What is rickets, is your child at risk

Rickets is a bone disorder that can be traced as far back as the 17th century. During this time it rose to infamy as “the English disease” due to its outbreak in 17th century England.  Until the 1920s not much was known about the disorder or what causes rickets. With time, further research highlighted the role that diet, lifestyle, environment and genetic factors played in developing this condition. Rickets affects infants and children causing long-term developmental problems and stunted growth.

In this article, we will shed more light on this condition and ways to manage it.

What causes rickets?

In the early days, rickets was mistakenly thought to have socio-economic roots. Today, that misconception has been cleared up and rickets is no longer considered to be a disease limited to lower economic countries or regions. So, what causes rickets? 

Rickets can be inherited or be caused due to diet and lifestyle. The latter is called nutritional rickets. In some cases, underlying conditions can also increase the risk of developing rickets. 

The most common cause of rickets is:

1. Vitamin D deficiency
2. Calcium deficiency

The importance of Vitamin D in our diet and lifestyle has come into light daily recently. Vitamin D is produced in our body when we are exposed to sunlight. This vitamin helps us absorb and process calcium. In adults, vitamin D deficiency can cause osteomalacia.

Rickets can occur in any child. Some children however are more prone towards developing this condition. Studies show that ethnicity can also increase the risk of developing rickets. Premature babies also have a greater tendency to develop this condition during their childhood as babies build up stores of vitamin D while they are inutero. 

Today, children tend to spend more time indoors. This further decreases their exposure to healthy sunlight. This greatly contributes to the increasing incidence of rickets in children. You should encourage your child to spend some time outside regularly to ensure that they get their daily dose of the sun.experts recommend 10-15 minutes of sunlight exposure daily. Remember to avoid direct sunlight, use ample amount of sunscreen and protective clothing to keep them safe from harmful rays. 

Symptoms of rickets

Delayed growth and delayed motor skills are some of the most obvious symptoms of rickets to watch out for. Read more on important growth and developmental milestones for your child. 

Children and infants with rickets may also experience pain in the spine, pelvis and legs as well as exhibit muscle weakness. 

Physical deformities such as bowed legs (commonly called knocked knees), thickened wrist and ankle joints as well as breastbone projection are common physical symptoms of rickets. Idetifying symptoms in infants can seem challenging. Babies with rickets are generally fussy and have soft skulls.

If these symptoms become too obvious and is becoming a cause of concern, consult a paediatric orthopaedic doctor immediately to form a treatment plan for arresting and correcting the deformity. 

Long term impact of rickets includes an abnormally curved spine, failure to grow, bone and dental deformities and seizures in extreme cases. 

Is your child at risk?

If your child has certain underlying or preexisting health conditions, they have a greater risk of developing rickets. You would need to take special care in spotting symptoms early if you child has condition such as Celiac disease, inflammatory bowel syndrome, Cystic fibrosis or kidney problems. These conditions impact the way vitamin D is absorbed in the body, resulting in rickets.

In some cases, long term use of specific medications such as anti-seizure medication and antireteroviral medications can also interfere in the body’s ability to absorb vitamin D. In such cases, consult your child’s paediatrician to develop a plan for preventing rickets. 

Treatment for rickets

Depending on the severity of the condition and its root cause, treatment approaches can be medical, dietary or surgical. In case the condition is caused by some other underlying ailment, treating the primary disease is essential. Inhertited rickets requires a more specialised approach and it is best to consult a doctor experienced in managing rickets. 

Extremely serious deformities such as extreme cases of knock-knees can also be surgically corrected. 

Medical management of rickets includes annual injections of vitamin D (recommended if the child is unable to take oral supplements or has intestinal/liver disease), oral vitamin D & calcium supplements and dietary changes. 

Also, read: Importance of Vitamin D

Tips for preventing rickets

• The most important thing to keep in mind for preventing rickets is ensuring your child is getting atleast 10-15 minutes of sunlight exposure daily and is getting adequate calcium through diet.
• If your baby is being fed only breastmilk, consult your paediatrician for vitamin D nutritional support.
• Vitamin D and calcium supplements is aslo recommended during pregnancy to help your baby build their reserves before birth.
• For older children, food rich in calcium such as milk, cheese, guava and green vegetables are a must. Other foods that are rich in vitamin D and calcium are fatty fish like salmon and tuna, orange juice, soy milk and fortified cereals. 

A paediatrician or a paediatric orthopaedic doctor will be able to provide more insight into your child’s health and help you create a customised diet that addresses any nutritional gaps your child has. You would need to take extra care if your child is lactose intolerant. In India, we get most of our calcium from dairy products. If your child is lactose intolerant, talk to your doctor to know more about dietary substitutes. 

For more information, you can visit at the CK Birla Hospital, Gurgaon. Book your appointment today!

Also, read: Countering Vitamin D deficiency with little sunshine and right lifestyle