Rickets is a skeletal disorder that’s caused by a lack of vitamin D, calcium, or phosphate. These nutrients are important for the development of strong, healthy bones. People with rickets may have weak and soft bones, stunted growth, and, in severe cases, skeletal deformities. It is a disease of children.
Vitamin D helps your child’s body absorb calcium and phosphorus from food. Not enough vitamin D makes it difficult to maintain proper calcium and phosphorus levels in bones, which can cause rickets. You can get vitamin D from various food products, including milk, eggs, and fish. Your body also produces the vitamin when you’re exposed to sunlight. Rickets occurs relatively commonly in the Middle East, Africa, and Asia.
Symptoms of Rickets
Signs and symptoms of rickets can include:
- Delayed growth
- Delayed motor skills
- Pain in the spine, pelvis, and legs
- Muscle weakness
- Bowed legs or knock knees
- Thickened wrists and ankles
- Breastbone projection
Causes of Rickets
Your child’s body needs vitamin D to absorb calcium and phosphorus from food. Rickets can occur if your child’s body doesn’t get enough vitamin D or if his or her body has problems using vitamin D properly. Occasionally, not getting enough calcium or lack of calcium and vitamin D can cause rickets.
-
Lack of vitamin D
Children who don’t get enough vitamin D from sunlight and food can develop a deficiency. Severe chronic vitamin D deficiency [25(OH)D level less than 15 ng/ml] leads to overt skeletal abnormalities in children that are typically defined as rickets
Your child’s skin produces vitamin D when it’s exposed to sunlight. But children in developed countries tend to spend less time outdoors. They’re also more likely to use sunscreen, which blocks the sun’s rays that trigger the skin’s production of vitamin D.
Fish oil, egg yolks, and fatty fish such as salmon and mackerel contain vitamin D. Vitamin D has also been added to some foods and beverages, such as milk, cereal, and some fruit juices.
-
Problems with absorption
Some children are born with or develop medical conditions that affect the way their bodies absorb vitamin D. Some examples include: Celiac disease, inflammatory bowel disease, cystic fibrosis, kidney problem.
Diagnosis
Your doctor may be able to diagnose rickets by performing a physical examination. They will check for tenderness or pain in the bones by lightly pressing on them. Your doctor may also order certain tests to help make a rickets diagnosis, including:
- blood tests to measure the levels of calcium and phosphate in the blood
- bone X-rays to check for bone deformities
In rare cases, a bone biopsy will be performed. This involves the removal of a very small section of bone, which will be sent to a laboratory for analysis.
Complications
Left untreated, rickets can lead to:
- Failure to grow
- An abnormally curved spine
- Bone deformities
- Dental defects
- Seizures
Risk factors
Factors that can increase a child’s risk of rickets include:
-
Dark skin
Dark skin has more of the pigment melanin, which lowers the skin’s ability to produce vitamin D from sunlight.
-
Vitamin D deficiency during pregnancy
A baby born to a mother with severe vitamin D deficiency can be born with signs of rickets or develop them within a few months after birth.
-
Northern latitudes
Children who live in geographical locations where there is less sunshine are at higher risk of rickets.
-
Premature birth
Babies 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.
-
Medications
Certain types of anti-seizure medications and antiretroviral medications, used to treat HIV infections, appear to interfere with the body’s ability to use vitamin D.
-
Exclusive breast-feeding
Breast milk doesn’t contain enough vitamin D to prevent rickets. Babies who are exclusively breastfed should receive vitamin D drops.
Treatment
Rickets is caused by vitamin D and calcium deficiency, it’s usually treated by increasing a child’s intake of vitamin D and calcium.
Foods
Vitamin D and calcium levels can be increased by eating more foods that are rich in calcium and vitamin D. Taking daily calcium and vitamin D supplements. Foods that provide vitamin D include:
- Fatty fish, like tuna, mackerel, and salmon.
- Foods fortified with vitamin D, like some dairy products, orange juice, soy milk, and cereals.
- Beef liver.
- Cheese
- Egg yolks.
Sunlight
Sunlight is the richest source of vitamin D. When your skin is exposed to sunlight, it makes vitamin D from cholesterol. The sun’s ultraviolet B (UVB) rays hit cholesterol in the skin cells, providing the energy for vitamin D synthesis to occur.
Vitamin D has many roles in the body and is essential for optimal health. It’s only the early morning sun that is, from 7 am to 11 am that helps generate Vitamin D.
