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There are many bone deformities and diseases that can strike children. One such disease is rickets. It causes softening and deformities of bones in children. Learn more about this bone condition from the following paragraphs.

What is Rickets?

Severe deficiency of calcium, vitamin D and phosphorus causes softening of bones in children. This condition is called as rickets that causes the child to suffer from bone deformity and recurrent fractures. This condition is not just restricted to children, it can occur in adults as well. However, it strikes more children than adults, especially in the developing countries. United States too has its share of rickets cases. In adults, this condition is called as osteomalacia.

What Causes Rickets?

Rickets is due to deficiency of calcium, phosphorus and vitamin D. Bone development occurs during childhood and adolescence years. During this period bones undergo mineralization that helps in depositing minerals like calcium and phosphorus to make bones stronger. Vitamin D is the facilitator during this process that helps in the absorption of calcium and phosphorus.

When these essential minerals and vitamin are not provided during the growth years, it leads to weak bones and teeth. As the child continues to grow, the body weight continues to increase. The bones can no longer support the increasing body mass. They tend to bend and become misshapen. The causes of rickets are as follows:

Calcium deficiency

Deficiency of calcium can lead to rickets. A child needs about 300 mg of calcium/day. This means one should include at least one cup of milk in their daily diet. Children who do not have dairy products in their diet, often suffer from calcium deficiency.

Vitamin D deficiency

Even though one includes calcium in their diet, it is of no use if they suffer from vitamin D deficiency. Vitamin D helps in the absorption of calcium and phosphorus in the bones. The best source of vitamin D is sunlight. Other sources of vitamin D include butter, eggs, fortified milk, juice, tuna, herring, salmon and fish liver oils. Thus, children should be given a healthy diet and allowed to go out in direct sunlight for some time daily. Children who are only breastfed by mothers suffering from vitamin deficiency, or those who live in areas that receive less sunlight and follow vegan diets are more at risk of developing vitamin D deficiency.

Genetic defects

One of the rare genetic conditions is hypophosphatemic rickets. It is a condition where the kidneys are unable to process phosphates leading to low blood phosphate levels. Thus, children with this condition suffer from soft bones that are prone to fractures.

Certain diseases

There are many diseases that can lead to vitamin D deficiencies in children. These include kidney diseases, cystic fibrosis, celiac disease and liver conditions. These diseases affect the way the body absorbs and metabolizes vitamin D leading to rickets.

Symptoms of Rickets

Signs and symptoms of rickets include:

  • Delay in growth of baby
  • Pain in bones of the legs, spine, pelvis
  • Teeth are prone to cavities, chipping and develop abnormally
  • The muscle tone of the child is quite weak
  • The child appears to be drowsy
  • Bowed legs
  • Wide wrists and ankle bones
  • Stooping or curved spine
  • Protruding chest bones
  • Low calcium level in blood
  • Soft skull
  • Prone to fractures

Diagnosis of Rickets

Rickets is diagnosed based on physical examination of the child. Serum calcium levels are checked with the help of blood tests. When the level of calcium and phosphorus is really low and serum alkaline phosphatase is very high, it indicates rickets. Other tests include bone X-ray that shows abnormal or deformed bone structure.

Treatment of Rickets

Rickets is usually caused by calcium deficiency. Thus, the child is asked to be given a calcium, phosphorus as well as vitamin D rich diet. The child should be allowed to play or taken for walks in direct sunlight, especially in the early morning. Some children may be given calcium and vitamin D supplements to overcome the deficiency. At times, the child may be given just one injection per year for vitamin D deficiency. Rickets caused due to other underlying medical conditions can be cured by treating the disease causing it.

If left untreated the child will suffer from fractures and permanent bone deformities. One can prevent rickets by providing the child with a balanced diet. Include eggs, butter, margarine, salt-water fish, milk, cheese, dried fruits, etc. in their food. Allow the child to be exposed to sunlight thrice or five times a week for at least 15 minutes. Those with sensitive skin should apply sunscreen with SPF 15 and move out in the sun. Infants should be given fortified milk, cereal and juices in their diet. Rickets is a preventable disease if occurs due to dietary deficiency. Speak to your healthcare provider for more details.

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Written by: Saptakee sengupta
Date last updated: February 4, 2015