Rickets in Children: Causes, Symptoms, and Treatment

 Rickets is a skeletal disorder that primarily affects children, resulting in weak, soft, and deformed bones. This condition occurs due to a deficiency of vitamin D, calcium, or phosphate, which are essential for proper bone growth and development. 

In this article, we will delve into the causes, symptoms, and treatment options for rickets in children.

What is Rickets ?

Rickets is typically caused by a lack of vitamin D, although it can also stem from inadequate calcium or phosphate levels in the body. Vitamin D is essential for the absorption and utilization of calcium and phosphate, which are crucial for bone mineralization. Without sufficient levels of these nutrients, bones become weak and susceptible to deformities.

Causes of Rickets

• Inadequate Sun Exposure: Sunlight is a primary source of vitamin D synthesis in the body. Insufficient exposure to sunlight, particularly in regions with limited sunshine or cultural practices that restrict outdoor activities, can lead to vitamin D deficiency and subsequently, rickets.

• Nutritional Deficiencies: Poor dietary intake of vitamin D, calcium, or phosphate-rich foods can contribute to the development of rickets. This may occur in cases where children have limited access to a balanced diet or consume a diet lacking in these essential nutrients.

• Malabsorption Disorders: Certain medical conditions, such as celiac disease, cystic fibrosis, or inflammatory bowel disease, can impair the absorption of nutrients, including vitamin D, calcium, and phosphate. Chronic malabsorption can increase the risk of rickets.

The lack of nutrients leads to rickets

1. Children lack calcium

Calcium is an essential mineral for the development and growth of children. Calcium not only helps support the formation and protection of bones and teeth of children, but also participates in the operation of nerve and muscle cells, supports the function of the heart, helps eliminate toxins. , and supports the child's immune system.

Children need a daily amount of calcium to help their bones and teeth grow and stay healthy. If children don't get enough calcium, they can experience problems like growth retardation, increased risk of bone injuries, malnutrition, and anemia.

2. Vitamin D deficiency

Vitamin D is an important vitamin for the development of bones and teeth, helping the body absorb calcium and phosphorus. Therefore, children with vitamin D deficiency may have delayed growth in height and body size, and have a higher risk of osteoporosis or rickets.

In addition, vitamin D also has an effect on the immune system of children, helping to prevent diseases related to the immune system such as colds, respiratory infections, meningitis, celiac disease, malnutrition. and some cancers.

3. Lack of phosphate

Phosphates are compounds in the salt form of phosphorus (phosphorus). This is an essential element, plays an important role in the formation of bones and teeth, and is also involved in metabolism and energy metabolism in the body.

When children do not get enough phosphorus, children can experience health problems, including delayed bone and tooth development, malnutrition, and immune factors.

4. Vitamin K2 Deficiency

Vitamin K2 helps the body absorb and use calcium effectively to support the development and protect the bones and teeth in children. Specifically, during bone formation, the body will produce a hormone called osteocalcin to help strengthen bones, but this hormone only works effectively when the body has enough K2. Therefore, when vitamin K2 deficiency, children will be at high risk of bone and joint diseases such as rickets, growth retardation, stunted growth, etc.

Moreover, vitamin K2 also helps prevent and treat oral mucosal ulcers, heal wounds and strengthen the immune system for children.

5. Magnesium deficiency

Magnesium not only provides energy for cells, maintains the functions of the nervous system, but also participates in the process of building and developing the skeletal system. Specifically, magnesium helps the child's body build bone tissue cells, increase bone mineral density, and prevent osteoporosis. Therefore, when children lack magnesium, they will be at high risk of bone and joint diseases such as rickets, arthritis, etc.

6. Zinc deficiency

Similar to calcium, zinc plays an important part in bone structure, helping to keep bones strong. Therefore, zinc deficiency is also one of the causes of rickets in children.

Symptoms of Rickets

The signs and symptoms of rickets can vary, but they primarily affect the skeletal system. Some common symptoms include:

• Delayed Growth: Children with rickets may experience slower growth rates and shorter stature compared to their peers.

• Bone Pain: Weak and soft bones can cause bone pain, tenderness, and muscle weakness. Children may have difficulty walking or exhibit a waddling gait.

• Skeletal Deformities: Rickets can lead to skeletal deformities, including bowed legs, a protruding breastbone (pectus carinatum), or a flattened skull shape (craniosynostosis).

• Dental Problems: Vitamin D deficiency can affect dental health, leading to delayed tooth eruption, dental cavities, and weakened tooth enamel.

Diagnosis and Treatment

If rickets is suspected, a thorough medical evaluation and diagnostic tests are necessary. Blood tests can assess levels of vitamin D, calcium, phosphate, and other relevant markers. X-rays may be performed to evaluate bone abnormalities.

The treatment of rickets focuses on addressing the underlying nutrient deficiency and promoting bone health. It typically includes:

• Vitamin D Supplementation: The administration of vitamin D supplements is the primary treatment for rickets caused by vitamin D deficiency. The dosage and duration of supplementation depend on the severity of the deficiency and the child's age.

• Calcium and Phosphate Supplementation: In some cases, calcium and phosphate supplements may also be prescribed to correct imbalances and support bone mineralization.

• Dietary Modifications: Encouraging a balanced diet rich in vitamin D, calcium, and phosphate sources is crucial for preventing rickets. Foods such as fatty fish, fortified dairy products, egg yolks, and leafy greens can help meet the nutritional requirements.

• Sunlight Exposure: Adequate exposure to sunlight, especially during safe hours and with appropriate sun protection measures, helps the body synthesize vitamin D naturally.

Prevention

Preventing rickets involves ensuring sufficient intake of vitamin D, calcium, and phosphate through a well-rounded diet and appropriate sun exposure. Regular pediatric check-ups, especially in high-risk populations, can help identify and address any potential deficiencies early on.

Conclusion

Rickets is a preventable condition that primarily affects children due to vitamin D, calcium, or phosphate deficiencies. Recognizing the symptoms and promptly seeking medical attention is crucial for diagnosis and initiating appropriate treatment. 

With proper management, including supplementation, dietary modifications, and adequate sunlight exposure, the prognosis for children with rickets is generally favorable, allowing for optimal bone health and development.