP before choosing any milk alternative (NHS). Soy needs care too: the AAP says soy should also be avoided after a cow’s milk protein allergy diagnosis, because about half of babies with that allergy may also react to soy. See cow’s milk allergy.
• Lactose intolerance. The AAP says children who can’t drink cow’s milk can meet their dairy needs with yogurt and cheese, though they may need a vitamin D supplement, because not all yogurts have vitamin D added. The US Dietary Guidelines list lactose-free milk as another option.
• Doesn’t like milk. Yogurt and cheese count, and soy drink, tofu, sardines and calcium-fortified foods are all options, according to the AAP.
• Plant drinks. The AAP says soy drink is the only plant drink nutritionally equivalent to cow’s milk. The NHS says unsweetened, calcium-fortified soya, almond and oat drinks can be given from the age of 1 as part of a healthy, balanced diet. Under 5, never rice drinks (NHS, arsenic). See plant milks for toddlers.

Calcium supplements: only on your doctor’s advice. The AAP says pediatricians may recommend them in some cases. The NIH upper limit for ages 1 to 3 is 2,500 mg a day from all sources, and more isn’t helpful.

Safe forms

• Cheese: grated, melted into food or in thin slices. The CDC lists large chunks of cheese, especially string cheese, as a choking hazard.
• Fish: check for bones; mash soft canned-fish bones completely flat.
• Seeds: ground only, never whole (CDC).
• Leafy greens: cooked until tender and finely chopped.

See safe food sizes and shapes.

A calcium-friendly day

Our own example, not a rule (see toddler portion sizes):

• Breakfast: oatmeal made with whole milk or fortified soy drink.
• Lunch: pasta with grated cheese and soft-cooked broccoli, and water.
• Snack: plain full-fat yogurt with mashed banana.
• Dinner: mashed sardines on toast fingers, or tofu and vegetable stir-fry, with a cup of milk.

Where US and UK advice differs

• How much milk. AAP: about 16 oz (480 ml) of whole milk a day at 12 to 24 months, and no more than about 24 oz (710 ml). NHS: at least 350 ml (12 oz) of milk a day, or 2 servings of milk-based foods.
• Which milk. AAP: whole milk from 12 to 24 months. NHS: whole or semi-skimmed milk from age 1.
• Plant drinks. AAP: only soy drink is nutritionally equivalent to cow’s milk. CDC: fortified, unsweetened dairy alternatives can be offered from 12 months. NHS: unsweetened, calcium-fortified soya, almond or oat drinks from the age of 1 as part of a healthy, balanced diet. The NHS says no rice drinks under 5, and this site follows that.
• Milk in cooking before 12 months. The NHS says cow’s milk can be used in cooking or mixed into food from around 6 months. The CDC says not to give cow’s milk before 12 months. If you follow US advice, use breast milk or formula instead.