Does rickets have anything to do with milk powder?

Written by Tong Peng
Pediatrics
Updated on February 27, 2025
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Rickets is not necessarily linked to formula milk. Rickets is mainly a metabolic bone disease caused by a deficiency of vitamin D in the body, while the main components of formula milk are various nutrients, including trace elements and vitamins. If the formula contains insufficient calcium, it may exacerbate the symptoms of rickets. Therefore, the main requirement is to intake enough vitamin D. National child healthcare guidelines require that children be supplemented with 400 to 800 units of vitamin D daily from two weeks after birth until the age of two. Additionally, it is important to get ample sunlight in daily life and engage in reasonable outdoor activities to promote calcium absorption, which can effectively prevent rickets. The amount of vitamin D and calcium in formula milk cannot meet the growth and developmental needs of children, so additional supplementation is necessary. Thus, there is a certain connection between rickets and formula milk, but it is not inevitable.

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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.

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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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How is rickets diagnosed?

Rickets is a chronic nutritional disease caused by a deficiency in vitamin D, which leads to a disruption in calcium and phosphorus metabolism, resulting in abnormal bone development. Typically, the initial symptoms of rickets are most commonly seen 2-3 months after birth. At this stage, affected children often show neurological symptoms such as excessive sweating unrelated to the season, irritability, particularly in infants under three months old who can become easily agitated, and exhibit straining as if constipated, but these are not specific symptoms of rickets. Early diagnosis generally requires specific tests such as blood biochemistry to check the levels of 125 dihydroxy vitamin D3, as well as calcium and phosphorus levels in the blood, and to see if there is any change in serum alkaline phosphatase. The active phase is mainly characterized by skeletal changes, such as early signs of enlarged fontanelles or delayed closure, late teething, and sometimes a softening of the skull resembling a ping-pong ball, gradually leading to a square skull. Subsequently, changes like pigeon chest or noticeable deformities in the lower limbs such as X-shaped legs, O-shaped legs, or K-shaped legs may appear. Sometimes, there may also be curvature of the spine, with occasional scoliosis. These obvious skeletal changes make the condition more recognizable, though the initial presentations are not very typical, necessitating related biochemical blood tests.

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Nursing Measures for Children with Rickets

Rickets requires relevant home care. During the active phase of rickets, it is best to avoid early sitting, standing, and walking. For chest deformities, prone neck lifting and chest expansion exercises can be performed. For lower limb deformities, muscle massage can be done. For bow legs, massage the outer leg muscles and perform abductive and external rotation exercises after massaging both knee joints. For knock knees, massage the inner muscle group and perform internal rotation exercises after massaging both ankle joints. For posterior protrusion of the lumbar spine, massage the lumbosacral area and frequently lie prone to increase muscle tone, assisting in the recovery of deformities. For mild to moderate bow legs, it may be appropriate to slightly elevate the outside of the shoe by about 0.5 cm. For mild to moderate knock knees, it may be appropriate to slightly elevate the inside of the shoe by about 0.5 cm. Observe for one to three months and adjust the padding height as necessary, which generally can correct the condition. Additionally, children should be exposed to more outdoor sunlight and have a rich nutritional intake, including nutrient-rich proteins and dairy products to aid in recovery from the disease.

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The main manifestations of rickets in the early stage

Rickets generally refers to vitamin D deficiency rickets, mainly due to insufficient vitamin D in children, leading to calcium and phosphorus metabolism disorders. It is a chronic nutritional disease characterized by skeletal lesions. The main manifestations are changes in the fastest growing parts of the skeleton, which can also affect muscle development and changes in neural excitability. The initial symptoms of rickets are common in infants, especially those under three months old. The main symptom is increased neural excitability; the child is particularly prone to being agitated, irritable, crying, sweating, and shaking their head due to scalp stimulation, but these are not specific symptoms of rickets. Therefore, blood tests are still necessary in the early stages, showing decreased levels of 25-hydroxyvitamin D3, blood calcium, and blood phosphate, increased PTH, normal or slightly elevated alkaline phosphatase activity, and normal or slightly blurry calcification zones in skeletal X-rays. These are the early manifestations of rickets.