Rickets

Description

Rickets is the softening and weakening of bones in children, often because of an extreme and prolonged vitamin D or calcium deficiency. Rare hereditary problems can also cause rickets.

Vitamin D helps the body absorb calcium and phosphorus from food. There is not enough vitamin D makes it difficult to maintain adequate levels of calcium and phosphorus in the bones, which can cause rickets.

The addition of vitamin D or calcium in the diet usually fixes the bone problems associated with rickets. When rickets is due to another underlying medical problem, your child may need additional medication or other treatment. Some skeletal deformities caused by rickets may require surgical correction.

Rare inherited disorders associated with low levels of phosphorus, the other mineral component of bone, it may require other medications.

Symptoms

The symptoms of rickets can include:

  • Growth retardation.
  • Delay in motor skills.
  • Pain in the spine, pelvis, and legs.
  • The muscle weakness.

In babies, the symptoms of rickets can be more difficult to identify because ofthe mail of the bones and muscles of the complaints are often not detected until the child begins to walk. The symptoms of rickets in infants caused by low levels of calcium in the blood may include:

  • Tight muscle tone.
  • The breathing, the sounds that are not regular.

Because the rickets softens the areas of tissue culture in the ends of the bones of the child, known as growth plates, it can cause skeletal deformities, such as:

  • Bowed legs or knock-knees.
  • Thickening of the wrists and the ankles.
  • Sternum projection.

When to see a doctor

Talk with your health care professional if your child develops bone pain, muscle weakness or obvious skeletal deformities. If you are concerned that your baby is not getting enough vitamin D, especially if they have risk factors for vitamin D deficiency, such as dark skin pigmentation or exclusive breastfeeding, talk to your health professional.

Causes

Your child's body needs vitamin D to absorb calcium and phosphorus from food. Rickets may occur if your child's body does not get enough vitamin D or have problems using vitamin D properly. Sometimes, not getting enough calcium or the lack of calcium and vitamin D can cause rickets.

The lack of vitamin D

Children who do not get enough vitamin D from these two sources may develop a deficiency of:

  • The light of the sun. In the skin produces vitamin D when exposed to sunlight. But the children in the developed countries tend to spend less time in the open air. They are also more likely to use sunscreen, which blocks the sun's rays that trigger the skin's production of vitamin D.
  • Food. The fish oil, egg yolks, and fatty fish such as salmon and mackerel contain vitamin D. Vitamin D is also added to some foods and beverages, such as milk, cereal, and some fruit juices.

Problems with the absorption of

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

  • The celiac disease.
  • The inflammatory bowel disease.
  • Cystic fibrosis.
  • Kidney problems.

Risk factors

Factors that can increase a child's risk of rickets are:

  • More dark pigmentation of the skin. Brown or Black skin has more of the pigment melanin, which reduces the ability of the skin to produce vitamin D from sunlight.
  • The mother of vitamin D deficiency during pregnancy. A baby born to a mother with severe vitamin D deficiency may be born with symptoms of rickets or develop within a couple of months after birth.
  • The northern latitudes. Children who live in geographic areas where there is less sun are at increased risk of rickets.
  • The preterm birth. Babies who are born before their due dates tend to have lower levels of vitamin D because they had less time to receive the vitamin from their mothers in the womb.
  • Drugs. Certain types of anti-epileptic drugs and antiretroviral used for the treatment of HIV infections, appears to interfere with the body's ability to use the vitamin D.
  • Exclusive breastfeeding. Breast milk does not contain enough vitamin D to prevent rickets. Babies who are exclusively breastfed tend to receive the vitamin D drops.

Complications

If not treated, rickets can lead to:

  • Failure to grow.
  • Deformities of the bones.
  • Dental defects.
  • Seizures.

Prevention

Exposure to sunlight is the best source of vitamin D. During most of the seasons, from 10 to 15 minutes of sun exposure around midday is enough. But if you have brown or Black skin, if it is winter, or if you live in the northern latitudes, you might not be able to obtain enough vitamin D from exposure to the sun.

Furthermore, due to skin cancer concerns, infants and young children, especially, are advised to avoid direct sun or use sunscreen and protective clothing.

To prevent rickets, make sure that your child eats foods that contain vitamin D naturally — oily fish like salmon and tuna, fish oil, and egg yolk — or that have been fortified with vitamin D, such as:

  • The infant formula.
  • Cereal.
  • Bread.
  • The milk, but not a food derived from milk, such as yogurt and cheese.
  • Orange juice.

Check the label to determine the vitamin D content of fortified foods.

If you are pregnant, consult your health care professional about taking supplements of vitamin D.

The guidelines recommend that all children should receive 400 international units (IU) per day of vitamin D. Because human milk contains only a small amount of vitamin D, infants who are fed exclusively with breast milk should receive a vitamin D supplement per day. Some of the bottle-fed infants may also need vitamin D supplements if they are not receiving enough of your formula.

Rickets

Diagnosis

During the exam, the health care professional in general, gently press on the bones of the child, checking for irregularities. You can pay special attention to the following:

  • The skull. Babies with rickets often soft bones of the skull, and there may be a delay in the closing of the fontanelles, called fontanelles.
  • Legs. While even healthy children are a little bowlegged, an exaggerated tilt of the legs is common with rickets.
  • Chest. Some children with rickets develop changes in their rib cages, they can flatten and cause their breastbones to excel.
  • The wrists and ankles. Children with rickets often have larger or thicker wrists and ankles.

The diagnosis of rickets in babies can be a challenge. Rickets can be more difficult to identify as the bone and muscle changes often are not detected until the child begins to walk. Your health professional likely to pay attention to whether your baby is growing well, regular breathing and sounds, has the typical muscle tone.

For children of all ages, the X-rays of the affected bones may reveal deformities of the bones. Blood and urine tests can confirm a diagnosis of rickets and also monitor the progress of the treatment.

Treatment

The majority of cases of rickets can be treated with vitamin D and calcium supplements. Follow direction in terms of the dose. Too much vitamin D can be harmful.

Your child's health care team can check the progress of your child with X-rays and blood tests.

If your child has a rare inherited disorder that causes low amounts of phosphorus, supplements and medications can be prescribed.

For some cases of bowleg or deformities of the spine, your health care professional may be able to suggest, in particular strengthening of the position of your child's body correctly as the growth of the bones. More severe skeletal deformities may require surgery.

Preparing for your appointment

It is likely to start by seeing your primary care professional or a pediatrician. Depending on the cause of your child's symptoms, you may be referred to a specialist.

Here is the information to help you prepare for your appointment.

What you can do

Before your appointment, make a list of:

  • Your child's symptoms, including those that do not appear to be related to the reason he made the appointment, and it shows when they began.
  • Key personal information, including medications and supplements that your child you take and if someone in your immediate family has had similar symptoms.
  • Information about your child's diet, including foods and drinks your child usually eats.

What to expect from your doctor

Your health care team may ask some of the dwing questions:

  • What your baby is receiving vitamin D supplements?
  • How often your child to play outdoors?
  • Does your child wear sunscreen?
  • At what age did your child begin to walk?
  • Your child has had a lot of tartar on the teeth?
Symptoms and treatment of Rickets