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Rickets is a softening and weakening of the bones in children caused by a severe and sustained vitamin D deficiency. Rickets can also be caused by rare hereditary disorders.
Vitamin D aids in the absorption of calcium and phosphorus from diet by your child's body. Lack of vitamin D makes maintaining correct calcium and phosphorus levels in bones challenging, which can lead to rickets.
In most cases, supplementing the diet with vitamin D or calcium corrects the bone abnormalities associated with rickets. When rickets is caused by another underlying medical condition, your kid may require additional medications or treatment. Some bone abnormalities induced by rickets may necessitate surgery to rectify.
Rare genetic illnesses caused by low amounts of phosphorus, the other mineral component of bone, may necessitate the use of additional drugs.
WHAT ARE THE SYMPTOMS OF RICKETS?
Rickets can cause the following signs and symptoms:
- Growth that is delayed
- Motor skills that are delayed
- Spinal, pelvic, and leg pain
- Muscle fatigue
- Rickets can cause skeletal abnormalities because it weakens the portions of growing tissue at the ends of a child's bones (growth plates).
- Knock knees or bowed legs
- Wrists and ankles that have thickened
- Breastbone projection
WHAT ARE THE CAUSES OF RICKETS?
Vitamin D is required for your child's body to absorb calcium and phosphorus from diet. Rickets can develop if your child's body does not obtain enough vitamin D or if his or her body has difficulty absorbing vitamin D. Rickets can be caused by a lack of calcium or a lack of calcium plus vitamin D.
Vitamin D deficiency
Children who do not acquire enough vitamin D from these two sources are at risk of developing a deficiency:
- Sunlight: When your child's skin is exposed to sunshine, it creates vitamin D. However, youngsters in developed countries spend less time outside. They're also more likely to wear sunscreen, which prevents the UV rays that cause the skin to produce vitamin D.
- Food: Vitamin D is found in fish oil, egg yolks, and fatty fish such as salmon and mackerel. Some foods and beverages, such as milk, cereal, and some fruit juices, now contain vitamin D.
Absorption difficulties
Some children are born with or develop medical disorders that impair their bodies' ability to absorb vitamin D. Here are a few examples:
- Celiac disease
- Inflammatory bowel disease
- Cystic fibrosis (CF)
- Kidney issues
WHAT ARE THE RISK FACTORS FOR RICKETS?
The following factors can raise a child's risk of rickets:
- Dark skin: Dark skin contains more melanin, which reduces the skin's capacity to synthesize vitamin D from sunshine.
- Vitamin D deficiency in the mother during pregnancy: A baby born to a woman who is severely deficient in vitamin D may be born with rickets or develop it within a few months of birth.
- Northern latitudes: Children who live in areas with less sunlight are at a higher risk of developing rickets.
- Premature delivery: Babies delivered before their due dates have lower vitamin D levels because they have less time in the womb to obtain the vitamin from their moms.
- Medications: Certain anti-seizure drugs and antiretroviral medications used to treat HIV infections tend to impair the body's ability to utilize vitamin D.
- Breast-feeding exclusively: Breast milk does not contain enough vitamin D to keep rickets at bay. Vitamin D drops should be given to exclusively breastfed babies.
WHAT ARE THE COMPLICATIONS OF RICKETS?
Rickets, if left untreated, can cause:
- Inability to grow
- A spine that is unusually curved
- Deformities of the bones
- Defects in the teeth
- Seizures
HOW IS RICKETS DIAGNOSED?
The doctor will gently press on your child's bones throughout the exam to look for any anomalies. He or she will be especially attentive to your child's:
- Skull: Babies with rickets typically have softer skull bones and may experience a delay in the closure of soft areas (fontanels).
- Legs: While even healthy toddlers are a little bowlegged, rickets is characterized by an excessive bowing of the legs.
- Chest: Some children with rickets develop rib cage deformities, which can flatten and cause their breastbones to protrude.
- Ankles and wrists: Children with rickets may have bigger or thicker wrists and ankles than normal.
Bone abnormalities can be seen by X-rays of the damaged bones. Blood and urine testing can confirm a rickets diagnosis and track therapy success.
WHAT ARE THE TREATMENTS FOR RICKETS?
The majority of rickets patients can be treated with vitamin D and calcium supplementation. Follow your child's doctor's dosing instructions. Too much vitamin D might be toxic.
X-rays and blood tests will be used by your child's doctor to track his or her progress.
Supplements and medication may be suggested if your child has a rare hereditary disease that causes low phosphorus levels.
In some cases of bowleg or spinal abnormalities, your doctor may recommend special bracing to properly place your child's body as the bones grow. Severe skeletal abnormalities may necessitate surgery.
HOW CAN RICKETS BE PREVENTED?
The best source of vitamin D is exposure to sunlight. During most seasons, 10 to 15 minutes of solar exposure at midday is sufficient. However, if you have dark skin, it's winter, or you reside in the north, you may not be able to get enough vitamin D from sunlight.
Furthermore, due to skin cancer concerns, infants and young children, in particular, are advised to avoid direct sunlight and to always use sunscreen and protective gear.
To avoid rickets, make sure your child consumes vitamin D-rich meals, such as fatty fish like salmon and tuna, fish oil, and egg yolks, or foods fortified with vitamin D, such as:
- Formula for infants
- Cereal
- Bread
- Milk, but not milk-based items such as yogurt and cheese
- Orange juice
Check the labels of fortified foods to see how much vitamin D is in them.
Consult your doctor about taking vitamin D supplements if you are pregnant.
All newborns should consume 400 IU of vitamin D every day, according to guidelines. Because human milk contains just a trace quantity of vitamin D, infants who are solely breast-fed should take vitamin D supplements on a daily basis. Some bottle-fed infants may require vitamin D supplements if their formula does not provide enough.