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Rickets
Causes of Rickets
Rickets, also known as Vitamin D-deficiency rickets, implies from its name that the cause of the disease is due to insufficient intake of Vitamin D in children, leading to disorders in calcium and phosphorus metabolism and resulting in nutritional disease with skeletal deformities. The incidence of the disease is higher in the north than in the south. Currently, the incidence of mild and moderate rickets is relatively high, while severe cases are less common because people are increasingly paying attention to the supplementation of Vitamin D for children. It is recommended that full-term infants start supplementing with 400 units of Vitamin D daily two weeks after birth, which is the physiological requirement. For premature infants, twins, and extremely low birth weight infants, the daily physiological requirement of supplementation is 800 units per day. After supplementing continuously for three months, it should be adjusted to 400 units per day as per the requirement for full-term infants. With such management, the child will not suffer from rickets. However, if there is no regular supplementation after birth, the lack of Vitamin D can lead to skeletal changes in the child, and once rickets is diagnosed, it requires high doses of supplementation.
Can rickets be cured?
Rickets is a chronic nutritional disease caused by vitamin D deficiency that leads to disturbed calcium and phosphorus metabolism in the body, causing abnormal skeletal development. If a square skull is observed, it indicates that the child's disease has entered an active phase. Generally, in the early stages, there is an enlargement of the fontanelle or a delay in the closure of the fontanelle. By seven to eight months, a square skull can appear, primarily characterized by outward bulging centered on the frontal and parietal bones. At this time, it is generally necessary to administer a sufficient dose of vitamin D and encourage appropriate outdoor activities. Depending on the child's condition, it might be appropriate to supplement with calcium as well. Gradually, this should be curable; however, if there are other special causes for the abnormal vitamin D levels, such as severe liver or kidney disease or some new genetic diseases causing square skull, the treatment might be more challenging.
Rickets is a disease that affects bone development in children due to vitamin D deficiency, calcium, or phosphate. It is treatable with proper nutrition and supplementation.
Rickets, also known as vitamin D deficiency rickets, is caused by a lack of vitamin D, leading to abnormal calcium and phosphorus metabolism in the body. The calcium salts cannot be properly deposited in the growing parts of the skeleton, causing incomplete mineralization of the bone tissue during growth. This results in a chronic systemic nutritional disease closely related to lifestyle, characterized by skeletal abnormalities. The most common is nutritional vitamin D deficiency, which is self-limiting. Typically, sufficient vitamin D supplementation and appropriate sun exposure can cure it. If caused by other severe diseases, vitamin D deficiency will significantly manifest liver and kidney function abnormalities. Additionally, some congenital genetic diseases make treatment more difficult when vitamin D levels are deficient.
What are the early symptoms of rickets?
The early symptoms of rickets are mainly due to the inadequate intake of vitamin D in children, leading to disturbances in the body's calcium and phosphorus metabolism. Early signs usually appear around three months of age in infants, characterized by changes in mental state, restless sleep, frequent crying, and excessive sweating. Increased sweating is often accompanied by cradle cap, where circular bald patches appear on the back of the head. In such cases, it is important to include vitamin D-rich foods in the diet and supplement with vitamin D. Continued breastfeeding, engaging in outdoor activities, and exposure to sunlight are recommended to promote the body’s own synthesis of vitamin D. Regular physical examinations are also advised, and if symptoms of rickets occur, an appropriate increase in vitamin D intake may be necessary.
Is rickets easy to treat?
Rickets is primarily a nutritional disease caused by insufficient levels of vitamin D leading to disturbances in calcium and phosphate metabolism, resulting in abnormal bone development. The most common type is nutritional vitamin D-deficiency rickets. This type of disease is self-limiting and thus relatively easy to treat. It requires early detection and proactive intervention. Early measures include encouraging children to engage in outdoor activities and supplementing with appropriate doses of vitamin D, which can effectively treat rickets. However, there are also special causes of vitamin D deficiency such as significant anomalies in liver or kidney function and certain genetic diseases that severely impair vitamin D absorption. When vitamin D treatment is ineffective, it may be due to other special causes. Treatment of rickets under these circumstances can be more challenging, and genetic diseases may respond poorly to treatment.
What are the symptoms of rickets?
The condition generally referred to as rickets is most commonly nutritional vitamin D deficiency rickets, a type of nutritional disease that is prevalent among infants and young children, particularly very young babies. It primarily manifests as changes in the bones where growth is most rapid and can also affect muscle development and changes in nervous excitability. Initially, especially within the first three months, symptoms in very young infants typically include increased nervous excitability, such as crying easily, excessive head sweating, and as a result of the sweating, frequent head shaking, irritability, restlessness, and noticeable crying and restlessness at night. These symptoms at this stage are not necessarily indicative of typical rickets. As the condition progresses, changes in the skeleton gradually become apparent. In infants under six months with rickets, the changes are mainly in the skull, typically feeling like pressing on a ping-pong ball. After six months of age, the head shape becomes squared or box-like, and the head circumference is larger than normal. Later, the characteristic beading changes of rickets appear, with beaded protrusions above the ribs, followed by the formation of blunt, circular raised areas at the wrists and ankles, referred to as wrist and ankle bracelets. Around the age of one, infants may develop a deformity resembling pigeon chest. As the child begins to stand and walk, the weight bearing on the lower limbs may lead to deformities, such as bowlegs or knock-knees, and sometimes even K-shaped deformities of the legs, and some might develop spinal deformities.
What foods should not be eaten with rickets?
Patients with rickets should not eat some cereal foods, such as millet, rice, wheat, corn, and other foods. Cereal foods also contain vitamin D and calcium, and eating too much of these foods can exacerbate the disease. Patients with rickets should eat more light, low-fat, and easily digestible foods. They should control the intake of high-fat content daily and avoid eating stimulating and spicy foods. At the same time, they should increase their intake of vitamins, encourage the child to eat more fruits and vegetables to ensure an adequate supply of vitamins, and patients can also exercise more. More physical activity can help boost the immune system.
Symptoms of rickets in infants and young children
The symptoms of rickets in infants and young children mainly include excessive sweating, night terrors, thinning hair at the back of the head, rib cage flaring, pigeon chest, bow legs, and knock knees, among others. If a child exhibits the above symptoms, it is necessary to promptly test for trace elements and check bone density to see if the child has symptoms of calcium deficiency. If so, it is crucial to supplement the child with vitamin D and calcium. In terms of diet, it is necessary to enhance the child's nutrition and increase outdoor activities. Ensure that the child engages in outdoor activities for more than two hours each day, particularly between 12 PM and 2 PM. Avoid exposing the child to sunlight during this time to prevent sunburn, especially to the child's eyes.
Can rickets be treated with vitamin D3?
Rickets can be treated with Vitamin D3; first, we need to understand the pathology of the disease. It is a metabolic, obstructive disease caused by a deficiency of Vitamin D. Often, this deficiency leads to impaired calcium absorption in the body, causing osteoporosis and bone deformity. Infants typically exhibit symptoms like square skulls, pigeon chests, outward flaring ribs, bow legs, and knock knees. Additionally, it affects the baby's sleep quality. The lack of Vitamin D can increase the baby's neural excitability, leading to poor sleep and easy waking. Moreover, severe cases can affect growth and development. Presence of these symptoms should be confirmed by laboratory testing of 25-hydroxy Vitamin D3 to determine specific levels and choose the appropriate dose of Vitamin D3 supplementation. It is also encouraged to promote children's physical activity and exposure to sunlight to enhance the body's synthesis of Vitamin D, which is beneficial for bone development. (Medication should be administered under the guidance of a professional doctor.)
What is the treatment method for rickets?
Rickets is primarily caused by a deficiency in vitamin D, leading to disturbances in calcium and phosphorus metabolism in the body, which results in abnormal skeletal development—a type of systemic nutritional disease. The most common form is nutritional rickets due to a deficiency in nutrients and vitamin D. Treatment focuses on controlling the active phase to prevent relapse of deformities. Therefore, early detection and comprehensive treatment are crucial. The primary treatment method involves supplementing with vitamin D. The choice of vitamin D, the dosage, and the length of treatment generally need to be tailored to the specific circumstances of the child. Additionally, increased exposure to sunlight and appropriate outdoor activities should be encouraged to enhance the absorption of vitamin D. Children should also be supplemented with calcium and a variety of vitamins. Follow-ups during the recovery phase are necessary, and training in sitting, standing, and walking should not be started too early to avoid deformities in the lower limbs. Furthermore, no medication is needed during the residual stage of the disease. For mild to moderate cases, physical exercise should be intensified, and skeletal deformities can be corrected using active or passive exercises. Severe skeletal deformities may require surgical correction.