How to Treat Low Bone Density in Kids

Strong bones are a big part of any child’s health. They are even more important because long-term skeletal health depends in part on developing bone strength and density in childhood. But how can you avoid low bone density in your kids? Build good habits for life – feed your children a proper diet, encourage an active lifestyle, and be sure that other factors are not standing in the way.

Part 1

Part 1 of 3:

Strengthening Bones with Diet

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Feed your kids a calcium-rich diet. Bone growth and density depends in large part on a good diet and especially on getting enough calcium. Calcium is a mineral that goes into bone as well as teeth and finger and toe nails. It’s found in many different foods, so ensure that your kids are getting the right things and the right amount of calcium.^{[1]XResearch source}^{[2]XResearch source}
- Dairy foods are rich in calcium. Choose foods like milk, yogurt, cottage cheese, and other cheeses several times per day for your kids.
- There’s also large amounts of calcium in leafy greens like spinach and kale, in fish like salmon and sardines, in beans and tofu, and in oranges.
- How much should your kids get per day? It depends. Infants need about 200 to 260 milligrams per day. Toddlers aged 1 to 3 need about 700 mgs, while children aged 4 to 8 need 1,000 mgs and kids from 9 to 19 1,300 mgs.
- Kids and teens will need several servings of calcium-rich food per day to meet the minimum. For example, an 8 oz. portion of plain yogurt has about 300 mgs of calcium. A half cup of raw kale has about 90 mgs.
2
Supplement food with milk. Milk is one of the best foods that your kids can consume for calcium. Each 8 oz. glass of milk contains between 280 to 300 mgs of calcium, which is a big part of the daily recommended amount. It doesn’t have to be just a beverage, either. You can add milk to other foods like oatmeal and soup instead of water, to cold cereal, or to a fruit smoothie. Be creative!^{[3]XResearch source}
- Some kids have trouble digesting milk because of lactose intolerance, which can give them gas, stomach cramps, diarrhea, and nausea. Consider lactose-free milk if this is a problem. You can also buy digestive tablets like Lactaid or try to mix small amounts of milk in with food. These should all help symptoms.
- If your child is allergic to dairy products, it will be a little harder for him or her to get enough calcium. Talk to your doctor or nutritionist if you are having trouble getting enough calcium in your child's diet. Your doctor or nutritionist may recommend supplements to fill in any gaps in your child's diet.
- Encourage your children to drink milk or calcium-fortified orange juice rather than less healthy options like soft drinks. This is particularly important for teen girls. Studies show that teens who drink soda get much less calcium than they should.
- If taste is a problem, try giving kids chocolate milk or hot cocoa with milk or an occasional flavored milk like strawberry. Just be aware that flavored milks usually have more sugar and calories than regular milk.
- Dispel the idea that milk is a “fattening” drink, too. Try nonfat skim milk or low fat varieties if your children raise this concern.
3
Make sure children get enough Vitamin D. Another important part of bone growth is Vitamin D, which promotes the absorption of calcium in the digestive tract. This means that Vitamin D helps your body take in and use calcium better and more efficiently. Without it, bones can become thin, brittle, or misshapen.^{[4]XResearch source}^{[5]XTrustworthy SourceNational Health Service (UK)Public healthcare system of the UKGo to source}
- You can only get Vitamin D in a few ways: through some foods like fish and fish oil and in small amounts in egg yolks, beef liver, and cheese. Your body also naturally produces Vitamin D when you are exposed to sunlight. Some foods that do not naturally contain vitamin D are also fortified with vitamin D.
- Take a mixed approach to Vitamin D. Try to add the few foods that contain it into your diet, including periodic servings of fish like salmon. Also try Vitamin D fortified foods. Milk, orange juice, and breakfast cereal are often enriched with extra Vitamin D.
- With parents more and more limiting kids’ exposure to sunlight, you may need to consider Vitamin D supplements. Using sunscreen 100% of the time also blocks vitamin D production. The American Academy of Pediatricians recommends supplements for infants, children, and adolescents, including kids who are breastfed. Any chewable multi-vitamin with 400 International Units (IU) of Vitamin D is good.
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Part 2

Part 2 of 3:

Increasing Density Through Lifestyle

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Get moving. Physical activity helps to increase your child’s bone density. Like muscles, bones get stronger when we use them and get weaker when we don’t. Any activity is great, but the best are weight-bearing exercises that will put mild stress on the bones and cause the body to strengthen them. Keep in mind that not all activities are created equal for this – some are better than others.^{[6]XTrustworthy SourceNational Health Service (UK)Public healthcare system of the UKGo to source}^{[7]XResearch source}
- Encourage kids to run, jump, and climb. These are great weight-bearing exercises. Others include walking, dancing, hiking, basketball, gymnastics, hockey, soccer, skiing, and others.
- Try not to let your kids be too sedentary. Limit their time watching television, using the computer or other electronic devices, and sitting indoors.
- Encourage kids who aren’t walking yet to play actively on the floor. Kids who can walk should ideally be active for at least 3 hours, spread throughout the day. Older kids (5 to 18) should aim for at least one hour per day of moderate-intensity activity, along with vigorous-intensity exercise three times per week.
2
Get outside. As said, Vitamin D is an essential element of healthy bone development and comes in large part through exposure to natural sunlight. Kids who play and spend time outdoors will get more of this vitamin than those who spend more time inside. While we know that too much sun is a bad thing, limited sun exposure for older children and teens will ensure that they get enough Vitamin D.^{[8]XResearch source}^{[9]XResearch source}
- Exposure to sunlight for between 5 to 30 minutes between 10 am and 3 pm, twice per week on the face, arms, legs, and back should lead to significant Vitamin D synthesis.
- However, it’s best to limit overall exposure to the sun and other sources of ultra violet radiation. While sunscreen over SPF 8 will reduce Vitamin D synthesis, the American Academy of Dermatology advises that you should always use it and other photo-protective steps when in the sun. Children should also not use tanning beds. However, about 10 minutes of sun exposure without sunscreen three times per week may help your child's body to produce Vitamin D safely.
- Diet, body weight, and Vitamin D may all be linked, as well. Higher rates of Vitamin D deficiency may be related to growing levels of childhood obesity, as the vitamin is fat soluble and may get trapped in the body’s fat cells rather than functioning normally.
3
Encourage healthy habits and body image. Good nutrition and maintaining a healthy weight are keys for developing bone density and strength, as well. Children should not diet. One big concern for teen girls as well as boys is the development of unhealthy habits and body image, dieting, restricting calories, and over-exercising and training. These behaviors may point to a risk of an eating disorder.^{[10]XResearch source}
- Teens who develop anorexia have much weaker bones. In girls, one sign of anorexia is missed or infrequent periods – this indicates low levels of estrogen, which is an essential hormone for bone growth.
- Bone fractures are often one of the first signs of anorexia. Teen girls with anorexia are also at a much higher risk for osteoporosis and fractures later in life. In severe cases, this damage can’t be reversed.
- Look for signs and talk to a doctor if you think your child may be struggling with an eating disorder. Symptoms include extreme thinness or unhealthy appearance, missed periods, rapid weight loss, preoccupation with thinness, eating infrequently or not in front of others, trips to the bathroom after meals.
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Part 3

Part 3 of 3:

Treating Other Factors

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Test for medical problems. Bone density can be affected by other factors apart from diet and lifestyle. In fact, there are some medical problems that can lead to low bone density or even osteoporosis in kids if left unchecked. These include hormone deficiencies, metabolic problems, kidney diseases, bowel malabsorption disorders like celiac disease, and others.^{[11]XResearch source}^{[12]XTrustworthy SourceMayo ClinicEducational website from one of the world's leading hospitalsGo to source}
- Children with low bone density can get tested by a doctor. The doctor will screen the levels of Vitamin D, serum calcium, hormones involved in bone growth, and alkaline phosphatase, which the body uses in the mineralization of bone.
- Doctors can also test your kids’ bone mass with a special kind of x-ray called dual x-ray absorptiometry (DXA). DXA takes an image using two x-ray beams of different energy directed, in children, at the spine.
2
Ask about bisphosphonates for juvenile osteoporosis. If your child has osteoporosis, then medicines called bisphosphonates may help. These FDA approved drugs are prescribed to adults with osteoporosis and they have been tried with children as well.^{[13]XResearch source} Talk to your doctor about medication options if your child has osteoporosis.
3
Avoid bone-weakening medicines, if possible. Doctors now know that certain medicines interfere with how the intestines absorb calcium and can decrease the amount the body uses for bone growth. Kids who take these medicines may not be getting enough calcium for good bone density. Such medicines include corticosteroids, which treat asthma, and many other disorders, some medicines that treat seizures, and perhaps stimulants used to treat Attention Deficit-Hyperactivity Disorder.^{[14]XResearch source}
- These medications can stop the body from correctly using calcium in food and dietary supplements, but also increase calcium loss from the kidneys and lead to lower bone density. Talk to a doctor about these possible side effects and how to make sure your child’s bones are healthy.
- Make sure that an asthmatic child gets enough calcium, if she needs corticosteroids, and know that the idea that dairy products can trigger asthma attacks is not true, unless your child is allergic to dairy. Encourage your child to play and exercise safely to build bone density further. Your child may be able to exercise more comfortably in an air-conditioned space like a school gym.
4
Discourage alcohol and smoking. Smoking and drinking too much can also have a bad effect on your child’s (or more likely teen’s) bone density. Both of these behaviors are completely avoidable and associated with a higher risk for breaks, osteoporosis, and weaker bones. Talk to you kids and discourage them from doing either.^{[15]XResearch source}^{[16]XResearch source}
- Chronic alcohol use can lead to lower bone strength and density. In fact, between 28% to 52% of alcoholics have osteoporosis. This in part is because of poor nutrition.
- We don’t know how and why, but smoking is also directly related to lower bone density. The decrease may be from smoking itself or from other factors – smokers tend to be thinner, less active, more likely to drink, and have poorer diets.
- Talk to your kids and teens about the dangers of smoking. While there are many other reasons to avoid smoking, smokers have a greater risk of breaks as they age, take longer to heal, and have lower overall bone density.
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