Rickets in children is primarily caused by a deficiency in vitamin D, calcium, or phosphate, which are essential for healthy bone development. When these nutrients are lacking, the bones cannot mineralize properly, leading to soft, weak bones that are prone to deformities and fractures. Vitamin D plays a crucial role because it helps the body absorb calcium and phosphate from the diet. Without enough vitamin D, even if calcium and phosphate are present, the body cannot use them effectively to build strong bones.
The most common cause of rickets is **vitamin D deficiency**, which can happen for several reasons. One major factor is insufficient exposure to sunlight, as the skin produces vitamin D when exposed to ultraviolet rays from the sun. Children who spend little time outdoors, live in areas with limited sunlight, or consistently use sunscreen that blocks UV rays may not produce enough vitamin D naturally. Additionally, babies who are exclusively breastfed without vitamin D supplementation can be at risk because breast milk typically contains low levels of vitamin D.
Another cause is **nutritional deficiency** of calcium or phosphate. Even if vitamin D levels are adequate, a diet lacking in calcium-rich foods like milk, cheese, and leafy green vegetables can lead to rickets. Similarly, phosphate deficiency, although less common, can also impair bone mineralization.
Certain medical conditions can also cause rickets by interfering with the body’s ability to absorb or process these nutrients. For example, disorders affecting the kidneys or liver can disrupt vitamin D metabolism. Some genetic forms of rickets affect how the kidneys handle phosphate, leading to low phosphate levels in the blood despite adequate intake.
The symptoms of rickets develop gradually and can vary in severity. Common signs include bone pain or tenderness, especially in the legs, spine, and pelvis. Children may show delayed growth, appearing shorter or smaller than their peers. Skeletal deformities such as bowed legs, thickened wrists and ankles, or a curved spine are typical physical manifestations. Dental problems like delayed tooth eruption or increased cavities can also occur. Muscle weakness is another symptom, which may cause difficulty standing or walking and general fatigue.
Treatment focuses on correcting the underlying deficiencies. Vitamin D and calcium supplements are the primary therapies, helping to restore proper bone mineralization and strength. In cases where sunlight exposure is limited, encouraging safe daily sun exposure for about 15 to 30 minutes can boost natural vitamin D production. Improving nutrition by including vitamin D and calcium-rich foods supports recovery and prevention. For children with underlying medical conditions affecting mineral metabolism, specialized medications such as phosphate supplements or active forms of vitamin D may be necessary. In severe cases with significant bone deformities, surgical intervention might be required to realign bones.
Preventing rickets involves ensuring adequate vitamin D and calcium intake through diet, supplementation when necessary, and regular, safe exposure to sunlight. Awareness of risk factors like limited sun exposure, exclusive breastfeeding without supplementation, and poor nutrition is important for early intervention and avoiding long-term complications.
