Why does it impact children’s bones?
If you’re like most people, you might’ve heard about rickets from your grandparents or great-grandparents. This might lead you to believe that it’s something that you don’t have to worry about. While this is probably true, what should you be looking for? What causes it? How is it treated?
Definition
Rickets, or osteomalacia, is when the bones in children soften or weaken. The most common reason for this is a lack of vitamin D for an extended period of time. Since your body needs vitamin D to absorb calcium and phosphorus, when it isn’t able to do this, the bones get weak. The two main sources of vitamin D are sunlight (the skin produces it when exposed to sunlight) and certain foods, such as fish oil, egg yolks, and fatty fish (ex. salmon, tuna, and mackerel). In addition, it’s often added to foods, like milk, cereal, some fruit juices, and infant formula. If a child doesn’t spend enough time in the sun or eat enough food that contains vitamin D, they’re more likely to have rickets. Some children have conditions, including celiac disease, inflammatory bowel disease, cystic fibrosis, and kidney problems, that impact how their body absorbs vitamin D, which can increase their chances of having the disorder. Others that are at higher risk are individuals with darker skin since it has more melanin, which lowers the ability to create vitamin D from sunlight, living in northern latitudes where there is less exposure to sunlight, a mother having vitamin D deficiency during pregnancy, premature birth, a baby that’s breastfeed only or taking certain medications (ex. antiseizure or antiretroviral).
Symptoms of rickets are delayed growth, delayed motor skills, muscle weakness, and pain in the spine/pelvis/legs. Since the disease affects the growth plates, it can result in skeletal deformities, like bowed legs/knock knees, thickened wrists/ankles, or breastbone projection. If not treated, complications include failure to grow, abnormally curved spine, bone deformities, dental defects, and seizures.
Treatment
The good news is that most cases of rickets are treated with vitamin D and calcium supplements. If your child has another disorder that is causing rickets, that will need to be addressed as well. With any medication that is prescribed, it’s essential that you follow the doctor’s directions regarding dosage since too much can be harmful to your child. Your child’s doctor will monitor any changes via blood work and X-rays. If your child has bone deformities, their doctor will usually recommend special braces to help the bones grow properly. If the deformities are severe, your child may need surgery to correct them.
Prevention
The first step in preventing rickets is to get enough sunlight since it’s the best source of vitamin D. All it takes is 10-15 minutes of exposure each day. This can be challenging if it’s winter, you live in northern latitudes or have dark skin. Also, we’re typically told to keep infants and small children out of direct sunlight or to put sunscreen and protective clothing on them. This is why getting vitamin D in their diet is key by either eating foods that contain it or are fortified with it. The best way to determine this is to check the nutrition label. If you’re pregnant, you might want to take a vitamin D supplement. For infants, they should get 400 IU (international units) of vitamin D a day, so they might need to receive a supplement as well if they’re not getting enough through their diet.
Rickets can be a concerning disease. However, it can easily be prevented. If you have any questions or concerns about rickets, please speak with your doctor. If you would like more information, please visit MedlinePlus’s rickets page at https://medlineplus.gov/ency/article/000344.htm