Calcium and Vitamin D

Recommended Dietary Allowances

Calcium:
  • 1-3 years old: 700 mg
  • 4-8 years old: 1,000 mg
  • 9-18 years old: 1,300 mg
Vitamin D:
  • 0-12 months old: 400 IU
  • 1-18 years old: 600 IU
These recommendations assume there is no dietary intake of calcium and vitamin D or sunlight exposure. They are meant as guidelines only.

Dietary Intake

In general, the American Academy of Pediatrics and American Dietetic Association recommend that nutrients for healthy children should be consumed from foods.
Calcium: Children eating a regular diet tend to get about 200 mg of calcium at baseline, and about 300 mg for each serving of dairy products, such as milk, yogurt, and cheese. Calcium-fortified orange juice, soy milk, and almond milk contain about the same amount of calcium as an equivalent amount of cow milk. A few vegetables, including broccoli, rhubarb, soybeans, arugula, kale and collard greens contain smaller amounts of calcium.

Vitamin D: Although our bodies can make vitamin D after skin is exposed to sunlight, most people now limit sun exposure. Vitamin D is naturally present in very few foods; it is added to many, though, and is also available as a dietary supplement. The most common natural and fortified sources of vitamin D include some fatty fish such as tuna and salmon; most milk; and many types of orange juice, yogurt, cheeses, breakfast cereals, breads and soy drinks. Most milk is fortified with 100 IU of vitamin D in an 8-ounce serving.

Supplementation

For nutritionally vulnerable populations, multivitamin-mineral supplements can help meet nutrition needs.
Calcium: High calcium intake above 1,200-1,500 mg is not necessary. Taking calcium supplements between meals can minimize calcium-induced inhibition of iron absorption. Calcium supplements are best absorbed when taken as a 500 mg dose.

Vitamin D: The safest and most economical way to ensure adequate vitamin D status is to use oral dosing of native vitamin D3, cholecalciferol. Both daily and intermittent regimens work well. [Russo: 2011]) Serum 25(OH) D can be expected to rise by about 1 ng/mL (2.5 nmol/L) for every 100 IU of additional vitamin D each day. [Heaney: 2008]

Resources

Information & Support

For Professionals

Vitamin D: Fact Sheet for Health Professionals (NIH)
Cites guidelines and contains information about natural sources of vitamin D, its potential interactions with medications, what constitutes excessive amounts, and who is at risk for deficiencies; National Institutes of Health.

Calcium: Fact Sheet for Health Professionals (NIH)
Cites guidelines and contains information about natural sources of calcium, its potential interactions with medications, what constitutes excessive amounts, and who is at risk for deficiencies; National Institutes of Health.

Helpful Articles

Abrams SA.
Dietary guidelines for calcium and vitamin D: a new era.
Pediatrics. 2011;127(3):566-8. PubMed abstract

Golden NH, Abrams SA.
Optimizing bone health in children and adolescents.
Pediatrics. 2014;134(4):e1229-43. PubMed abstract

Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M.
Vitamin D deficiency in children and its management: review of current knowledge and recommendations.
Pediatrics. 2008;122(2):398-417. PubMed abstract

Hollis BW, Wagner CL, Howard CR, Ebeling M, Shary JR, Smith PG, Taylor SN, Morella K, Lawrence RA, Hulsey TC.
Maternal Versus Infant Vitamin D Supplementation During Lactation: A Randomized Controlled Trial.
Pediatrics. 2015;136(4):625-34. PubMed abstract / Full Text

Authors

Author: Lynne M Kerr, MD, PhD - 12/2013
Reviewing Authors: Meghan Candee, MD - 11/2015
Elizabeth Miller, MS, RD - 11/2015
Content Last Updated: 1/2016

Page Bibliography

Heaney RP.
Vitamin D in health and disease.
Clin J Am Soc Nephrol. 2008;3(5):1535-41. PubMed abstract

Russo S, Carlucci L, Cipriani C, Ragno A, Piemonte S, Fiacco RD, Pepe J, Fassino V, Arima S, Romagnoli E, Minisola S.
Metabolic Changes Following 500 μg Monthly Administration of Calcidiol: A Study in Normal Females.
Calcif Tissue Int. 2011. PubMed abstract