Early symptoms of rickets

Written by Quan Xiang Mei
Pediatrics
Updated on February 13, 2025
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Rickets is a bone disease formed due to a deficiency of vitamin D, clinically referred to as rickets. The early clinical symptoms of rickets, which correspond to the early stages of vitamin D deficiency, primarily manifest as autonomic dysfunction, including night terrors, night sweats, and crying. In the early stages of rickets symptoms, parents often believe the cause to be calcium deficiency. Indeed, vitamin D deficiency can also impair calcium absorption, and these are linked reactions. Therefore, parents should pay attention to supplementing vitamin D, especially in areas with insufficient sunlight, ensuring that children receive less than two hours of sunlight exposure per day. During children's growth phases, it is essential to ensure adequate daily intake of vitamin D, with a basic amount of 400 IU being necessary.

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Can rickets be vaccinated against?

Children with rickets can be vaccinated, as rickets is not listed among the contraindications for vaccination. Rickets is a disease caused by a deficiency of vitamin D, a nutritional issue. Once diagnosed with rickets, it is essential to treat the child promptly by supplementing vitamin D. Generally, if treated early during infancy, rickets can be cured. To prevent rickets, all children should supplement with the physiological requirement of vitamin D from birth, engage in outdoor activities, and get ample sunlight to thoroughly prevent the occurrence of rickets. Rickets does not affect the administration of vaccines, nor does vaccination exacerbate the symptoms of rickets. Therefore, it is clear that children with rickets can be vaccinated.

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Clinical manifestations of rickets

Rickets, also known as vitamin D deficiency rickets, occurs because children do not supplement vitamin D in a timely manner after birth, leading to a deficiency of vitamin D in the body and resulting in a nutritional metabolic disease primarily involving skeletal changes. In the early stages, children mainly show symptoms related to mental and emotional state, such as irritability, crying, excessive sweating, shaking their heads back and forth, and rubbing their heads. Subsequently, symptoms like bald patches on the back of the head and softening of the skull bones may appear. As children grow, they may develop conditions such as a square-shaped skull, beaded ribs, pigeon chest, funnel chest, and bracelet-like deformities around the wrists and ankles. In severe cases, children may later develop X-shaped legs and O-shaped legs. If rickets is suspected, it is crucial to promptly conduct a blood test to measure the vitamin D level. If the level is below normal, it is essential to actively treat the diagnosed rickets.

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Can rickets be cured?

The rickets we commonly talk about is nutritional Vitamin D deficiency rickets, which is due to a deficiency of Vitamin D in the body leading to a disorder of calcium and phosphorus metabolism. This results in a systemic nutritional disease characterized by skeletal lesions. If rickets is caused by insufficient intake, it can be self-healing and is a self-limiting disease. Once infants and young children spend enough time outdoors and receive physiological doses of Vitamin D treatment, rickets can be treated. However, treatment becomes significantly challenging in cases of congenital developmental abnormalities causing skeletal lesions, or any genetic diseases that lead to Vitamin D absorption disorders. Such cases often result in severe complications, including prominent kidney dysfunction leading to further disturbances in calcium and phosphorus metabolism, as well as liver function abnormalities causing Vitamin D synthesis disorders. Therefore, it is important to understand the specific causes of Vitamin D deficiency in children, and if the deficiency is due to common reasons that can be promptly controlled, then supplementation with Vitamin D and trace elements like calcium can effectively treat the condition.

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What foods are good for rickets?

Rickets is a global chronic nutritional disease caused by a deficiency of vitamin D, leading to disorders in calcium and phosphorus metabolism and abnormal bone development. The main issue stems from the lack of vitamin D, which causes abnormalities in the body's calcium levels, thus it's important to ensure dietary intake of vitamin D. For early infancy, it is generally recommended to strengthen feeding practices. Infants under six months should be exclusively breastfed until six months of age, followed by timely introduction of complementary foods. Cod liver oil, which is rich in vitamin D, should be routinely supplemented starting from the second week after birth, along with regular monitoring of growth and development. As complementary foods are introduced, try to include vitamin-rich vegetables and appropriately supplement with calcium-rich foods, such as certain seafood, while being mindful of potential allergies in children. Additionally, it is beneficial to include some high-protein, nutritious foods. Most importantly, children should persist in outdoor activities to get ample sunlight and continue supplementing with cod liver oil.

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Early manifestations of rickets

Rickets is a disease caused by a lack of vitamin D, which leads to a disorder in calcium and phosphorus metabolism, resulting in abnormal bone development. It primarily appears in the early stages in infants within six months old, and particularly within three months after birth. The initial presentation is an increase in nervous excitability, such as fussiness and unease in children, symptoms like excessive internal heat and sweating, especially more sweat on the head. Continuous sweating can lead to significant baldness at the back of the head. Sometimes, children may exhibit constant head shaking, but these are not very specific symptoms. Early detection involves decreased blood calcium and phosphorus levels, increased parathyroid hormone levels, and decreased levels of related markers in blood tests. Early bone X-rays appear normal, so initial symptoms are not so typical. Therefore, it is recommended that infants be taken to a pediatrician for a physical examination as soon as possible, where their developmental status can be assessed and rickets can be diagnosed. If it is early-stage vitamin D deficiency rickets, timely supplementation of vitamin D levels can be an effective cure.