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Vitamin D Deficient Rickets, The rachitic rosary
Good health is often a balancing act. Too much sun exposure can cause unwanted sunburn in babies, but too little sun exposure can lead to vitamin D deficient rickets.
Breast milk does not necessarily contain much vitamin D. Neither does cow’s milk, nor most baby foods. Theoretically, mothers and babies can produce their own when their skin is exposed to sunlight. However, the optimal amount of sunlight for each baby is different and difficult to determine. Exposure to direct sunlight in young babies also carries the potential increased risk for burns and eventual development of skin cancer.
Babies who do not get enough or produce enough vitamin D can develop rickets, the failure of developing bones to form properly. In the absence of adequate amounts of vitamin D, the body steals calcium from the bones to keep the blood levels of calcium high enough for life.
In rickets, the bones do not form properly. Often the first noticeable instance of this is the thin, pliable skull. Pressing on it can feel like pressing on a ping-pong ball. The head shape may be abnormal.
Teething may be delayed and the teeth may be poorly formed. Severe cavities are common.
The wrists and ankles may appear swollen. The tips of the rib bones can enlarge creating a string of lumps called the rachitic rosary. Bowed legs, knock-knees, or fractures are common.
Kids with rickets tend to sweat more than average.
No
Rickets lasts until treated.
Rickets is suspected by the history and the physical examination. The diagnosis is confirmed by lab tests and x-rays.
For children with nutritional rickets, giving vitamin D will begin reversing the problem.
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