You might be looking forward to Halloween this month, but did you know that October 19th is National Pediatric Bone and Joint Day? If you’re a parent, this is a great excuse to learn more about your child’s developing skeletal system and what you can do to keep it healthy. 

When thinking about children’s health, bones don’t often come up. Diseases like osteoporosis and arthritis are associated with old age, not childhood. You may be surprised to learn that nutrition and lifestyle during childhood can determine a person’s bone and joint health later in life. Let’s take a look at how skeletal development happens in children, and what you can do to help:

How Bones Work

Bones are a living organ that continually shed old bone and grow new bone. During childhood and adolescence, the shedding of old bone does not happen as often as the growth of new bone. This is what causes your child’s bones to develop and your child to grow taller. In addition to growing in size, your child’s bones are also increasing in density. “Bone density” is a measure of how strong a bone is. Bones with low density are weak and more prone to fracture. Up to 90 percent of a person’s bone density is acquired by age 18 in girls and age 20 in boys. Children and adolescents who have not grown healthy bones during this period are more likely to struggle with osteoporosis later in life. 

Several factors influence bone health throughout life:

  • Gender: Women are at a higher risk of osteoporosis than men.
  • Race: Caucasian and Asian women are at a higher risk than African American women.
  • Hormones: Estrogen and testosterone both play a role in bone growth. If these hormones are out of balance, bones can weaken.
  • Nutrition: A healthy diet is one of the most critical factors in bone health. Calcium, Vitamin D, Vitamin K, and other nutrients play a direct role in the bone-building process. 
  • Physical activity: Weight-bearing exercises like walking or gymnastics help the skeleton to build strength in the areas that bear the most weight like the hips. 

How to Support Your Child’s Bones:


The best way to help your kids build healthy bones is by making sure they are eating a healthy diet. At ages 1-3, your child needs 700 mg. Of calcium a day, at ages 4-8, the recommended amount jumps to 1000 mg and then to 1300 mg during adolescence. Vitamin D is essential to the absorption of calcium, so make sure your child gets plenty of sunshine and eats foods that have been fortified with both calcium and vitamin D, like milk and fortified orange juice. 

Milk is great for bones, but if your child can’t (or won’t) drink milk, there are still plenty of calcium-rich foods they can eat. Cheese, yogurt, leafy greens, and even bread can be excellent sources of calcium. When you are looking at nutrition labels, try to pick foods that have at least 20% of the recommended daily value of calcium. These foods are considered high sources of calcium. If your child is lactose intolerant, try a milk product that contains the lactase enzyme or give this to your child separately. It’s always best to get nutrition from food, but if your child is going through a picky eater stage, it might be a good idea to ask their doctor about a supplement. 

Limit your child’s intake of soda and other caffeinated beverages. There is some evidence that these may interfere with calcium absorption. Teens also tend to drink soda in place of milk, which can lead to calcium deficiency if their diet doesn’t contain many calcium-rich foods. 

In addition to causing cancer and lung disease, smoking can also be detrimental to bone health. Talk to your teens about the long term consequences of smoking, and make sure they understand that e-cigarettes are not a healthier alternative. 

Exercise and Weight

Physical activity is also essential for bone health, so make sure that your kids are spending plenty of time on their feet. Swimming and bicycling can be great for your child’s overall health, but these are not weight-bearing exercises, so make sure your kids participate in a variety of physical activities. Even just walking around is better than sitting. Playing outside is great for kid’s bones because they get exercise and Vitamin D producing sunshine. 

When we talk about healthy weight, we are usually talking about not putting on too much weight, but for active kids or diet conscious teens, being too thin can also be a problem. The body needs a certain amount of calories and fat reserves to function properly. Being too thin can interfere with hormone balance, which can cause bone loss. This is especially a problem for teen girls. 

If your daughter is an athlete, she may be at risk for amenorrhea- loss of menstrual period. This is a sign of a hormone imbalance that is putting her bones and overall health at risk. If your daughter is missing periods, she may need to increase her caloric intake, decrease her physical activity, or both. 

 One in three girls will develop an eating disorder. This also puts bones at risk and makes women more likely to have osteoporosis in their later years. If your daughter is showing any signs of having an eating disorder, such as limiting her food intake, visiting the bathroom after meals, missing periods, or extreme exercise, talk to her doctor. 

Protecting Your Child’s Joints

Just like your child’s bones, their joints are developing and changing as they grow. Most of the above advice about bone health also applies to joints. Some joints, like the knees, need extra protection in kids. Children do not have fully developed knee caps, and their joints are more prone to some types of injuries. So make sure your child wears knee and elbow pads (and of course a helmet) when rollerblading or riding a bicycle. 

Joints in both adults and children can be prone to inflammation. You can reduce inflammation by feeding your family a healthy diet that includes a variety of plant-based foods and a very limited amount of sugar and preservatives. If possible, choose organic fruits and vegetables. Limiting your child’s intake of chemicals will promote a healthier inflammatory response that will benefit their joints and their overall health. Setting up these habits now will help keep them healthy in their later years when they are more at risk for joint-related problems. 

Teaching your kids to maintain a healthy posture will also help to keep their joints in good shape.