Although rickets was thought to be an illness of the past, unfortunately it’s reappearing. Let’s find out exactly what rickets is, what the risk factors and causes are, how to have rickets diagnosed, and what to do if your child has rickets.
What is rickets?
Rickets is a disease primarily caused by vitamin D deficiency. It affects bone development in children, which means there can be pain and poor bone growth that might lead to soft and weak tissue development and possible bone deformities.
Although the name ‘rickets’ originated in England around 1630 as a local way to name the disease in Dorset and Somerset, its pseudo-scientific name was obtained from the Greek word ‘rachitis’, which means ‘in or of the spine’. Because they didn’t know the cause of the disease but could see that rickets caused several skeletal deformities, it was thought that any bone-related conditions were related to the spine.
The correct scientific terminology for rickets is osteomalacia.
What causes rickets?
Rickets is caused by vitamin D deficiency. There are, however, various reasons why this vitamin D deficiency happens.
Types of rickets
If you develop rickets, it basically means your body doesn’t get or produce enough vitamin D. Rickets can also develop when your body lacks certain minerals like calcium and phosphorus, which are essential for the synthesis of vitamin D.
Rickets affects bone development in children. As a child’s bones are growing and developing fast, vitamin D levels are critical for appropriate bone development.
Vitamin D deficiency rickets
This is the most common type of rickets. Here the person suffers from a lack of vitamin D. This lack of vitamin D can be corrected by having a varied diet that’s rich in vitamin D and also by increasing exposure to sunlight. When sunlight touches the skin, the body has the capacity to producing vitamin D.
Although the amount of exposure to sunlight might be adequate, nutritional rickets occurs when the body struggles to absorb calcium and phosphorus. Calcium and phosphorus levels must be optimal for the body to synthesize vitamin D correctly.
A varied diet is essential to keep the body in good health. Developing rickets takes quite a bit of time which means there are one or more important vitamins and minerals missing from the diet.
Inherited rickets happens when the pregnant mother has a vitamin D deficiency. There isn’t enough vitamin D or calcium in her bloodstream to pass on to the baby, via the placenta.
This is why a healthy diet is so important, especially during pregnancy. Women who might have inadequate levels of vitamins in their diet should be taking pregnancy vitamin supplements.
What foods are good for preventing rickets?
Foods that are rich in vitamin D:
- Fatty fish, such as salmon, sardines, mackerel and herrings
- Egg yolks
- Red meat and liver.
Foods that are rich in calcium and phosphorus:
- Fatty fish. Make sure you include these in your diet, as fatty fish is very good for you. Small fish are better than larger ones. Limit your consumption of big fatty fish like salmon or tuna to two portions a week
- Dairy products
- Green leafy vegetables
- Seeds and pulses
Vitamin D deficiency
When our body lacks vitamin D, weak and soft bones develop as a consequence. There might be bone and skeletal deformities, as bones need vitamin D to grow properly and develop in a healthy way.
Vitamin D deficiency can cause bone pain and bone disease. Because the bones aren’t developing as they should, the muscles that connect to the bones might also be affected. Rickets can also cause muscle weakness and muscle pain.
Healthy bones are of paramount importance during a child’s growth and development. These days, vitamin D deficiency shouldn’t be a problem – even in climates with long winters or little sunlight.
However, research shows that rickets is coming back in many developed countries where it was thought to be eradicated. Avoiding sun exposure by using high blocking factor sunscreens and clothes, or even purposely avoiding exposure to sunlight in general so as to protect the skin, is thought to be the cause of the rise in rickets during the last couple of decades.
What are the symptoms of rickets?
Vitamin D helps a child’s body absorb calcium and phosphorus. These minerals are very important for the bones to develop strongly.
These are the most common signs and symptoms of rickets.
#1. Bone pain
Bone pain is usually the number 1 symptom of rickets. As the bone is not developing as it should, the muscles and the rest of structures connected with the bones will add weight to them, making it painful for the bones to perform their ‘normal’ tasks.
#2. Skeletal deformities
As the bones are weak and soft it is easy for deformities to appear. Some, such as bowed legs, are very obvious; others are more subtle but also debilitating.
#3. Poor growth
As the growth plates develop differently from healthy bones, children who suffer from rickets will most likely be shorter than the average person due to this slower bone growth.
#4. Dental problems
There is a delay in teeth coming out, tooth enamel is weaker and the chances of getting cavities increase.
#5. Bone fractures
If your child has broken bones more frequently than most – especially if these fractures are greenstick fractures – you should probably arrange some blood tests, to eliminate rickets from the equation.
How is rickets diagnosed?
Your doctor will diagnose rickets by doing a physical exam to check bone pain, and blood tests to check phosphorus, vitamin D and calcium levels.
If rickets is suspected, it’s also likely that your doctor will ask for X-rays, to see the status of those bones and to determine whether there are any bone problems, such as pelvic deformities, that cannot be seen with the naked eye.
Because most of the causes for rickets are related to low levels of vitamin D or calcium and phosphorus, treatment will mean a change in the child’s diet. It might involve adding artificially fortified foods and taking daily calcium and vitamin D supplements.
An increase in daily sun exposure should also be part of the treatment.
If you’re breastfeeding your child, treatment will depend on several factors, such as the child’s age, or whether the child is exclusively breastfed. The amount of vitamin D found in breast milk really depends on the levels in the breastfeeding mother.
Many babies, especially those born in cold or not-too-sunny places, are given vitamin D supplements to make sure they maintain high levels of vitamin D. If you’re breastfeeding and you don’t feel too confident about giving your baby anything extra, you can increase your vitamin D intake or you can take a vitamin D supplement yourself. That way you will have enough vitamin D for both of you.
Can rickets be prevented?
Yes, rickets can be prevented and it should be, as rickets can become really incapacitating for some.
To prevent rickets, a pregnant mother should consume a good, healthy diet. She should eat plenty of vitamin D and calcium-rich foods to make sure the baby’s bones grow strong and healthy. Once the baby is born, the mother’s diet is still very important, especially if she breastfeeds. Vitamin intake is important for the baby to grow strong bones.
Formula milk comes with extra vitamin D, a calcium supplement and many more extras. Whether your baby is formula fed or breastfed, keep an eye on bone development.
Also try to get some sun on your baby’s skin for a few minutes each day. Wear sunscreen only when the exposure is going to be for more than 20-30 minutes.
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