Getting enough calcium on a milkfree diet: information for parents and carers

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Getting enough calcium on a milk- free diet: information for parents and carers

This is a diet sheet to help you make sure you and your child are getting enough calcium from your diet.

What is calcium?

Calcium is a mineral that is important at all ages for strong bones and teeth. The main sources of calcium in the diet are cow’s milk and dairy products. However, it is still possible to have a good calcium intake when you are on a cow’s milk-free diet because calcium is present in a range of other foods.

General tips

1. Always check the cow’s milk replacement you are using is fortified with calcium.

Examples include: soya, coconut, oat, almond, hazelnut, hemp, quinoa and rice milks.

Please note that rice milk is not suitable for children under 5 years of age.

2. Organic products do not have added calcium as there is no organic source of calcium currently available.

3. Many cow’s milk and dairy free replacement products have their calcium content listed on the nutrition panel.

4. Meals and snack ideas to increase calcium intake:

• Start the day with a fortified cereal and cow’s milk substitute (with added calcium) for breakfast.

• For dessert add soya yoghurt or ready made soya custard to fruit or make custard and milk puddings with a milk substitute.

• Offer baked beans or calcium fortified soya cheese on a jacket potato or crackers.

• Add pulses to soups, stews or on top of a baked potato.

• Offer dried fruit as a snack between meals.

5. In order to use and absorb the calcium we eat we need to get enough Vitamin D. We get most of our Vitamin D from direct sunlight during the summer months. However small amounts of Vitamin D come from our diet. Vitamin D containing foods include; oily fish, margarine and fortified breakfast cereals.

All children aged 1-5 years should have a daily vitamin D supplement (available free of charge for those eligible for Healthy Start vouchers).

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What is the recommended daily amount of calcium?

The recommended daily amount of calcium is outlined in the table below.

One star equals about 60mg of calcium*.

Age group Requirements Calcium stars*

Infants (0 – 12 months) 525mg 9 stars

Children

1 – 3 years 350mg 6 stars

4 – 6 years 450mg 7½ stars

7 – 10 years 550mg 9 stars

Adolescents (11 – 18 years) Girls: 800mg Boys: 1000mg

13 stars 16 ½ stars

Adults (19 +) 700mg 12 stars

Breastfeeding mothers 1250 mg 20 stars

The following table shows the calcium content of some dairy and non-dairy foods and drinks.

You can count the calcium stars to make sure that your child is having enough calcium in their diet.

Calcium in cow’s milk and dairy products

Food Portion size Calcium Calcium stars

Cow’s milk (all types) 1/3 pint (200mls) 240mg ✰✰✰✰

Infant formula (cow’s milk) 100ml (3oz) 50mg ✰

Yoghurt (plain/fruit) 1 medium pot (120g) 200mg ✰✰✰1/2

Cheese, hard e.g. Cheddar Matchbox size (30g) 220mg ✰✰✰✰

Cheese triangle 1 triangle (15g) 60mg ✰

Cottage cheese 1 pot (100g) 127mg ✰✰

Custard 1 serving (120ml) 120mg ✰✰

Clover Additions Strong

Bones 28g serving 121mg ✰✰

Calcium enriched Fromage

Frais e.g. Petit Filous 1 pot (50g) 125mg ✰✰

Fromage Frais e.g. Plum,

Ella Kitchen, Munch bunch 1 pot (40-55g) 60-90mg ✰

Horlicks 25g serving in 200ml milk 710mg ✰✰✰✰✰✰✰✰✰✰✰✰

Ovaltine 25g serving in 200ml milk 444mg ✰✰✰✰✰✰✰

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Calcium in foods free from milk and dairy Alternative dairy products

Calcium fortified milks e.g.

soya/oat/coconut/rice/hazel nut/almond/hemp/quinoa

200ml (1/3 Pint) 240mg ✰✰✰✰

Calcium fortified soya

yoghurts/desserts/custards 1 medium pot (125g) 120mg ✰✰

Wot no Dairy (milk and soya

free yogurt) 1 pot (125g) 392mg ✰✰✰✰✰✰

Milk/soya free cheese e.g.

Redwoods cheezly Matchbox size (30g) 60mg ✰

Hypoallergenic formula

Infant formula: Nutramigen 1, Aptamil Pepti 1 Althera, Alimentum, Neocate LCP, Nutramigen AA, Infasoy, Wysoy

100mls (3oz) 50-70mg ✰

Follow on formula: Nutramigen

2, Aptamil Pepti 2 100ml (3oz) 60-95mg ✰

Breads and cereals

Chapatti/Pitta bread 2 small (120g) 80mg ✰

White Bread 2 medium slices (72g) 80mg ✰

Wholemeal Bread 2 medium slices (72g) 80mg ✰

Hovis Best of Both 2 medium slices (72g) 382mg ✰✰✰✰✰✰

Instant porridge (fortified) e.g. supermarket own brand Ready brek (may contain milk)

1 tbsp dry cereal (15g) 180mg ✰✰✰

Fortified cereals e.g. Rice Krispies Multigrain Shapes, Cheerios

1 medium portion (30g) 137mg ✰✰

Swiss Muesli 3 ½ tbsp (50g) 55mg ✰

Plain scone 1 plain scone (50g) 89mg ✰1/2

Protein sources

Anchovies 1 small tin (50g) 150mg ✰✰

Prawns 1 medium portion (60g) 66mg ✰

Scampi in breadcrumbs 10 pieces (150g) 315mg ✰✰✰✰✰

Tinned Salmon (inc. bones) 1 small can (120g) 363mg ✰✰✰✰✰✰

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Tofu (Soya bean curd) 2 tbsp (50g) 56mg ✰ Tahini (sesame seed paste) 1 heaped tsp (20g) 130mg ✰✰

Tinned Sardines or

pilchards (including bones)

1 sardine or pilchard

(25g-55g) 125mg-138 mg ✰✰

Whitebait 1 small portion (50g) 430mg ✰✰✰✰✰✰✰

Fruit and vegetables

Broccoli 3 spears (boiled) (135g) 60mg ✰

Curly Kale 1 medium portion (70g) 90mg ✰

Spring Cabbage 1 medium portion (90g) 50mg ✰

Spinach (boiled) 2 tbsp (90g) 145mg ✰✰ 1/2

Okra (stir fried) 1 medium portion (60g) 132mg ✰✰

Watercress ½ a bunch (40g) 68mg ✰

Currants 2 heaped tbsp (50g) 47mg ✰

Dried Mixed Fruit 3 tbsp (75g) 54mg ✰

Dried Figs 2 dried figs (40g) 100mg ✰✰

Dried Apricots 8 dried apricots (66g) 60mg ✰

Orange 1 medium (160g) 75mg ✰

Beans and lentils

Baked Beans 2 tbsp (80g) 42mg ✰

Lentils (cooked) 5 tbsp (200g) 30mg ½

Red Kidney Beans 2 tbsp (60g) 43mg ✰

Soya Beans 2 tbsp (60g) 50mg ✰

Miscellaneous

Almonds or Brazil nuts 1 handful (30g) 72mg ✰

Black Treacle 2 toffees (20g) 100mg ✰1/2

Liquorice Allsorts 1 small bag (56g) 95mg ✰1/2

Orange Juice (fresh) 1 large glass (300ml) 32mg 1/2

Orange Juice enriched with

calcium e.g. Tropicana 1 medium glass (200ml) 244mg ✰✰✰✰

Ribena Plus (healthy bones) 1 carton (200ml) 120mg ✰✰

PLEASE NOTE: if avoiding Cow’s milk, always check ingredient labels every time you buy as ingredients and manufacturing processes can change

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What if my child is not meeting their recommended daily amount of calcium?

If your child is unable to meet their calcium requirements from food, they will need a calcium supplement. There are a wide range of calcium supplements available from your doctor (or chemist). Please ask your dietitian or doctor for more information.

Pharmacy Medicines Helpline

If you have any questions or concerns about your medicines, please speak to the staff caring for you or call our helpline. t: 020 7188 8748 9am to 5pm, Monday to Friday

Patient Advice and Liaison Service (PALS)

To make comments or raise concerns about the Trust’s services, please contact PALS. Ask a member of staff to direct you to the PALS office or:

t: 020 7188 8801 at St Thomas’ t: 020 7188 8803 at Guy’s e: pals@gstt.nhs.uk

Knowledge & Information Centre (KIC)

For more information about health conditions, support groups and local services, or to search the internet and send emails, please visit the KIC on the Ground Floor, North Wing, St Thomas’

Hospital. t: 020 7188 3416 Language support services

If you need an interpreter or information about your care in a different language or format, please get in touch using the following contact details. t: 020 7188 8815 fax: 020 7188 5953

NHS Direct

Offers health information and advice from specially trained nurses over the phone 24 hours a day.

t: 0845 4647 w: www.nhsdirect.nhs.uk

NHS Choices

Provides online information and guidance on all aspects of health and healthcare, to help you make choices about your health. w: www.nhs.uk

Contact us

If you have any questions or concerns about the information covered in this leaflet, please telephone us via the following details:

• Paediatric allergy dietitians on 020 7188 8494, Monday to Friday, 9am to 5pm

• Paediatric dietitians on 020 7188 4568 Monday to Friday, 9am to 5pm

• Children’s Allergy Service on 020 7188 3300, Monday to Friday, 9am to 5pm

For more information leaflets on conditions, procedures, treatments and services offered at our hospitals, please visit www.guysandstthomas.nhs.uk/leaflets

Leaflet number: 2294/VER2