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What to Know About Rickets

Medically Reviewed by Jabeen Begum, MD on November 11, 2021

Rickets is a condition that weakens and softens bones in children. It usually happens in children who don't get enough vitamin D. They may not get enough sun exposure, the primary source of vitamin D, or are not getting enough vitamin D in their diet.

Vitamin D is an essential part of every child's daily nutrient intake. It helps their body absorb vital nutrients, such as phosphorus and calcium, from food. Both of these components strengthen your child's bones.

When your child doesn't get enough vitamin D, their body can't keep a normal balance of calcium and phosphorus levels. This may lead to rickets. 

Rickets leads to several types of bone defects in children. The standard treatment for rickets is adding foods rich in vitamin D or calcium to the child's diet. Severe skeletal defects require corrective surgery.

What Causes Rickets?

Rickets can be caused by many factors, including: 

  • Dark skin tone
  • Limited exposure to the outside world
  • Too much use of sunscreen when outdoors 
  • Less intake of vitamin D foods due to lactose intolerance 
  • A strict vegetarian diet that excludes vitamin D rich foods
  • Celiac disease, a condition in which the child can't produce or use vitamin D

In some children, rickets is not caused by lack of vitamin D. Instead, these children are born with a medical condition that affects their bodies' vitamin D absorption, such as celiac disease.

Inherited medical conditions of rickets include:

What Are Rickets Symptoms?

Rickets symptoms usually appear in the early stages. The infants may become more moody and fussy. Their skulls may also feel softer than usual. 

These young children may have issues with development throughout their lives. 

Some common rickets symptoms include:

  • Delayed growth
  • Difficulty walking and running
  • Delayed motor skills
  • Severe pain in the legs, spine, and pelvis 
  • Abnormally curved spine
  • Bones weakness
  • Teeth abnormalities
  • Large abdomen
  • Muscles weakness

Rickets can soften the growing tissue at the end of your child's bones. It can also lead to skeletal abnormalities, including:

  • Knock knees or bowed (curved) legs
  • Thickened wrists 
  • Thickened ankles
  • Wild elbow joints
  • Breastbone projection
  • Large forehead
  • Abnormally shaped ribs

How Is Rickets Diagnosed?

Rickets can be diagnosed with a physical examination. The doctor will gently press on your child's bones or skull to identify any abnormalities. 

A general diagnosis for rickets includes the examination of:

  • Skull. The doctor will check if your baby's skull is soft enough. The soft spots (fontanels) on your baby's skull may close late.
  • Legs. Toddlers sometimes have bowed legs. The doctor will check to see if your baby's bowed legs are normal or an indication of rickets.
  • Chest. Children with rickets develop abnormalities in their chest area. These abnormalities may include the flattening of the rib cage and the projection of the breast bones.
  • Wrists and ankles. The wrists and ankles of children with rickets are wider or thicker than normal.

X-rays may help the doctor see the bone deformities. Some doctors also recommend urine and blood tests to confirm rickets and to monitor the treatment.

What Is the Treatment for Rickets?

Rickets treatment starts with vitamin D and calcium supplements. In most cases, the right supplements can treat the condition. 

Carefully monitor the vitamin D dosage for your child. Too much consumption of vitamin D can be harmful to your child's health. 

The recommended daily vitamin D dosage for infants is 1,000 to 2,000 International Units. 

The recommended daily calcium intake for children with rickets is 1,000 to 1,500 milligrams (mg) per day. The source could be either calcium-rich foods or supplementation.

In cases of rickets caused by rare inherited disorders, doctors may prescribe medications along with supplements. 

If your child has developed a bowed leg or any spinal deformity, the doctor may suggest bracing to position your child's posture. In severe skeletal deformity cases, surgery may be required.

Your child's doctor may use X-rays and blood tests to evaluate your child's recovery progress.

Are There Complications with Rickets?

If left untreated, rickets can cause severe complications, including: 

  • Growth failure
  • Curved spine
  • Bone deformities
  • Teeth defects
  • Seizures

How Is Rickets Prevented?

A key to rickets prevention is making sure that your child has a balanced diet. It should include the essential vitamins, minerals, and proteins required for healthy growth.

Add vitamin D-rich foods to their diet, including salmon, fish oil, and eggs.

Other sources of vitamin D are:

  • Infant formula
  • Cereals
  • Milk, but not milk products like yogurts and cheese
  • Bread, better if it's not made of milk
  • Orange juice

Show Sources

SOURCES:
American Academy of Family Physicians: "Rickets: What It Is and How It's Treated."
American Academy of Orthopaedic Surgeons: "OrthoInfo: Rickets."
Mayo Clinic: "Rickets."
National Institutes of Health: "Genetic and Rare Diseases Information Center (GARD): Rickets."
NHS: "Rickets and Osteomalacia."
The University of Chicago: "Rickets."

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