Signs and symptoms of rickets can include:
- Delayed growth
- Pain in the spine, pelvis and legs
- Muscle weakness
Because rickets softens the growth plates at the ends of a child's bones, it can cause skeletal deformities such as:
- Bowed legs or knock knees
- Thickened wrists and ankles
- Breastbone projection
When to see a doctor
Talk to your doctor if your child develops bone pain, muscle weakness or obvious skeletal deformities.
Your body needs vitamin D to absorb calcium and phosphorus from food. Rickets can occur if your child's body doesn't get enough vitamin D or if his or her body has problems using vitamin D properly. Occasionally, not getting enough calcium or lack of calcium and vitamin D can cause rickets.
Lack of vitamin D
Children who don't get enough vitamin D from these two sources can develop a deficiency:
- Sunlight. Your skin produces vitamin D when it's exposed to sunlight. But children in developed countries tend to spend less time outdoors. They're also more likely to use sunscreen, which blocks the rays that trigger the skin's production of vitamin D.
- Food. Fish oils, fatty fish and egg yolks contain vitamin D. Vitamin D also has been added to some foods, such as milk, cereal and some fruit juices.
Problems with absorption
Some children are born with or develop medical conditions that affect the way their bodies absorb vitamin D. Some examples include:
- Celiac disease
- Inflammatory bowel disease
- Cystic fibrosis
- Kidney problems
Factors that can increase a child's risk of rickets include:
- Dark skin. Dark skin doesn't react as strongly to sunshine as does lighter skin, so it produces less vitamin D.
- Mother's vitamin D deficiency during pregnancy. A baby born to a mother with severe vitamin D deficiency can be born with signs of rickets or develop them within a few months after birth.
- Northern latitudes. Children who live in geographical locations where there is less sunshine are at higher risk of rickets.
- Premature birth. Babies born before their due dates are more likely to develop rickets.
- Medications. Certain types of anti-seizure medications and antiretroviral medications, used to treat HIV infections, appear to interfere with the body's ability to use vitamin D.
- Exclusive breast-feeding. Breast milk doesn't contain enough vitamin D to prevent rickets. Babies who are exclusively breast-fed should receive vitamin D drops.
Left untreated, rickets can lead to:
- Failure to grow
- Abnormally curved spine
- Skeletal deformities
- Dental defects
May 24, 2016
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- Carpenter T. Etiology and treatment of calcipenic rickets in children. http://www.uptodate.com/home. Accessed March 21, 2016.
- Elder CJ, et al. Rickets. The Lancet. 2014;383:1665.
- Misra M. Vitamin D insufficiency and deficiency in children and adolescents. http://www.uptodate.com/home. Accessed March 21, 2016.
- Vitamin D. Office of Dietary Supplements. http://ods.od.nih.gov/factsheets/VitaminD-QuickFacts. Accessed March 23, 2016.
- Vitamin D supplementation for infants. American Academy of Pediatrics. https://www.aap.org/en-us/about-the-aap/aap-press-room/pages/Vitamin-D-Supplementation-for-Infants.aspx. Accessed March 23, 2016.