Dairy products seem to be the first line of defense when thinking about ways to provide calcium. However, for some parents, offering a cheese stick or cup of yogurt is impossible, due to a child’s allergy or intolerance.

Stephanie Harzewski of Greenwood Lake has had to become creative in offering her eldest son, Nicholas, 10, calcium. Diagnosed with autism, Nicholas developed intolerance for casein, the protein found in milk, when he was three. Not only can he not tolerate milk, he can’t have anything made with milk products, so common childhood staples like cheese and ice cream are out as well.

Harzewski gives her son a daily vitamin, along with a calcium supplement and offers green, leafy vegetables like spinach and broccoli, which are also excellent sources of calcium.

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For some parents, even a calcium supplement can be difficult. Because her three-year-old son has a life-threatening allergy to milk protein, Jennifer DeWolf must supplement his diet with a soy milk drink as well as a liquid poly-vitamin. The supplement helps ensure that he receives the proper daily caloric load for his age.

While she feels it is always better to get nutrients from their original food source, Harzewski does suggest that desperate parents consider purchasing calcium powder at a health food store; it can be easily mixed into eggs or other foods. Dr. Jana explains “whether your child gets calcium from a supplement or food, it serves the same purpose. Parents should really teach healthy eating habits.”

The clear benefit of using a supplement is that it can take a bit of pressure off parents; they know their child is getting the needed dosage without having to strictly monitor the child’s food intake.

Getting calcium into your child is only half the battle. Dr. Jana points out that in order for children to develop strong bones, they need to remain active and exercise. Exercise is beneficial for bone development and one’s health. “In general, kids are very active. A combination of this regular activity – whether it’s playing ball in the park or kick ball in the gym – and a healthy diet are the ingredients to building healthy bones. It’s important that regular activity and a healthy diet be taken in tandem. If you don’t have a healthy diet but you are very active, you won’t build strong bones. The same goes for the reverse: if you aren’t active but have a very health diet, you still won’t build strong bones.

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 Weight-bearing exercise, such as running and jumping, is the most effective for building and maintaining bone mass.

In order to properly absorb calcium effectively, the body requires vitamin D. According to James E. Dowd, MD, associate clinical professor of medicine at Michigan State University and the founder and director of both the Arthritis Institute of Michigan and the Michigan Arthritis Research Center, 55 percent of American children are deficient in vitamin D, leading to a rise in cases of rickets, primarily an infantile disease that is a result of severe vitamin D deficiency.

Warning signs for rickets include frequent infections in young children (because of a compromised immune system), growth retardation and a bowing of the legs. Because vitamin D is not produced in breast milk, Dr. Dowd suggests that breastfeeding mothers discuss supplementation options with their pediatrician or lactation consultant.

In his new book The Vitamin D Cure, Dowd suggests that if children had higher levels of vitamin D, their bodies would better absorb calcium and they wouldn’t need to consume as many dairy products. To boost vitamin D and calcium Dr. Dowd recommends getting kids into the kitchen; the more kids can help prepare food, the more likely they are to eat it. Start with foods they are familiar with. For example, serve a hamburger with all of the condiments, but put it between green, leafy lettuce leaves instead of a bun.

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Outside exercise is recommended; exposure to the sun will help the body to produce vitamin D. According to Dr. Dowd, children should be exposed to the sun (without sunscreen) for a little each day. The exact number of minutes will be determined by the child’s pigmentation. UVB rays help make vitamin D and UVA rays can improve the immune system.

Warding off future osteoporosis problems takes a multi-pronged approach. Children need to have the proper amount of calcium, vitamin D and exercise. The proper combination of these three elements can help ensure that your child is growing strong, healthy bones.

Jennifer O’Brien is a freelance writer and former resident of Ulster County.