How to treat rickets in a 2-year-old baby?

Written by Li Jiao Yan
Neonatology
Updated on October 28, 2024
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Rickets in two-year-old infants is caused by a deficiency in vitamin D leading to a disturbance in calcium and phosphorus metabolism, resulting in abnormal skeletal development. This class of systemic, chronic, nutritional diseases typically manifests in two-year-olds who are able to walk and stand. Due to the force of gravity, lower limb deformities may develop, leading to bowlegs or knock-knees, and possibly even a 'K'-shaped limb deformity. The spine may also develop kyphosis or scoliosis. Around the age of two, it is generally the residual stage of the disease, which often does not require pharmacological treatment. For mild to moderate cases, physical exercise should be enhanced, and active or passive rehabilitation methods should be used to correct skeletal deformities. It is recommended to seek treatment in the pediatric rehabilitation department; severe skeletal deformities may require surgical correction.

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Written by Li Jiao Yan
Neonatology
1min 24sec home-news-image

Rickets Causes

Rickets, fully termed as nutritional vitamin D deficiency rickets, is a chronic systemic nutritional disease characterized by epiphyseal lesions, caused by insufficient vitamin D in children, leading to disordered calcium and phosphate metabolism. The main causes of the disease include insufficient perinatal vitamin D, particularly during the prenatal and postnatal periods, as well as factors like severe maternal malnutrition, liver and kidney diseases, chronic diarrhea, prematurity, and having twins, which may lead to inadequate levels of vitamin D storage in the body. Additionally, insufficient sunlight exposure, such as children spending prolonged periods indoors, blocks sunlight, as ultraviolet rays cannot pass through glass. Ultraviolet light aids in the synthesis of endogenous vitamin D; lack of exposure can also reduce vitamin D levels. Another factor is rapid growth rates, and fourthly, insufficient dietary supplementation of vitamin D along with some diseases that affect the absorption of vitamin D, like gastrointestinal or liver and biliary diseases.

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Written by Yan Xin Liang
Pediatrics
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Does rickets have a hereditary component?

Rickets, also known as vitamin D deficiency rickets, is primarily a chronic nutritional disease characterized by skeletal lesions, caused by insufficient vitamin D in infants, children, or adolescents, which leads to disturbances in calcium and phosphorus metabolism. The main feature of this disease is the incomplete calcification of the growth plates and bone tissue in the growing long bones, due to the lack of vitamin D causing incomplete calcification of mature bones. This disease is most common in children under two years old. Its causes may be related to insufficient intake of vitamin D or insufficient sunlight exposure, as well as rapid growth. Additionally, other diseases may influence its development. Therefore, this disease is generally not closely related to genetics.

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Written by Li Jiao Yan
Neonatology
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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.

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Written by Tong Peng
Pediatrics
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Should I take vitamin D or D3 for rickets?

Rickets should be treated with D3, but strictly speaking, what we commonly refer to as vitamin D is D3, just phrased differently. Vitamin D3 helps promote the absorption of calcium by bones, preventing the occurrence of rickets symptoms. The main clinical manifestations of rickets appear in the deformation of bones, such as square skull, pigeon chest, flaring ribs, X-shaped legs, O-shaped legs, and other changes in bone status. The nervous system can show symptoms such as night sweats, nervous excitability, balding at the back of the head, poor sleep quality, and easiness to cry. For rickets, it is necessary to diagnose early, timely supplement with vitamin D to prevent symptoms from worsening, and also to get more sunlight and engage in outdoor activities, which helps the body synthesize vitamin D and absorb calcium.

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Written by Zhang Xian Hua
Pediatrics
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Is pillow baldness rickets?

Balding at the back of the head is a common clinical manifestation of rickets, but it does not mean that balding at the back of the head is equivalent to rickets, as there are many causes for this condition. In children with rickets, due to a lack of vitamin D leading to calcium deficiency, their neural excitability increases, which can affect the baby's sleep and cause restless sleep leading to balding at the back of the head. However, children who are in poor nutritional condition might also experience deficiencies in trace elements, such as a lack of zinc or iron, which can also lead to sleep disturbances and balding at the back of the head, indicating that the cause may not necessarily be rickets. Additionally, a small number of children might have an inherent condition of increased neural excitability that affects sleep, leading to balding at the back of the head, which also isn't due to rickets. Therefore, if balding at the back of the head occurs, it is advisable to visit a hospital’s pediatric healthcare department or pediatric outpatient clinic for a consultation and check-up, to actively treat and manage based on the underlying cause.