Rickets

What is rickets? Rickets is a bone disease that affects infants and young children. The child’s growing bones fail to develop properly due to a lack of. This can result in soft and weakened bones, fractures, bone and muscle pain, and bony deformities.

You can help protect your child from the effects of rickets by understanding the risk factors for vitamin D deficiency and taking steps to prevent it. Although rare, rickets is on the increase among American children. Most cases of rickets in United States occur due to low levels of vitamin D.

Overuse of sun protection, due to increased concerns about risks, may be one reason for the increasing rates.

If you think your child has rickets or is at risk of vitamin D deficiency, it is important to consult your or health care provider. They can help you decide on an appropriate treatment plan for your child.

Signs and symptoms of rickets can include:

• increased risk of broken bones
• including spontaneous breaks that occur by themselves without pressure or trauma deformities of the skeleton such as bowed legs
• kyphosis (‘hunch-back’)
• scoliosis (sideways curves of the spine)
• outward jutting breastbone or abnormal skull shape

Who is at risk of developing rickets? In United States, rickets occurs most frequently in recently arrived migrant, asylum seeker and refugee children, as well as in those whose parents migrated to United States. Children may be at increased risk of developing rickets due to vitamin D deficiency if they: in their diet.

Lack of vitamin D reduces the body’s ability to control the levels of these vital minerals and increases a child’s risk of developing rickets. About 90 per cent of our vitamin D comes from exposure to the sun.

When direct sunlight hits our skin, the ultraviolet radiation converts a skin substance called 7-dehydrocholesterol into vitamin D. There are also very small amounts of vitamin D in some foods.

However, food sources alone are usually not enough to maintain the levels of vitamin D that our body needs.

Once vitamin D is made in the skin or absorbed from food through the intestine, it is changed into its active form – a hormone – by the liver and kidneys. It is then available to help our body build strong bones and teeth, through the process of ‘mineralisation’. UV radiation levels vary depending on location, time of year, time of day, cloud coverage and the environment.

Babies and young children are particularly vulnerable to UV exposure damage and should always be well protected whenever UV radiation levels reach 3 or above. Physical sun protection measures such as dense shade, cool, covering clothing and wide-brimmed hats are recommended. For infants 6 months and older, apply a sensitive sunscreen to those small areas of exposed skin not protected by clothing or hats.

Rickets can often be prevented through preventing or treating low vitamin D levels, in addition to maintaining sufficient dietary intake of calcium and phosphate.

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Rickets may be diagnosed using a number of tests including: bone scans. Treatment options for rickets include: special forms of vitamin D supplements – for people whose bodies can’t convert vitamin D into its active form surgery to correct severe bone deformities. Bones that are poorly mineralised generally respond very quickly to dietary supplementation with calcium and vitamin D.

Improvements may be seen on x-ray after only a few days of treatment

If rickets is treated when the child is young, there is a good chance that the skeletal deformities will disappear as the child matures.

However, the deformities and reduced height will be permanent if the child goes through puberty without treatment.

(24 hours) Tel. (24 hours, 7 days) Tel. vitamin D skin cancer GP (doctor) Symptoms of rickets painful bones, muscle weakness, cramps and spasms slowed growth and development dental problems such as teeth failing to form or being slow to emerge, deformed teeth or soft tooth enamel prominent forehead and a large front fontanelle (soft spot) in infants have naturally very dark skin (which tends to absorb less sunlight than lighter skin) are born to women with a vitamin D deficiency cover most of their body for religious or cultural reasons are sick, have a disability or are unable to spend time outdoors for other reasons never go outside without sunscreen have a medical condition, such as certain bowel diseases disorders of the intestine, liver or kidneys that prevent the body from absorbing vitamin D or converting it into its active form disorders that reduce digestion or absorption of fats, as vitamin D is a fat-soluble vitamin have a lack of vitamin D or calcium The role of vitamin D Our body needs vitamin D to help it absorb calcium and phosphorus.

These minerals Sun exposure Preventing rickets Vitamin D fact sheet Diagnosis of rickets physical examination blood tests long bone x-rays Treatment of rickets improved sunlight exposure improved diet that includes adequate intake of calcium and vitamin D oral vitamin D supplements – these may need to be taken for about 3 months treatment for any underlying disorder Where to get help Your GP (doctor) Maternal and Child Health Line 13 22 29 Paediatrician Dietitians United States 1800 812 942 NURSE-ON-CALL (616) 555-0024 – for expert health information and advice.

Key Points

• Overuse of sun protection, due to increased concerns about risks, may be one reason for the increasing rates
• They can help you decide on an appropriate treatment plan for your child
• Children may be at increased risk of developing rickets due to vitamin D deficiency if they: in their diet
• are essential for the growth and development of strong, healthy bones
• However, food sources alone are usually not enough to maintain the levels of vitamin D that our body needs