Rickets in infants: symptoms, signs and how to treat

Causes of the disease

Vitamin D enters the baby’s body in two ways:

1. It is synthesized in the skin under the influence of sunlight (ultraviolet radiation). Further biotransformation takes place in the liver and kidneys.
2. With food. In this regard, artificial formula is more nutritious than breastfeeding.

Lack of sunlight and poor nutrition (including mothers) are the main reasons for the development of rickets in infants.

The following factors may increase the risk of developing the disease:

• not getting enough sunbathing;
• high birth weight;
• prematurity;
• refusal of breastfeeding and use of unbalanced formulas;
• rapid weight gain;
• digestive disorders;
• congenital diseases of the liver, kidneys, and endocrine system;
• taking anticonvulsants;
• low physical activity;
• hereditary metabolic disorders.

Reasons for the development of rickets in children

The leading factors in the development of calcium-phosphorus deficiency in young children are:

• Prematurity of the baby (premature birth), since it is in the last trimester of pregnancy that the supply of these minerals to the fetus is most intense;

• Feeding errors caused by phosphorus-calcium deficiency. It is not without reason that it has been noted that the cause of rickets in children is the great need for mineral components of the growing body;

• Kidney pathologies, diseases of the bone and gastrointestinal tract systems, causing disturbances in the transport of essential minerals;

• Increased contamination of the body with lead, strontium and chromium, which have a destructive effect on the bone structure;

• Genetic inheritance in 80% of cases determines the factor of variability (variability) of bone tissue density;

• Almost all endocrine pathologies contribute to the development of structural disorders of bone tissue (osteopenic conditions);

• The consequences of vitamin D deficiency in the body, with rickets, subsequently manifest as a negative effect on the ontogenesis (individual development) of children, impaired immune function, provoking the infant form of D-deficient rickets.

Clinical manifestations

Due to insufficient mineral metabolism, the development of bone tissue is disrupted. In addition, other systems also suffer: nervous, endocrine, muscular, etc.

Pathology has stages, its manifestations can vary greatly in intensity.

Stages of rickets in infants:

• initial stage;
• height;
• recovery (convalescence);
• residual effects.

The severity of rickets is determined by the severity of symptoms.

It is important to recognize rickets when the first symptoms appear. These include:

• thickenings on the ribs at the transition points between bone tissue and cartilaginous tissue - “rachitic rosary” (see photo);
• increased sweating;
• the baby is restless, there may be twitching of legs and arms during sleep;
• the edges of the large and small fontanelles soften;
• sweat and urine acquire a peculiar sourish odor.

The very first manifestations may occur at 2–3 months of life.

Damage to the skeletal system

The specificity of rickets is such that the bone apparatus undergoes the greatest changes. Even if there is a sufficient amount of calcium and phosphorus in the diet, if there is a lack of vitamin D, they will not be absorbed normally.

Damage to the skeletal system is manifested in the following:

• the edges of the fontanel and the sutures of the bones of the skull soften;
• the shape of the skull changes, it is sloping in the occipital region;
• the frontal and parietal regions protrude;
• fontanelles do not close for a long time;
• deformation of the chest is noted: “cobbler’s chest” - depression in the lower part of the sternum or “keeled (chicken)” chest - protrusion of the sternum;
• bone growths—“rosary beads”—appear on the ribs;
• rachitic kyphosis (curvature of the spine) develops;
• on the legs and hands, thickenings appear on the epiphyses of long bones - “rachitic bracelets”, on the phalanges of the fingers - “strings of pearls”;

If you ignore the problem and do not treat rickets, the symptoms will increase. There is a change in the pelvic bones, it flattens and decreases in size. The bones of the legs are curved in an O-shape or X-shape. Flat feet appear.

Teeth appear late, they are susceptible to caries, and the bite is disturbed.

Defeat of other systems

Calcium deficiency inevitably affects other systems of the baby.

The muscles and central nervous system suffer the most.

The muscles become flabby and lose tone. The tendons are not strong, the joints become loose. When a child sits down, he prefers to cross his legs and support his torso with his arms. The rectus abdominis muscles are hypotonic, can diverge, and a characteristic “frog belly” appears.

Neurological changes affect almost everything. Behavior changes, tearfulness and anxiety increase. Sweating of the skin increases, especially at the point of contact of the scalp with the pillow. Increased skin sensitivity (hyperesthesia). The baby begins to cry and be capricious when touched, although this has not been noticed before.

Doctor's advice

Walking is very important for a baby, especially under the age of one year. 20 minutes of exposure to the sun (not at noon, so as not to get sunburned, but in the morning or evening) will significantly increase the level of vitamin D. You must remember that the sun's rays penetrate through fabrics, clothes, and clouds, so you should not expose your child to the scorching sun for a long time, It is enough for him to sleep in the stroller outside even in cloudy weather.

Victoria Druzhikina Neurologist, Therapist

Deep progression of the pathology leads to general lethargy, lethargy, and apathy. Conditioned reflexes are poorly formed in sick children.

What is rickets?

The term rickets in infants defines a metabolic disorder that characterizes changes in the metabolism of calcium and phosphorus salts that develop against the background of a deficiency of vitamin D and its active metabolites. Disturbances primarily affect the functional changes of the nervous and musculoskeletal systems. In general, the pathogenesis (development mechanism) of metabolic pathology includes several links:

• A decrease in the concentration of vitamin D in the child’s body, the active metabolite of which is the main regulator of the exchange of mineral salts of calcium and phosphorus in the body. It determines the activity of absorption, assimilation by tissues, and excretion.
• Reducing the concentration of calcium and phosphorus ions in the body, reducing their entry into tissues.
• Violation of the functional state of the nervous system, as well as the bone structures of the musculoskeletal system, associated with an insufficient supply of ions of mineral salts.

Functional changes in the nervous system develop first and are reversible. Insufficient intake of mineral salts into bone tissue leads to a decrease in its strength (softening due to insufficient mineralization), the formation of growths of various localizations, and changes in the shape of bones, which are irreversible. With severe deformities of the spine and chest, compression of the internal organs occurs with corresponding disturbances in their condition.

Diagnostics

An accurate diagnosis can only be made using laboratory tests:

1. Biochemical analysis of blood and urine will help determine the content of phosphorus, calcium and alkaline phosphatase.
2. Urinalysis - Sulkovich's test shows the amount of calcium excreted from the body.
3. Diagnostic radiography and bone ultrasound may be prescribed.

Interpretation of test results allows you to accurately determine the cause and source of negative phenomena.

If you suspect rickets in your baby, be sure to consult a pediatrician. Some residual effects of the disease may remain with the child for life.

Traditional methods of treating rickets in children

Traditional medicine recommendations on how to treat rickets in a child can only be used as an addition to the main therapy prescribed by the pediatrician:

• take the child a decoction of the herb trifid; Preparation of the decoction: pour 1 tablespoon of dry herb with a glass of water, boil over low heat for no more than 15 minutes, then, wrapped in a towel, leave for 3-4 hours, strain; take 1 tablespoon 3 times a day;

• take equal quantities of white cabbage, carrots and beets, boil for about half an hour; infants take the decoction several times a day;

• take your child an infusion of walnut leaves; preparing the infusion: place 1 tablespoon of dry, crushed leaves in a preheated container, pour a glass of boiling water and, wrap it up, leave for about an hour, strain; take 1 teaspoon 3 times a day before meals;

• give the child general warm baths with a decoction of oat straw added to the bath water; preparing the decoction: cut 1 kg of dry straw into smaller pieces and add a bucket of water, boil for at least half an hour, strain, pour the resulting decoction into the bath;

• give the child general warm baths with an infusion of pine needles added to the bath water; preparing the infusion: pour 50-100 g of dry pine needles into a bucket of water and leave for at least 8 hours, then strain and add to bath water; alternate with baths with the addition of other products;

• a child of the first year of life regularly takes general warm baths with the addition of a decoction prepared from the following mixture of plant materials: Scots pine needles - 1 part, hay dust - 1 part, oat straw - 1 part, walnut leaves - 1 part, rhizomes with calamus roots - 1 part; preparation of the decoction: 200-300 g of the dried mixture, crushed to a powder, pour 1-2 liters of boiling water and heat in a boiling water bath for at least 15 minutes, then leave the product in a sealed container at room temperature for about half an hour, strain through 1-2 layers of gauze, squeeze out the remaining raw materials, pour the finished broth into bath water, stir; take the procedure at a water temperature of 36-37.5 ° C; Duration of the procedure: no more than 8 minutes; You can add table (iodized) salt to the water for a full bath with a decoction of this mixture in the amount of 50-80 g per 10 liters of water.

Treatment

There are two therapeutic approaches: specific treatment and nonspecific. The ideal option is their combination – complex treatment:

• balanced diet;
• walk outdoors;
• gymnastics, massage, water treatments;
• symptomatic treatment of other diseases;
• prescribing medications containing vitamin D and calcium.

It happens that rickets appears for other reasons not related to calcium and vitamins. For example, in case of impaired absorption of calcium in the gastrointestinal tract, pathology of the parathyroid glands or pituitary gland. These forms of rickets are much more difficult to treat.

Preventive measures

Prevention of rickets in an infant should begin in the last months of pregnancy and should only be carried out under the supervision of a specialist.

A pregnant woman needs to eat well, walk in nature, and take vitamins in recommended doses.

It is important for the baby to provide rational feeding, going for walks, exercise and massage.

All children under three years of age are prescribed vitamin D in prophylactic doses depending on age, type of feeding and region of residence.

Victoria Druzhikina

Neurologist, Therapist

For information on the symptoms and treatment of rickets in infants, watch the video “Doctor Komarovsky’s School”:

This article has been verified by a current qualified physician, Victoria Druzhikina, and can be considered a reliable source of information for site users.

Bibliography

1. https://sevgb6.ru/doc/klinicheskie-rekomendacii/raxit.pdf
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