Rickets is the softening and weakening of bones in children, usually because of an extreme and prolonged vitamin D deficiency. Rare inherited problems also can cause rickets.
Vitamin D helps your child's body absorb calcium and phosphorus from food. Not enough vitamin D makes it difficult to maintain proper calcium and phosphorus levels in bones, which can cause rickets.
Adding vitamin D or calcium to the diet generally corrects the bone problems associated with rickets. When rickets is due to another underlying medical problem, your child may need additional medications or other treatment. Some skeletal deformities caused by rickets may require corrective surgery.
Rare inherited disorders related to low levels of phosphorus, the other mineral component in bone, may require other medications.
Signs and symptoms of rickets can include:
Because rickets softens the areas of growing tissue at the ends of a child's bones (growth plates), it can cause skeletal deformities such as:
Talk to your doctor if your child develops bone pain, muscle weakness or obvious skeletal deformities.
Your child's 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.
Children who don't get enough vitamin D from these two sources can develop a deficiency:
Some children are born with or develop medical conditions that affect the way their bodies absorb vitamin D. Some examples include:
Factors that can increase a child's risk of rickets include:
Left untreated, rickets can lead to:
Exposure to sunlight provides the best source of vitamin D. During most seasons, 10 to 15 minutes of exposure to the sun near midday is enough. However, if you're dark-skinned, if it's winter or if you live in northern latitudes, you might not be able to get enough vitamin D from sun exposure.
In addition, because of skin cancer concerns, infants and young children, especially, are warned to avoid direct sun or to always wear sunscreen and protective clothing.
To prevent rickets, make sure your child eats foods that contain vitamin D naturally — fatty fish such as salmon and tuna, fish oil and egg yolks — or that have been fortified with vitamin D, such as:
Check labels to determine the vitamin D content of fortified foods.
If you're pregnant, ask your doctor about taking vitamin D supplements.
Guidelines recommend that all infants should receive 400 IU a day of vitamin D. Because human milk contains only a small amount of vitamin D, infants who are exclusively breast-fed should receive supplemental vitamin D daily. Some bottle-fed infants may also need vitamin D supplements if they aren't receiving enough from their formula.
During the exam, the doctor will gently press on your child's bones, checking for abnormalities. He or she will pay particular attention to your child's:
X-rays of the affected bones can reveal bone deformities. Blood and urine tests can confirm a diagnosis of rickets and also monitor the progress of treatment.
Most cases of rickets can be treated with vitamin D and calcium supplements. Follow your child's doctor's directions as to dosage. Too much vitamin D can be harmful.
Your child's doctor will monitor your child's progress with X-rays and blood tests.
If your child has a rare inherited disorder that causes low amounts of phosphorus, supplements and medication may be prescribed.
For some cases of bowleg or spinal deformities, your doctor might suggest special bracing to position your child's body appropriately as the bones grow. More-severe skeletal deformities might require surgery.
You'll likely start by seeing your family doctor or a pediatrician. Depending on the cause of your child's symptoms, you might be referred to a specialist.
Here's information to help you get ready for your appointment.
Before your appointment, make a list of:
Your doctor might ask some of the following questions: