Calcium

These instructions are for Children's Hospital of Philadelphia (CHOP) patients to learn more about the importance of calcium, foods that have calcium, and what to look for in a calcium supplement.

Important information about calcium:

Children need calcium to grow and have healthy teeth, bones, nerves and muscles.

The daily Dietary Reference Intakes (D.R.I.) recommendations for the daily amount of elemental calcium are:

• 0 - 6 months: 200 mg/day

• 6 months - 1 year: 260 mg/day

• 1 - 3 years: 700 mg/day

• 4 - 8 years: 1,000 mg/day

• 9 - 18 years: 1,300 mg/day

• 19 - 50 years: 1,000 mg/day

The amount of calcium your child needs depends on your child's health. Children with different medical conditions may need different doses of calcium. Your child's healthcare provider or registered dietitian will tell you the correct dose for your child.

Children can get the right amount of calcium through:

• Foods and drinks that contain calcium.

• Calcium supplements (tablets, liquids, or chewables).

Information about calcium in foods:

The following foods and drinks contain about 300 mg elemental calcium for each serving:

• 8 ounces milk

• 8 oz calcium-fortified almond, oat, rice, soy milk

• 1 cup yogurt

• 8 ounces fortified orange juice

• 1 ½ ounces natural cheese, 2 ounces processed cheese

• ¼ cup non-fat dry milk powder

• 6 oz tofu

• 1 cup pudding

• 4 ½ oz canned pink salmon

• 1 cup cooked collard greens

It is important to read labels on food packages, as the amount of calcium in some foods may vary by brand. When reading a food label, the percent calcium is out of 1,300 mg. If a label reads 30% calcium, then it contains 390 mg of elemental calcium. To replace one serving of milk, choose a product with 25% to 35% of calcium in each serving.

Caution: If your child follows a Gluten Free Diet, read ingredient labels and/or contact the manufacturer to ensure you purchase a gluten free product.

Important information about calcium supplements:

If your child's diet doesn't provide enough calcium, your child's healthcare provider will tell you what kind of calcium supplementation is needed and how much.

It is important to read labels on packages of supplements. Most calcium supplement labels list the amount of ‘elemental' calcium found in one dose, sometimes referred to as ‘Ca ++'. This is the amount of calcium that is absorbed by the body. Ask your healthcare provider if you have any questions regarding how much elemental calcium is in a supplement.

Calcium supplements may also contain Vitamin D, other vitamins or minerals.

If your child is following a specific diet, always carefully read ingredient lists and contact the manufacturer for further information about the product.

Calcium supplements come in a few different forms:

• Calcium carbonate is the least expensive and most common form of calcium. It is found in products such as Adora®, Caltrate®, Oysco®, Os-cal®, Rolaids®, Tums® and Viactiv®.

• Calcium citrate and calcium citrate malate are easily absorbed, but the tablets may be difficult to swallow. Calcium citrate is found in Citracal®. Calcium citrate malate is in Calcimate®.

• Calcium phosphate and calcium gluconate are used less often. If your child has kidney problems, ask your healthcare provider before you use calcium phosphate.

Calcium supplements can be found at your local pharmacy in the vitamins and minerals section. If the supplement is not available at your pharmacy, you may need to buy it on the internet. Speak with your healthcare provider before ordering any calcium supplements from the internet.

Products that are "USP verified" are preferred when available to ensure product quality.

Follow these instructions for taking a calcium supplement:

• Do not take more than 600 mg elemental calcium per dose. This allows your body to absorb the calcium.

• Calcium carbonate should be taken with at least 8 ounces of water with or following a meal.

• Calcium citrate can be taken with or without food when used for calcium supplementation.

• If any type of calcium is being used for phosphate binding, it should be taken with meals.

• Liquid calcium can be mixed with any type of food or drink. If your child receives tube feedings, you may add calcium to the feedings. Be sure to add your child's calcium dose to the smallest volume of food possible to ensure they get the full dose of the medicine.

• Calcium can affect the absorption of some other medications if they are not spaced apart. Ask your healthcare provider about how calcium works with the medicines your child is taking.

Reviewed February 2025, by Erica Schwab, RD, CSP, LDN; Susan Ramsey, PharmD, BCPPS, Kara Feigenbaum RD, Janel Steinhoff, RD