What is rickets?
Rickets is the softness and weakness of the bones in children, and is usually caused by a severe and prolonged deficiency of vitamin D. Rare genetic problems may also cause rickets.
Vitamin D helps your child’s body absorb calcium and phosphorous from food. Vitamin D deficiency makes it difficult to maintain adequate levels of calcium and phosphorous in the bones, which can lead to rickets. Adding vitamin D or calcium to the diet generally corrects bone problems associated with rickets.
When rickets is the result of another underlying medical problem, your child may need additional medications or another treatment.
Some structural deformities caused by rickets may require corrective surgery. Rare genetic disorders associated with low levels of phosphorous, the other mineral component in bone, may require other medications.
what are the reasons.
1. Vitamin D deficiency.
Children who do not get enough vitamin D from these two sources can develop a deficiency:
Your baby’s skin produces vitamin D when it is exposed to sunlight. But children in developed countries tend to spend less time outdoors. They are more likely to use sunscreen, which blocks rays that stimulate the skin’s production of vitamin D.
Fish oils, egg yolks and oily fish such as salmon and mackerel contain vitamin D. Vitamin D has also been added to some foods. Such as milk, cereals, and some fruit juices.
2. Problems with absorption.
Some babies are born with or have medical conditions that affect the way their bodies absorb vitamin D.
Some examples include:
▪️ Celiac disease.
▪️ Inflammatory bowel disease.
▪️ Cystic fibrosis.
▪️ Kidney problems.
▪️ Medicines such as phenytoin.
What are the symptoms.
Signs and symptoms of rickets can include:
▪️ Softness of the skull and delayed closure of the fontanelles.
▪️ Joint pain and swelling.
▪️ Delayed growth.
▪️ Delayed motor skills.
▪️ Pain in the spine, pelvis and legs.
▪️ Muscle weakness.
▪️ Dental abnormalities.
▪️ Sometimes fractures occur.
Because rickets results in weakening of the areas of growth tissue at the ends of a child’s bones (growth plates), this can cause deformation of the skeleton such as:
Arch legs, or loose knees.
Thickening of the wrist and ankle.
Prominence of the breastbone .
1. Chronic skeletal pain.
2. Skeletal deformity.
3. Skeletal fracture.
Factors that may increase a child’s risk of rickets include:
1. Dark complexion.
Darker skin contains more melanin, which reduces the skin’s ability to produce vitamin D from sunlight.
2. Mother’s vitamin D deficiency during pregnancy.
A baby whose mother is severely deficient in Vitamin D may be born with signs of rickets or show signs of within a few months after birth.
3. Northern regions.
Children who live in geographic locations with less sunlight have a higher risk of developing rickets.
4. Premature birth.
Babies born prematurely tend to have lower levels of vitamin D because they have less time to receive the vitamin from their mothers in the womb.
Certain types of anti-seizure medications and anti-retroviral drugs used to treat HIV infections seem to interfere with the body’s ability to utilize vitamin D.
6. Breastfeeding only.
Breast milk does not contain enough vitamin D to prevent rickets. Only breastfed infants should receive vitamin D drops.
Rickets is most common in children between the ages of 6 and 36 months. Rapid growth in children during this period needs complete nutrients such as calcium and phosphate to strengthen their bones.
8. The type of food.
Your baby is more likely to develop rickets if he does not eat beneficial foods such as fish, eggs and milk, or if the child has trouble digesting milk or is allergic to milk sugar (lactose).
_ Ways to prevent the occurrence of rickets in children.
Rickets can be prevented in children by following the following methods:
1. Ensure that women have good levels of vitamin D during pregnancy.
2. Offer your baby solid foods and breast milk when he’s four to six months old.
3. Have regular follow-ups with your pediatrician to ensure healthy levels of vitamin D, calcium and phosphate are maintained.
4. Have your child have blood tests periodically to measure vitamin D levels.
5. Expose your child to the sun daily. 20 minutes of early morning or afternoon rays are sufficient for those with brownish skin, but those with darker skin may need longer.
_ Methods of treating rickets in children.
1. Your child’s doctor may do blood tests – to check your vitamin D level, calcium balance, phosphate, kidney function, bone turnover, urine tests, pictures and x-rays – to determine the cause of rickets and then how to treat.
2. If your child has low calcium, he may need to be admitted to the hospital for treatment because low in calcium may affect the heart rhythm.
3. The doctor may give your child vitamin D supplements if rickets is caused by a low level.
4. Your child may need additional amounts of calcium and phosphate by increasing dairy products or by taking nutritional supplements.
الكساح / www.mayoclinic.org
أمراض العظام / الكساح / www.moh.gov.sa
كساح الأطفال: أعراضه وأسبابه وطرق علاجه / www.webteb.com