Rickets

Fortunately, most cases of rickets can be corrected through proper nutritional support. Increasing vitamin D and calcium intake, either through diet or supplements, usually improves bone health and corrects deficiencies. If rickets is caused by an underlying medical issue, such as a genetic condition, doctors may recommend additional treatments, medications, or even corrective surgery to manage bone deformities.

What is Rickets?

Rickets is a disease that affects bone development in children, making bones soft, weak, and prone to fractures or deformities. According to the World Health Organization (WHO), rickets mainly results from prolonged vitamin D deficiency. Without enough vitamin D, the body struggles to maintain proper calcium and phosphate levels, both essential for strong bones.

The disease can lead to bowed legs, delayed growth, and, in severe cases, skeletal abnormalities. Although rare in developed countries due to fortified foods, it still poses a significant health challenge in regions with poor nutrition or limited access to healthcare.

Causes & Risk Factors

1. Vitamin D Deficiency (Nutritional Rickets)

The most common cause of rickets is a deficiency of vitamin D, known as nutritional rickets. Vitamin D plays a crucial role in helping the body absorb calcium and phosphorus, minerals vital for building and maintaining strong bones. When children don’t get enough vitamin D, their bones can become soft, weak, and prone to deformity.

Several factors can lead to vitamin D deficiency in children, such as:

• Limited intake of vitamin D-rich foods.
• Being lactose intolerant.
• Following a vegetarian or vegan diets that exclude animal-based vitamin D sources.
• Exclusive breastfeeding without vitamin D supplementation.
• Health conditions that impair nutrient absorption, such as celiac disease, Crohn’s disease, or ulcerative colitis.
• Insufficient sun exposure, which reduces the body’s natural vitamin D production.
• Diets low in calcium further weaken bones.

2. Genetic Causes

Although rare, some inherited disorders can cause rickets. These genetic conditions affect how the body processes or absorb vitamin D or phosphorus. Some genetic mutations interfere with vitamin D metabolism, while others impact the proteins that help transport or activate these essential nutrients, leading to bone problems even with adequate vitamin D intake.

3. Underlying Health Conditions

Certain medical conditions can also contribute to rickets. Children with chronic diseases affecting the liver, kidneys, intestines, or lungs may struggle to absorb or process vitamin D and phosphorus efficiently. These underlying conditions can lead to secondary rickets, where bone health deteriorates due to poor nutrient absorption despite a reasonably good diet.

Risk Factors

Some children are more likely to develop rickets due to their age, diet, or environment. Common risk factors include:

• Exclusively Breastfed Babies (Especially Beyond 6 Months): Breast milk alone may not provide enough vitamin D. Babies who are only breastfed should receive vitamin D supplements to support healthy bone development.
• Infants and Toddlers Aged 6 to 24 Months: Young children are at a higher risk of rickets since their bones are rapidly growing during this stage, making adequate vitamin D and calcium intake crucial.
• Premature Babies: Babies born before full term may have lower vitamin D stores since they miss out on the important vitamin D buildup that happens during the final stages of pregnancy.
• Children with Darker Skin Tones: Darker skin reduces the skin’s ability to produce vitamin D from sunlight. These children may need more sun exposure or supplements to maintain healthy vitamin D levels.
• Children with Limited Sun Exposure: Kids who spend little time outdoors or live in areas with less sunlight are at risk. Sunlight through windows doesn’t provide enough UVB rays, so direct outdoor sunlight is important for natural vitamin D production.

Signs & Symptoms of Rickets

Children with rickets may show various signs depending on severity. Early identification is crucial.

• Delayed growth and short stature
• Bowed or bent legs
• Thickened wrists and ankles
• Dental issues like delayed tooth eruption
• Muscle weakness
• Skeletal deformities (knock knees, pigeon chest)
• Frequent bone pain or tenderness
• Seizures in severe cases (due to low calcium levels).
• Swelling at the ends of the ribs (known as the “rachitic rosary”).

Complications if Left Untreated

Untreated rickets can cause:

• Permanent bone deformities
• Stunted growth
• Dental problems
• Increased risk of fractures
• Muscle weakness persisting into adulthood

Early medical attention prevents long-term disability.

How is Rickets Diagnosed

• X-rays: Reveal bone softening and abnormalities.
• Blood Tests: Assess calcium, phosphate, alkaline phosphatase, and vitamin D levels.
• Genetic Testing: In hereditary cases.

Treatment Options for Rickets

1. Nutritional Supplementation

• Vitamin D Supplements (oral or injectable)
• Calcium Supplements
• Phosphate Supplements in hereditary rickets

2. Dietary Modifications

Adding vitamin D and calcium-rich foods like dairy, fish, and eggs.

3. Sunlight Exposure

Safe, controlled exposure to morning sunlight enhances vitamin D synthesis.

4. Corrective Surgery

Rarely, severe bone deformities may need orthopaedic intervention.

At Apex Hospitals, treatment plans are tailored by expert paediatricians and endocrinologists based on each child’s individual needs.

Prevention & Risk Reduction Strategies

• Prenatal vitamin D supplementation during pregnancy
• Routine vitamin D drops for exclusively breastfed infants after birth
• Balanced diet rich in dairy, fish, and green vegetables
• Safe outdoor playtime for adequate sun exposure
• Screening for vitamin D deficiency in high-risk children

Why Choose Apex Hospitals for Rickets Care

• NABH-accredited diagnostic and treatment facilities
• On-site X-ray, DEXA scan, and paediatric orthopaedic specialists
• Customized care plans under paediatric endocrinology experts
• 24/7 paediatric emergency services

At Apex Hospitals, we combine expert care with compassionate support to help your child lead a healthier, happier life.

When to Seek Immediate Medical Help

If your child shows bowed legs, unexplained muscle weakness, or delayed milestones, consult a paediatrician immediately. Book an appointment with our paediatric specialist at Apex Hospitals.

Expert Opinions

Rickets is entirely preventable with early detection, proper nutrition, and regular sunlight exposure. Timely intervention prevents lifelong disabilities.” — Dr. Sanjiv Hooja, Senior Consultant – Paediatrics and Child Care

According to the American Academy of Paediatrics (AAP) and World Health Organization (WHO), vitamin D supplementation and balanced nutrition remain the most effective preventive strategies against rickets.

Rickets is a preventable and treatable bone disorder affecting children, primarily caused by vitamin D, calcium, or phosphate deficiency. With early detection and timely care, children can recover fully without lasting effects. At Apex Hospitals, we offer comprehensive, evidence-based care with advanced diagnostics, personalized treatments, and dedicated paediatric experts.