Objective Plant-based milk alternatives are increasingly utilized in children with cow milk allergy, lactose intolerance, and personal preference. However, notable differences exist in mineral content between cow milk and plant-based alternatives. Almond milk, in particular, varies in mineral and caloric content across different brands. This case report highlights a toddler who developed hypercalcemia and hypophosphatemia attributed to almond milk consumption. Case presentation A fourteen-month-old girl with a history of biliary atresia underwent liver transplant at seven months of age. She was exclusively consuming almond milk for two months prior to presentation. She was admitted to the hospital for severe hypercalcemia (14.6 mg/dL) and hypophosphatemia (1.6 mg/dL). She had elevated random urine calcium to creatinine ratio (2.56 mg/g) and low urine phosphorus to creatinine ratio (<0.44 mg/g) were noted. Parathyroid hormone (PTH) level was appropriately suppressed (<6 pg/mL), while 1,25 dihydroxyvitamin D level was slightly elevated at 88 pg/mL. Initial management included intravenous fluids, followed by a switch to a formula with higher phosphorus and lower calcium concentrations. The patient was discharged after six days with normalized calcium and phosphorus levels, which remained within the normal range. Conclusion Although plant-derived milk serves as a viable alternative to cow milk, careful consideration of mineral content, particularly in infants and toddlers, is imperative. Sole reliance on almond milk for nutritional needs in this population is not recommended. Caregivers should be informed about the potential risks associated with almond milk consumption in infants and toddlers.

中文翻译：

---

由于仅使用杏仁奶而导致婴儿出现高钙血症和低磷血症

目的 植物奶替代品越来越多地用于患有牛奶过敏、乳糖不耐症和个人喜好的儿童。然而，牛奶和植物性替代品之间的矿物质含量存在显着差异。尤其是杏仁奶，不同品牌的矿物质和热量含量各不相同。本病例报告重点介绍了一名因食用杏仁奶而出现高钙血症和低磷血症的幼儿。病例介绍 一名有胆道闭锁病史的 14 个月大女孩在 7 个月大时接受了肝移植。在就诊前的两个月里，她只喝杏仁奶。她因严重高钙血症（14.6 mg/dL）和低磷血症（1.6 mg/dL）入院。她的随机尿钙与肌酐比值升高（2.56 毫克/克），尿磷与肌酐比值较低（<0.44 毫克/克）。甲状旁腺激素 (PTH) 水平得到适当抑制 (<6 pg/mL)，而 1,25 二羟基维生素 D 水平略有升高，为 88 pg/mL。最初的治疗包括静脉输液，然后改用磷含量较高、钙浓度较低的配方奶粉。六天后，患者出院，钙和磷水平恢复正常，保持在正常范围内。结论 虽然植物奶是牛奶的可行替代品，但必须仔细考虑矿物质含量，特别是对于婴儿和幼儿。不建议仅依靠杏仁奶来满足该人群的营养需求。应告知护理人员婴儿和幼儿食用杏仁奶的潜在风险。