Dietary Considerations and Rickets

Since rickets is a nutritional disease related to a deficiency of vitamin D, it is important for a person who has rickets to eat foods rich in vitamin D. Foods that contain high amounts of vitamin D include fatty fish, cheese, egg yolks, and other foods fortified with vitamin D. Nowadays, these can include cereal, some dairy products, orange juice, or soy milk.

Image Source

 It is also recommended that the diet includes the contribution of other vitamins and minerals, such as vitamin C.  These foods can include bell peppers, leafy greens, and other vegetables. Fruits such as kiwis, papayas, and berries also contain high amounts of vitamin C.

Avoiding foods that are high in white sugar is often advised because these foods hold very little benefits, and definitely are not high in vitamin D or C.

Consuming enough vitamin D while pregnant can also be crucial in ensuring that your child will not develop rickets later in life. Make sure to eat a diet rich in vegetables that have not been overcooked, which can cause them to lose some of their nutritional properties. After the baby is born, make sure to include a vitamin D supplement in addition to breast milk. Breast milk on its own does not include the necessary 400 IU of vitamin D that a baby needs daily.

Of course, overall, follow the diet regiment that is advised by a medical professional.

For more information please read

http://en.biomanantial.com/rickets-children-diet-and-treatment-for-its-cure-and-prevention-a-2419-en.html

Rickets Treatment

            Most cases of nutritional rickets are caused by vitamin D and calcium deficiency. So, it’s logical that the treatment for is rickets is to increase a child’s daily intake of vitamin D and calcium. The levels of these nutrients can be increased by including more vitamin D and calcium rich foods in the child’s diet, or having the child take a supplement. Foods that are good sources of vitamin D include fatty fish such as tuna, mackerel, or salmon, cheese, egg yolks, and some types of mushrooms. Additionally, many foods are fortified with vitamin D nowadays, like cereal, milk, or even orange juice. Increasing the amount of these foods in a child's diet will help to lessen and eventually eliminate symptoms of rickets. 

Exposure to sunlight increases vitamin D levels as well, so you may be advised to have your child spend more time outside.

More specifically, treatment for rickets can either be treated over several months or in a single-day dose. If the first method is chosen, a certain amount of vitamin D is given to the child over a course of a few months. The second method is divided into 4 to 6 oral doses in one day.

Image Source

It’s important to see a doctor to be treated for rickets. They will know how much vitamin D and calcium that your child will need. Too much vitamin D can lead to hypercalcemia (too much calcium in the blood), which can cause nausea, vomiting, and poor appetite. Frequent urination, kidney problems, and weakness may also result from too much vitamin D.

          If severe deformities have occurred because of rickets, orthopedic correction may be required. Correction will normally occur as the child grows, and the symptoms of rickets will disappear. However, if a child goes too long without being treated, lifelong consequences may result. These include spinal deformities and a shorter stature. Thankfully, rickets is easy to identify and cure. Treatment has a very high success rate. 

For more information, please read:

http://emedicine.medscape.com/article/985510-treatment

or

http://www.nhs.uk/Conditions/Rickets/Pages/Treatment.aspx

Signs and Symptoms of Rickets

Rickets manifests in several different ways. A baby might seem “floppy”, or floppier than normal. A child may complain of bone tenderness or pain, or they may be resistant to walking or tire easily. Bones affected by rickets break easily, so if a child breaks a lot of bones that could be a sign of rickets. Rachitic rosary, the enlarged ends of ribs that appear beadlike, and Harrizon’s groove, a horizontal line that is seen where the diaphragm attaches to the ribs, and also signs of rickets.

In this image, both rachitic rosary and Harrizon's groove are visible. The bead-like bumps on the baby's chest is rachitic rosary, and the line on his abdomen in Harrizon's groove.

Image Source

Additionally, hypocalcemia, or low blood calcium levels, can indicate rickets. If the calcium levels are low enough, it may cause muscle cramps, twitching, tingling, or even seizures (though this is rare).  A parent might notice soft spots in a child’s skull that otherwise shouldn’t be there. A child’s wrists and ankles may begin to widen, or there may be other spinal, pelvic, or cranial deformities. The height and weight of a child can also be affected by rickets, the child will be shorter and lighter. Muscle weakness may be a sign of rickets as well. Due to the poor absorption of calcium, dental deformities or delayed dental growth may appear. The enamel on the teeth will be weak, so there is an increased risk for cavities. As I’ve mentioned before, a protruding breast bone, or pigeon chest, and bowed legs are some of the most well-known rickets symptoms. Rickets symptoms and signs are mainly physical, making it fairly easy to identify the need for medical help.

For more information please read http://www.medicalnewstoday.com/articles/176941.php or http://www.medicinenet.com/rickets/page3.htm#what_are_rickets_symptoms_and_signs

Rickets Pathophysiology

Rickets is a disease that directly results from a lack of Vitamin D and the improper mineral absorption that comes from response to that. If not enough Vitamin D is ingested, calcium and phosphorus cannot be absorbed. These minerals are crucial in the formation and maintenance of healthy and strong bones. Low Vitamin D levels leads to low calcium absorption in the intestines. In order to make up for this, the body will increase levels of Parathyroid Hormone (or PTH) which signals the body to increase levels of calcium. The body will them begin to reabsorb calcium from its own bones.  A disruption in the homeostasis (or equilibrium) of calcium and phosphorus causes poor calcification (or accumulation of calcium) of the cartilage in growing long bones such as the femur. This is what contributes to the bowing of the legs. The bones are weaker and less dense because not enough calcium has been brought together. Thus, it is more likely for the bones to bend.  

These legs are affected by rickets, and display bowed legs.

Image source

Additionally, rickets can cause the widening of wrist or the splaying of bones. The bones may be widening in attempt to compensate in size for what they lack in strength. This doesn’t do much to help however, bone stability is not enhanced.

For more information, please read:

http://emedicine.medscape.com/article/985510-overview#a5
                                   or
http://www.uptodate.com/contents/overview-of-rickets-in-children