Rickets

Rickets is a skeletal disorder that’s caused by a lack of vitamin D, calcium, or phosphate. These nutrients are important for the development of strong, healthy bones. People with rickets may have weak and soft bones, stunted growth, and, in severe cases, skeletal deformities.

Causes #

Lack of vitamin D #

Children who don’t get enough vitamin D from these two sources can develop a deficiency:

Sunlight #

Your child’s skin produces vitamin D when it’s exposed to sunlight. But children in developed countries tend to spend less time outdoors. They’re also more likely to use sunscreen, which blocks the sun’s rays that trigger the skin’s production of vitamin D.

Food #

Fish oil, egg yolks and fatty fish such as salmon and mackerel contain vitamin D. Vitamin D has also been added to some foods and beverages, such as milk, cereal and some fruit juices.

Problems with absorption #

Some children are born with or develop medical conditions that affect the way their bodies absorb vitamin D. Some examples include:

• Celiac disease

• Inflammatory bowel disease

• Cystic fibrosis

• Kidney problems

Risk factors #

Dark skin #

Dark skin has more of the pigment melanin, which lowers the skin’s ability to produce vitamin D from sunlight.

Mother’s vitamin D deficiency during pregnancy #

A baby born to a mother with severe vitamin D deficiency can be born with signs of rickets or develop them within a few months after birth.

Northern latitudes #

Children who live in geographical locations where there is less sunshine are at higher risk of rickets.

Premature birth #

Babies born before their due dates tend have lower levels of vitamin D because they had less time to receive the vitamin from their mothers in the womb.

Medications #

Certain types of anti-seizure medications and antiretroviral medications, used to treat HIV infections, appear to interfere with the body’s ability to use vitamin D.

Exclusive breast-feeding #

Breast milk doesn’t contain enough vitamin D to prevent rickets. Babies who are exclusively breast-fed should receive vitamin D drops.

Symptoms #

Signs and symptoms of rickets can include:

• Delayed growth

• Delayed motor skills

• Pain in the spine, pelvis and legs

• Muscle weakness

Because rickets softens the areas of growing tissue at the ends of a child’s bones (growth plates), it can cause skeletal deformities such as:

• Bowed legs or knock knees

• Thickened wrists and ankles

• Breastbone projection

Treatment #

As most cases of rickets are caused by a vitamin D and calcium deficiency, it’s usually treated by increasing a child’s intake of vitamin D and calcium.

Vitamin D and calcium levels can be increased by:

• Eating more foods that are rich in calcium and vitamin D

• Taking daily calcium and vitamin D supplements

• Sunlight also helps our bodies to make vitamin D, so you may be advised to increase the amount of time your child spends outside for safe exposure to sunlight.

• Your doctor will advise you about how much vitamin D and calcium your child will need to take. This will depend on their age and the cause of rickets. If your child has problems absorbing vitamins, they may need a higher dose.