Rickets is a development disorder found in children and infants who are deficient in vitamin D. Babies and children who do not get the daily recommended amount of vitamin D will begin to show signs of abnormal growth in their bones and teeth. Vitamin D is crucial for the development of bones and teeth as it helps maintain normal amounts of calcium and phosphorus in the blood as well as an aid in the absorption of calcium in the body. With out vitamin D, calcium cannot be used properly by the body which leads to deformities caused by soft and brittle developing bones.
Characteristics of children and babies with rickets are tenderness and pain in the bones of the arms, legs, pelvis and spine. Teeth develop at a much slower rate and are weak and more prone to cavities. Children with rickets long term will be shorter in stature, bow legged, and will have an increased rate of bone fractures. Other signs of rickets include muscle cramps, odd-shaped skull, protruding sternum, and scoliosis of the spine.
Diagnosis of rickets is primarily performed with a physical to determine the level of tenderness and pain of the bones. X-rays as well as blood tests used to check the levels of calcium may also be used to aid in the diagnosis.
Although often thought of as a problem in developing nations, cases of rickets are still being found and documented in developed nations such as the United States. Humans obtain vitamin D in two ways: from specific foods such as eggs and milk and from sunlight exposure. Lack of vitamin D in children living in the United States can be attributed to children spending more time indoors and less time playing outside. While the intentions of getting less exposure from UV rays are good, UV rays, specifically UVB rays, are what the body needs in order to create vitamin D. Other cases of rickets are found in babies that are exclusively fed breast milk. This information seems very contradictory as the push for babies fed with breast milk only has become a mainstream ideal that many new mothers have embraced. According to the American Academy of Pediatrics, children and infants should receive a minimum of 400 micro units of supplemental vitamin D a day to prevent rickets. This means that babies can still be breastfed, just as long as they are receiving the recommended amount of supplemental vitamin D.
In most cases, rickets can be successfully treated with increased dietary amounts of vitamin D, calcium, and phosphorus. The recommended amount of UVB exposure is undetermined but studies have shown that 10-15 minutes a day of exposure to natural light will increase the amount of vitamin D produced in the skin over a 24 hour period. Factors such as pigments in the skin, body mass, time of year, and longitude all will effect how much vitamin D is synthesized therefore making this method an unreliable source for the daily recommendation. Food sources of vitamin D include eggs, fortified milk, fish, and cod liver oil. Supplements in the form of vitamin tablets may also be consumed as long as the daily recommended amount of 400 micro units is reached.
In children and infants with mild or early stages of rickets, all symptoms will dissapear after in a relatively short amount of time (1-2 weeks). Children who have suffered with rickets for longer periods of time will have irreversable damage to their bones and spine and may need corrective surgery. Those with stunted height, unfortunately, will not reach their potential height.
Although not called rickets, adults may also become deficient in vitamin D. Most adults spend 90% or more of their day indoors and the only time they may go outside is to go to and from the car. Sunscreens and sunblocks are being used more commonly which also block out UV rays, further preventing the skin from synthesizing vitamin D.
Deficiencies in vitamin D may be more common in industrialized nations than what most had believed. With increased awareness of how deficiencies of vitamin D affect the bodies of both children and adults, this trend could be reversed.
References:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001384/
http://aappolicy.aappublications.org/cgi/content/full/pediatrics;122/5/1142#T1
http://www.mayoclinic.com/health/vitamin-d/NS_patient-vitamind
