Disease of infancy and childhood characterized by defective bone growth due to lack of vitamin D. Calcium phosphate is not properly deposited in the bones, which become soft, curved, and stunted. Early symptoms include restlessness, profuse sweating, lack of limb and abdominal-muscle tone, soft skull bones, and developmental delays. Muscles may cramp and twitch. Without early treatment, effects may include bowlegs, knock-knees, and beadiness where the ribs meet the breastbone. A narrow chest and pelvis can later increase susceptibility to lung diseases and impede childbirth. Treatment is with high-dose vitamin D supplementation, sunlight, and a balanced diet. Adding vitamin D to milk has reduced rickets in high-latitude areas where the skin cannot produce enough.
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Those at higher risk for developing rickets include:
Individuals with red hair have been speculated to have a decreased risk for rickets due to their greater production of vitamin D in sunlight.
Signs and symptoms of rickets include:
An X-ray or radiograph of an advanced sufferer from rickets tends to present in a classic way: bow legs (outward curve of long bone of the legs) and a deformed chest. Changes in the skull also occur causing a distinctive "square headed" appearance. These deformities persist into adult life if not treated.
Long-term consequences include permanent bends or disfiguration of the long bones, and a curved back.
The treatment and prevention of rickets is known as antirachitic.
Treatment involves increasing dietary intake of calcium, phosphates and vitamin D. Exposure to ultraviolet light (sunshine), cod liver oil, halibut-liver oil, and viosterol are all sources of vitamin D.
A sufficient amount of ultraviolet in sunlight each day and adequate supplies of calcium and phosphorus in the diet can prevent rickets. Darker-skinned babies need to be exposed longer to the ultraviolet rays. The replacement of vitamin D has been proven to correct rickets using these methods of ultraviolet light therapy and medicine.
Recommendations are for 200 international units (IU) of vitamin D a day for infants and children. Children who do not get adequate amounts of vitamin D are at increased risk of rickets. Vitamin D is essential for allowing the body to uptake calcium for use in proper bone calcification and maintenance.
According to the American Academy of Pediatrics (AAP), infants who are breast-fed may not get enough vitamin D from breast milk alone. For this reason, the AAP recommends that infants who are exclusively breast-fed receive daily supplements of vitamin D from age 2 months until they start drinking at least 17 ounces of vitamin D-fortified milk or formula a day. This requirement for supplemental vitamin D is not a defect in the evolution of human breastmilk but is instead a result of the modern-day infant's decreased exposure to sunlight.