Rickets

Overview

Rickets is a condition marked by weakened and softened bones in children, often resulting from a severe and prolonged deficiency of vitamin D. Inherited disorders can also contribute to its development.

Vitamin D is vital for facilitating the absorption of calcium and phosphorus from food in the body. Inadequate levels of vitamin D can disrupt the proper maintenance of calcium and phosphorus levels in bones, leading to rickets.

Treatment typically involves supplementing the diet with vitamin D or calcium to address the bone issues associated with rickets. However, if rickets is secondary to an underlying medical condition, additional medications or alternative treatments may be necessary. In cases where skeletal deformities arise from rickets, corrective surgery may be required.

In rare instances where inherited disorders affecting phosphorus levels are involved, different medications may be needed for treatment.

Symptoms

Rickets signs and symptoms can include:

• Pain in the legs, pelvis, and spine
• Delayed growth
• Delayed motor abilities
• Weakness in the muscles
• An unusually curved spine or unusually shaped skull.
• Protruding breastbone
• Swelling of the ends of ribs, termed rachitic rosary because the rib ends resemble rosary beads beneath the skin.
• Knock knees
• Bow legs
• Thickened wrists and ankles
• Dental issues, like cavities.
• Seizures (where there is an extreme reduction in calcium levels).

Consult your doctor if your child experiences bone pain, muscle weakness, or noticeable skeletal deformities.

Causes

Adequate levels of vitamin D are essential for your child’s body to efficiently absorb calcium and phosphorus from food. If your child doesn’t receive enough vitamin D or faces challenges in utilizing it effectively, rickets may develop. Insufficient intake of calcium or deficiencies in both calcium and vitamin D can also lead to rickets in some cases.

Vitamin D deficiency

Children who fail to obtain sufficient vitamin D from these two sources may experience a deficiency:

• Food. Fish oil, egg yolks, and fatty fish like salmon and mackerel are rich sources of vitamin D. Additionally, some foods and beverages such as milk, cereal, and certain fruit juices have been fortified with vitamin D.
• Sunlight. Your child’s skin synthesizes vitamin D upon exposure to sunlight. However, children in developed countries often have limited outdoor exposure and are more inclined to use sunscreen, which inhibits the skin’s production of vitamin D by blocking the sun’s rays.

Problems with absorption

Certain children either acquire or develop medical conditions that impact their body’s ability to absorb vitamin D. Examples of such conditions include celiac disease, inflammatory bowel disease, cystic fibrosis, and kidney problems.

Risk factors

Factors that may elevate a child’s susceptibility to rickets encompass:

• Dark complexion. The pigment melanin, which is more prevalent in dark skin, reduces the skin’s capacity to synthesize vitamin D from sunlight.
• Northern latitudes. Children who reside in areas with less sunshine are more likely to develop rickets.
• The mother’s lack of vitamin D during her pregnancy. If a mother has a severe lack of vitamin D, her unborn child may develop rickets either at birth or within a few months after the condition develops.
• Premature birth. Because they had less time in the womb to receive the vitamin from their mothers, babies born before their due dates typically have lower levels of vitamin D.
• Exclusive breastfeeding. Vitamin D levels in breast milk are insufficient to protect against rickets. It is recommended that babies who are breastfed exclusively be given vitamin D drops.
• Prescription drugs. It appears that several anti-seizure and antiretroviral drugs, which are used to treat HIV infections, interfere with the body’s utilization of vitamin D.