Rickets

Rickets is a condition in which there is a softening and weakening of the bones in children, usually resulted from an extreme, prolonged and untreated vitamin D deficiency.

The primary function of Vitamin D in the body is the absorption of calcium and phosphorus through the gastrointestinal tract which will later be absorbed and stored in the bones.

Once vitamin D becomes deficient it would be difficult to maintain proper calcium and phosphorus level in the bones, leading to the development of Rickets. Hence, treatment of rickets is primary focused on increasing the vitamin D level in the body which is achieved by increased intake of vitamin and calcium to correct any bone problems for your child.

There are other treatments associated with rickets as it is a genetic condition and might present different signs and symptoms. Although, there are some skeletal deformities caused by rickets that can no longer be treated with medication alone but with corrective surgery.

Signs and symptoms of rickets would mostly manifest as bone problems based on the direct effect of vitamin D deficiency to the functions of the bones.

Some of the signs and symptoms of rickets include: muscle weakness because rickets softens the growth plats at the end of a child’s bones, delayed growth, and pain in the spine, pelvis and legs.

There may also be presence of skeletal deformities such as thickened wrists and ankles, breastbone projection and bowed legs.

Observe your child for presence of bone pain, muscle weakness or obvious skeletal deformities as these symptoms should tell to have your child be seen by a doctor.

Rickets can be caused when your child's body doesn't get enough vitamin D or if his or her body has problems using vitamin D properly. Essentially, vitamin D is needed by the body as it facilitates the absorption of calcium and phosphorus from food. It is important to know the two main sources of vitamin D.

First is sunlight, your skin produces vitamin D when it's exposed to sunlight. But children in developed countries now tend to spend less time outdoors as they would want to limit exposure to sun. They're also more likely to use sunscreen, which blocks the rays that trigger the skin's production of vitamin D.

Second source of vitamin are different kinds of food, such as Fish oils, fatty fish and egg yolks. Vitamin D also has been added to some foods, such as milk, cereal and some fruit juices.

Children who don't eat enough of these fortified foods can develop a vitamin D deficiency. In addition, some children have underlying medical conditions that ineffectively absorb vitamin D in the body, such as Celiac disease, Inflammatory bowel disease, Cystic Fibrosis and Kidney problems, which lead to Rickets.

At the first sign of rickets bring your child to see your family doctor or a pediatrician for proper evaluation and diagnosis. Here are the things you would need to prepare prior to your appointment:

• have a list of the signs and symptoms experienced by the child including past medical history,
• any underlying medical condition,
• as well as present and past medications including supplements and vitamins and the dosage.

In understanding the condition of your child the doctor will most likely ask the following questions:

• What symptoms have you noticed, and when did they start?
• Has anyone in your immediate family had similar symptoms?
• What types of food and drink does your child usually consume?
• What medications and supplements does your child take?
• How often does your child play outdoors?
• Does your child always wear sunscreen?
• At what age did your child start walking?
• Has your child experienced much tooth decay?

Babies who have rickets often have softer skull bones and may experience a delay in the closure of the soft spots (fontanels). Hence, during physical exam the doctor will gently press on your child's bones, checking for abnormalities and will pay particular attention to your child's skull.

Legs will also be checked, since an exaggerated bowing of the legs is common with rickets. Chest will be palpated, as some children with rickets develop abnormalities in their rib cages, which may flatten and cause their breastbones to protrude.

Wrists and ankles, children who have rickets often have wrists and ankles that are larger or thicker than normal, X-ray of the affected bones is necessary to confirm bone deformities. Lastly, blood and urine tests can confirm a diagnosis of rickets and also monitor the progress of treatment.

Since the cause of rickets is vitamin D deficiency then treatment is also the use of vitamin D and calcium supplements. Seek your doctor’s advice on the correct dosage and other directions for use, which vary by the age and size of your child. Keep in mind that too vitamin D is also dangerous.

For more severe symptoms such as for some cases of bow legs or spinal deformities, your doctor may suggest special bracing to position your child's body appropriately as the bones grow. Surgery may also be required for more severe skeletal deformities.

In order to prevent rickets make sure your child is eating foods that contain vitamin D naturally such as:

• fatty fish,
• fish oil,
• egg yolks,

or that have been fortified with vitamin D, such as:

• infant formula,
• cereals,
• milk,
• orange juice.

Human milk contains only a small amount of vitamin D, all breast-fed infants should receive 400 international units (IU) of oral vitamin D daily.

Infants and young children, need to avoid direct sun entirely or be especially careful by always wearing sunscreen. Most adolescents and adults receive much of their necessary vitamin D from exposure to sunlight.

There are no homeopathic remedies for rickets.

Lifestyle modifications are necessary in order to manage rickets.

You should manage rickets by getting appropriate levels of calcium, phosphorus and vitamin D.

Eat fish and vitamin D fortified products such as:

• breakfast cereal,
• bread,
• milk products,
• orange juice.

Allowing for moderate levels of sun exposure.

There are several factors that puts a child at greater risk of developing rickets, which include:

• 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. Premature birth. Babies born before their due dates are more likely to develop rickets. Anti-seizure medications.
• Certain types of anti-seizure medications appear to interfere with the body's ability to use vitamin D. Age. Children 3 to 36 months old are most at risk of rickets because their skeletons are growing so rapidly.
• Dark skin. Dark skin doesn't react as strongly to sunshine as does lighter colored skin, so it produces less vitamin D. Northern latitudes.
• Children who live in geographical locations where there is less sunshine are at higher risk of rickets. Abnormally curved spine, skeletal deformities, dental defects and seizures are the complications that may result from leaving rickets untreated.