Mandy Lau, HK BioTek Nutritionist
Milk has always been regarded as a nutritious drink that provides children with essential nutrients for growth, such as protein and calcium. However, milk is also one of the top three common food allergens. Most of the children tend to show a strong antibody response towards milk and dairy products. As a result, their parents concern about the possibility of calcium deficiency.
In fact, even without milk, the kids still have many choices. For infants, breastmilk is the most ideal food. Otherwise, they can go for hydrolysed protein or soy formula. In general, children who have antibody reactions to cow milk, will respond similarly to goat milk, so it is not recommended to use goat milk formula in this case.
For school kids, plant-based milk, such as soy milk, rice milk, coconut milk, oat milk, hazelnut milk, cashew milk and so on, could replace cow’s milk. Adding cocoa powder on top of some nut milk could give a dairy-free “chocolate milk”, which has exactly the same taste and texture as ordinary chocolate milk. For breakfast, parents can choose oatmeal or corn flakes served with plant milk and different sugar-free dried fruits, crisp rice and mixed berries. Now, more and more health food stores and supermarkets are introducing different brands of plant milk to Hong Kong market. They are of reasonable price too. Parents can try different plant milk combination as well.
Parents should not overlook the potential dangers of dairy products such as cream, butter, cheese, yogurt and desserts. Take butter as an example. If the parents carelessly give their dairy-sensitive children a slice of buttered bread (which contains milk!), it might bring out symptoms. A safer choice will be vegetable butter (mostly made with olive oil or soybean oil), sesame spread and nut butter. In addition, there are also non-dairy vegan cheese available. They are all made of cashew nuts or vegetable oil, which could be used to make delicious dishes like cheesy pasta, baked potato and so on. Children who love yogurt can also choose soybean or coconut milk yogurt. These products are readily available in specialty shops and local supermarkets.
Calcium adequacy is the most common concerns among parents. However, milk and dairy products are not the only source of calcium. Some food have even higher calcium content. The table below shows that soft-boned fish, legumes and their products, nuts and seeds and dark green vegetables are also ideal sources of calcium.
(mg per 100 g of food)
|Dairy Products||Whole milk||125|
|Soft-boned Fishes||Sardine fish (with bones)||509|
|Hard bean curd||320|
|Nuts and Seeds||Sesame||975|
|Green Leafy Vegetables||Kale||150|
Source：United States Department of Agriculture（USDA）, Hong Kong Centre for Food Safety
According to the Institute of Medicine of the United States, the suggested daily calcium intake are as follows:
|Age group||Calcium Intake a (mg/day)|
|<1 years old||200-260 b|
|1-3 years old||700|
|4-8 years old||1000|
|9-18 years old||1300|
|>19 years old||1000-1200|
Source：Institute of Medicine. (2011). Dietary Reference Intakes for Calcium and Vitamin D. U.S.
a Recommended Dietary Allowance (RDA)
b Adequate Intake (AI)
When speaking of calcium sufficiency, apart from dietary intake, calcium absorption rate should also be taken into consideration. In addition to factors such as age, gender and ethnicity, there are also many dietary factors influencing the rate of calcium absorption. For example, the body needs enough vitamin D to help absorbing calcium. Also, excessive intake of sodium, caffeine and alcohol increase excretion of calcium. Medical literature also mentions that if the dietary phosphorus content is higher than that of calcium, it will also accelerate calcium loss. Therefore, new-born babies who consume cow milk product may cause insufficient calcium in blood. The ratio of phosphorus to calcium in breast milk is just the perfect for new-born babies, that’s also why breast milk is the perfect food for new-borns.