Calcium Deficiency in Infants: Addressing Feeding Issues and Oral Health

Are you lacking calcium?

Hello Dr.
Lin, I would like to ask you a few questions:
(1) My daughter is currently 11 months old.
When she was around six months, she experienced a decrease in appetite for milk.
At that time, you suggested that I try feeding her milk while she was sleeping, which did help somewhat.
However, in the past few days, she has started to refuse milk again, and her intake has decreased by half.
She also doesn't seem to enjoy eating porridge much.
It takes about half an hour to an hour to finish each meal, as I have to coax her for a long time.
What recommendations do you have to improve this situation? My daughter’s sleep schedule is now similar to that of adults; she doesn’t nap much during the day and sleeps at night.
Additionally, she has recently begun teething, with two upper incisors, two upper canines, and one lower canine coming in.
I’ve heard from friends that babies often have a reduced appetite when teething and that their calcium needs increase.
Is this true? Therefore, today I bought a jar of probiotics (to alter gut flora, enhance immunity, and promote appetite) and a jar of calcium powder (to supplement calcium), which I plan to mix into her milk.
Is this advisable?
(2) My niece is currently one year and nine months old.
A few days ago, she developed white spots in her mouth (located on the inside of her lower lip and the inner sides of her cheeks).
We visited a nearby pediatric clinic, and the doctor said that this was caused by excessive consumption of sweets, and that reducing sweet intake would help.
They also provided a tube of ointment, and she is much better now.
What is your perspective on these white spots? Is it true that eating too many sweets can cause this condition? Thank you, doctor, for your answers.

Xiao Fen, 30~39 year old female. Ask Date: 2005/09/22

Dr. Lin Huizhen reply Pediatrics

Dear Xiao Fen,
This is Dr.
Lin Hui-Chen from the Pediatrics Department of Tainan Hospital, Ministry of Health and Welfare.
(1) For a typical 11-month-old child, due to physiological changes, the caloric requirement decreases, and milk intake may reduce.
It is advisable to gradually increase the amount of complementary foods (such as rice cereal, wheat cereal, porridge, or other grain products).
You can incorporate some eggs, meat, and fish into these foods.
However, the additional nutrients are not a long-term solution.
(2) The white spots or patches on both cheeks are most likely due to a Candida infection.
Generally, topical medication is sufficient for treatment, and it is not related to excessive consumption of sweets.
Wishing you good health and all the best from the Pediatrics Department of Tainan Hospital.

Reply Date: 2005/09/22

More Info

When addressing the concerns regarding calcium deficiency in infants, particularly in the context of feeding issues and oral health, it is essential to consider several factors that can influence a child's nutritional intake and overall health.
Firstly, your daughter, at 11 months old, is at a critical stage of development where her dietary needs are evolving. It is not uncommon for infants to experience phases of decreased appetite or "food refusal," especially during teething. The discomfort associated with teething can lead to a temporary decline in interest in solid foods and even milk. This is a normal behavior as infants may associate eating with discomfort.
To improve her feeding experience, consider the following strategies:
1. Variety and Texture: Introduce a variety of textures and flavors in her meals. Since she is showing a preference for certain foods, try to incorporate those into her diet while gradually introducing new options. Soft, easy-to-eat foods like mashed fruits, yogurt, or pureed vegetables can be appealing.
2. Routine and Environment: Establish a consistent feeding routine in a calm environment. Minimize distractions during meal times to help her focus on eating. If she is tired or overstimulated, she may be less inclined to eat.
3. Timing: Since her sleep schedule aligns more with adults, consider adjusting meal times to when she is most alert and receptive to eating.
4. Teething Relief: Provide teething toys or cold foods that can soothe her gums. This may help alleviate some discomfort and encourage her to eat.

Regarding her calcium intake, it is crucial to ensure she receives adequate calcium for her growing bones and teeth. The recommended dietary allowance (RDA) for calcium in infants aged 7-12 months is about 270 mg per day. If she is consuming breast milk or formula, check the calcium content to ensure it meets her needs.
Adding probiotics to her diet can be beneficial for her gut health and may improve her appetite. However, be cautious with calcium supplements. While calcium is essential, excessive supplementation can lead to health issues, including constipation or kidney problems. It is best to consult with a pediatrician before introducing any supplements to ensure they are necessary and safe.

As for the white spots observed in your niece's mouth, they could be indicative of oral thrush, a common fungal infection in young children, rather than being solely caused by excessive sugar intake. While a diet high in sugar can contribute to dental issues and other health problems, oral thrush is typically treated with antifungal medications. It is essential to maintain good oral hygiene, even in infants, to prevent such conditions.

In summary, addressing feeding issues in infants requires patience and creativity. Focus on providing a balanced diet rich in essential nutrients, including calcium, while being mindful of her comfort and preferences. Regular check-ups with a pediatrician can help monitor her growth and nutritional status, ensuring she remains healthy and well-nourished.

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