Rickets is disease resulting from a vitamin D , calcium, or phosphate shortage in children. It causes bones to soften and weaken.
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Rickets results when there is a vitamin D, calcium, or phosphorous shortage in a child's body. This may occur when:
- The supply of vitamin D from diet or sun exposure is too low
- The way the body processes vitamin D is not typical
- Tissue does not respond to the action of vitamin D
- There is not enough calcium or phosphorous in the diet or it cannot be absorbed
Less often, rickets can be caused by other disorders that affect vitamin D absorption or calcium metabolism such as:
- Kidney problems:
- Diseases of the small intestines with malabsorption
- Disorders of the liver or pancreas disease
- Certain medications
Toxicity or poisoning from:
- Outdated tetracycline
Rickets is more common in children age 6 to 24 months. It is also more common in children of African American descent.
Factors that may increase your child's chances of getting rickets include:
- Lack of sun exposure
- Babies who are breastfed—breast milk is low in vitamin D
- Babies who do not drink enough formula that is fortified with vitamin D
- Children who do not drink enough vitamin D-fortified milk
- Lactose intolerance with low intake of vitamin D-fortified milk
- Family history of rickets
- Certain chronic illnesses that result in loss of or poor absorption of calcium
Symptoms may include:
- Bone pain and tenderness
- Skeletal and/or skull deformities
- Bow legs or knock knees
- Deformity or curvature of the spine
- Pigeon chest—a chest that protrudes
- Dental deformities
- Delayed tooth formation
- Defects in teeth
- Loss of appetite or weight loss
- Difficulty sleeping
- Muscle weakness
- Delayed walking
You will be asked about your child's symptoms and medical history. A physical exam will be done.
Your child's bodily fluids and bone may be tested. This can be done with:
- Blood tests
- Urine tests
- Bone biopsy
Pictures may be taken of structures inside your child's body. This can be done with an x-ray .
Treatment attempts to:
- Correct the underlying cause
- Relieve or reverse symptoms
Treating the Underlying Cause
Treatment of the underlying cause may include:
Adding the following to your child's diet:
- Vitamin D-fortified dairy products
- Foods high in vitamin D, such as fatty fish, egg yolk, and green vegetables
- Foods high in calcium
- Supplements of vitamin D, calcium, and other minerals
- Biologically active vitamin D
- Adequate, but not excessive, exposure to sunlight
- Avoiding medication that may be causing poor calcium absorption
- Treating underlying illnesses
Treatment to relieve or correct symptoms may include:
- Wearing braces to reduce or prevent bony deformities
- In severe cases, surgery to correct bony deformities
To help prevent rickets, your child should:
- Drink vitamin D-fortified milk.
- Consume enough vitamin D , calcium, and other minerals. If you think your child's diet may be lacking, talk with the doctor about other sources of vitamins and minerals.
- Get sufficient, but not excessive, exposure to sunlight. Fifteen minutes a day is usually enough. Any longer than that requires sun protection with clothing or sunscreens, especially in fair-skinned infants and children. Children with dark skin are at increased risk for rickets and may need more sun exposure and dietary supplements with vitamin D.
- Breastfed babies and bottle-fed babies who do not get enough vitamin-D fortified formula may need to be given a supplement starting within the first few days of life. Talk to the doctor to make sure your child is meeting the nutritional requirements for vitamin D.
- Michael Woods, MD
- Reviewed: 06/2015
- Updated: 05/11/2013
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