Rickets is disease that affects the bones. It causes them to soften and weaken.
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Rickets is caused by a vitamin D , calcium, or phosphorous shortage 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:
- Malabsorption-related diseases of the small intestine
- Liver or pancreatic diseases
- Certain medications
- Poisoning from:
- Outdated tetracycline
Rickets is more common in children aged 6-24 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 or having dark skin
- 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
- Vegetarian diet
- Family history of rickets
- Certain chronic illnesses that result in loss of or poor absorption of calcium or phosphorous
- Drugs that affect vitamin D, calcium, or phosphorous
Symptoms may include:
- Muscle weakness
- Bow legs or knock knees
- Bone pain and tenderness
- Skeletal and/or skull deformities
- Deformity or curvature of the spine—scoliosis
- Pigeon chest—a chest that protrudes
- Dental deformities
- Delayed tooth formation
- Defects in teeth
- Loss of appetite or weight loss
- Difficulty sleeping
- 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:
- Relieve or reverse symptoms and improve bone changes
- Correct the underlying cause
Treatment to relieve or correct symptoms and bone changes:
- Involves biologically active vitamin D, calcium, and/or phosphate
- May include:
- Wearing braces to reduce or prevent bony deformities
- In severe cases, surgery to correct bony deformities
Treating the Underlying Cause
Treatment of the underlying cause may include:
Adding the following to your child's diet:
- Supplements of vitamin D, calcium, and other minerals
- Vitamin D-fortified dairy products
- Foods high in vitamin D, such as fatty fish, egg yolk, and green vegetables
- Foods high in calcium
- Adequate, but not excessive, exposure to sunlight
- Avoiding medication that may be causing poor calcium, phosphorous, or vitamin D absorption
- Treating underlying illnesses
To help reduce your child's chance of rickets:
- 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: 05/2016
- Updated: 05/13/2016
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