Expert Shares How to Help Your Child Grow Strong, Healthy Bones

Bones create the very structure upon which our body exists.

Without bones, we will not be able to walk or move.

So, the importance of our skeleton is not something to be taken for granted, especially for children.

We sat down with Pharmacist Nazatul Amira Hamzah from Primabumi Sdn Bhd to help parents learn all they need to about their child’s bone health.

Nazatul currently holds the position of Pharmacist and Key Account Manager at a renowned pharmaceutical company in Kuala Lumpur.

Here’s a pharmacist’s advice on children’s bone health.

Why is bone health important during childhood?

Rapid bone development occurs during childhood and adolescence

This is when the body deposits far more new bone than it removes, enabling the bones to reach their maximum strength and density by the mid- to late-20s.

Proper nutrition, along with regular physical activities and a healthy lifestyle, promotes strong bones, helps to prevent fractures, and lowers the risk of osteoporosis and other bone-related diseases later in life.

What are the key nutrients necessary for healthy bone development in children?

The essential nutrients for healthy bone growth include calcium, vitamin D, phosphorus, magnesium, and protein.

What role do calcium and vitamin D play in the bone health of children?

Calcium is the basic building block of bone tissue. It provides the structural elements that give bones strength and rigidity.

Vitamin D supports optimal bone development by helping the body to absorb calcium.

How much calcium and vitamin D does my child need?

The Endocrine Society and the Institute of Medicine USA have proposed recommended daily allowances (RDA) for vitamin D and calcium.

They have also included maximum daily consumption levels that should not be exceeded.

*RDA stands for Recommended Daily Allowance i.e., the average daily level of intake sufficient to meet the nutrient requirements of nearly all (97–98%) healthy individuals.

**The table above serves as general guidance only. Please consult your healthcare professional before starting any supplement for your child.

The recommendations come with two precautions:

• Some children may need more than the RDA (after talking with their doctor) if they are:
  • Obese
  • Taking anticonvulsant medications, glucocorticoids, antifungals such as ketoconazole or medications for AIDS.
•  Excessive intake of calcium and vitamin D can be harmful:
  • Too much calcium in supplements may cause kidney stones.
  • Very high levels of vitamin D (above 10,000 IUs per day) could lead to kidney and tissue damage.

What foods are rich in calcium and vitamin D and suitable for children?

Calcium is found mostly in dairy products such as milk, yoghurt and cheese.

Your child can also get calcium from beans, broccoli, leafy green vegetables, oranges, nuts, and seeds.

Foods that contain vitamin D include fatty fish like sardines and salmon, certain types of mushrooms, and egg yolks.

Additionally, fortified foods and beverages like cereals, breads, milk, and orange juice regularly contain calcium and vitamin D.

What are the signs of poor bone health in children?

Children with poor bone health may present with the following symptoms:

• Pain in the lower back, hips, and feet, often accompanied by difficulty walking.
• Muscle weakness
• Frequent fractures
• Slowed growth
• Low body weight
• In severe cases, abnormalities such as bowed legs or a curved spine.

What is the relationship between salt, sugar, and bone health?

Not only does sugar overconsumption contribute to obesity, but it may also harm your child’s bone health by raising blood glucose levels, resulting in calcium and vitamin D deficiency.

Excessive salt intake, on the other hand, increases the loss of calcium through urine.

How can sleep quality and childhood obesity have an impact on my child’s bone health?

During deep sleep, your child’s body releases growth hormones, which are necessary for bone development, healing, and maintenance.

Research indicates that children who receive less than 8 hours of sleep per day are more susceptible to impaired bone formation.

Childhood obesity puts too much stress on bones and joints, increasing the risk of fractures and joint problems.

Furthermore, obese children may have decreased levels of physical exercise, which is required for bone strength. 

How do I help my child build strong bones?

You can help your child develop strong, healthy bones by:

• Providing them with a well-balanced diet that is high in calcium and vitamin D.
• Limiting your child’s intake of sugary and high-fat foods to prevent obesity.
• Promoting safe sun exposure to help your child get enough vitamin D. Protect their skin outdoors by wearing sunscreen and clothing to prevent skin disorders.
• Encouraging them to engage in regular exercise. Physically active children grow more bone mass than less active kids, and their bone mass usually remains high as they get older.
• Consulting a paediatrician about starting your child on a supplement if their daily intake is insufficient.

How can I tell if my child needs an additional source of calcium through supplementation?

With a healthy, well-balanced diet and an active lifestyle, your child should be able to get enough calcium, unless they:

• Are vegan: Your child doesn’t take any dairy products, an important source of calcium.
• Are lactose intolerant: your child’s body is unable to fully digest lactose, a sugar found in milk and milk products, causing your child to have diarrhoea, gas, and bloating after eating or drinking them.
• Need to take a corticosteroid for a long-term treatment: Corticosteroids tend to reduce your child’s body’s ability to absorb calcium while increasing calcium loss through urine.
• Are taking anticonvulsants: Anticonvulsants, or antiepileptics, are a group of prescription medicines that are used to help treat and prevent seizures. Clinical studies suggest that long-term use of some anticonvulsants, including carbamazepine, phenytoin, primidone, and sodium valproate, is linked to reduced bone mineral density.
• Suffer from a digestive issue that impairs their ability to absorb calcium and other nutrients, such as Chron’s disease and coeliac disease.

Source: Nazatul Amira Hamzah, Pharmacist at Primabumi Sdn Bhd

Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.

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