As a rule, very healthy children are very few. One of the most commonly diagnosed diseases in children under one year of age is rickets. What is rickets? Why is it dangerous and why does it appear? How to treat it and what kind of prophylaxis is carried out in order to avoid this ailment? Everything in detail in this article.
What is this disease?
At the word "rickets" everyone imagines a child with a convex tummy, thin and weakened arms and legs. But the clinical picture can be much broader.
Rickets is not a disease of any particular organ, it is a complex metabolic disorder associated with a lack of nutrients.
You can talk about rickets when identifying a deficiency of vitamin D, which is the basis of calcium-phosphorus metabolism. It is this vitamin that is responsible for the correct formation of the child’s bone and muscle systems.
At what age is the disease diagnosed?
It is difficult to diagnose rickets in a month-old baby. The first signs of the disease begin to appear at the age of 1-2 months, and a detailed picture appears only by 3-6 months.
Usually children under 2 years old are affected. The development of rickets in older children is an extremely rare occurrence. If the child has not been diagnosed with the disease before this time, then you can not worry.
Rickets are susceptible to babies of all countries. Especially often the disease occurs in a population that lives in the northern regions. Lack of sunlight and a minimum amount of healthy fresh vegetables, fruits and herbs are comrades of rickets.
What is dangerous rickets?
Mass prophylaxis of the disease is currently underway, but it is still relevant as before. For life, rickets is not dangerous, but it carries a number of unpleasant moments, among which:
- violation of physical development;
- weakened immunity;
- hypoxia.
The disease itself is not as dangerous as its consequences. For example, girls may develop a flat-plank pelvis, which in the future will complicate the course of childbirth or even become an obstacle to natural delivery.
Children with rickets in the later stages noticeably slower develop both physically and mentally, which does not allow many kids to fully attend educational and developmental institutions.
Rickets distorts the structure of bones. The skull and spine noticeably suffer.
Reasons for the development of rickets
The disease appears for many reasons, among which are not only internal but also external.
Children develop rickets due to the lifestyle of a pregnant woman. If she does not get enough vitamins, has bad habits, does not appear much in the air and the sun - all this can become the causes of the disease in the future baby.
During pregnancy, it is recommended to maximize focus on foods rich in calcium.
Preterm birth can provoke rickets in children, since babies get the maximum calcium in the last month of gestation.
The birth of a child in the cold season, when there is little natural UV, is also the cause of the disease.
An early metabolism of the baby into mixtures, insufficient or excessive food intake can distort the body's metabolism. Do not feed your baby food, do not feed him on time. It is necessary to put the child to the chest at his request, and do not take it until he is full.
The cause of rickets can be a congenital metabolic disorder. A thyroid disease can provoke the development of rickets.
Rickets in children and sunlight
Human skin is able to synthesize vitamin D, which, as we have said, is responsible for the formation of bones and muscles. This vitamin is produced in large quantities in the body when walking in the sun. No wonder doctors recommend taking air and sun baths.
Even if a mother often walks with her child, gives the sun to fall on his skin, rickets can still occur. The fact is that the smoke, dust and dense buildings of large cities prevent the full penetration of sunlight on the ground.
Skin color is an important factor in the ability to synthesize vitamin D. The darker the epidermis, the lower the synthesis.
What foods have vitamin D?
The sun is good, but not everyone can fully understand it: the northern region, poor ecology, and so on. In addition to sunlight, vitamin D can be obtained from food, and its lack or complete absence can cause rickets in children.
Cholecalciferol is a vitamin D derived from animal products, and it is more productive than ergocalciferol, a vitamin derived from plant foods.
The maximum amount of cholecalciferol is found in the following products:
- egg yolk;
- liver of poultry and fish;
- cod fat;
- milk;
- butter.
Of course, all these products should not be given to infants, but they can be eaten by a nursing mother, and vitamins will enter the baby’s body through milk.
Kidney and liver disease is the cause of rickets, as vitamin D is converted through them. Vitamin A is absorbed through the small intestine. If at least one organ is something wrong, there are malfunctions, then rickets may develop.
It is not recommended to eat cereals in large quantities, since they contain phenobarbital, phytates and glucocorticosteroids, which block vitamin D receptors. With frequent consumption of cereals, the vitamin will simply be excreted from the body with feces.
How to identify vitamin D deficiency?
A photo of rickets in children (its symptoms) can be seen in this article. But to identify the early signs of a lack of vitamin D is quite realistic. Having learned that the baby lacks this substance, you can take measures to restore it as soon as possible.
The following symptoms indicate a vitamin D deficiency:
- The kid becomes lethargic, or, conversely, is capricious for no reason.
- Irritability and itching appear. In this case, the child turns his head in different directions to eliminate discomfort, which contributes to abrasion of hair on the back of the head.
- The baby sweats a lot. The smell of sweat is sour. Due to such sweating, irritation often occurs on the child’s body - sweating.
- The kid can start to tremble due to sharp, previously familiar sounds.
All these symptoms may appear due to dry air, heat and the baby’s natural activity. But they can also be the first signs of rickets. Do not wait for improvements, you need to show the baby to the pediatrician.
If you do not pay attention to the first signs, then rickets can be aggravated, and by 8 months the following symptoms will appear:
- The bones on the wrists are compacted, and the lower ribs begin to grow rapidly.
- The baby’s tummy and forehead will become more convex.
- The head will begin to grow disproportionately and sweat heavily.
- Due to weakened muscles, the child will not only be unable to crawl, but also to sit on his own, which is not normal for 8 months.
- The fontanel will stop contracting and begin to expand.
- The baby often starts in a dream.
- During crying, the baby's chin trembles.
- Shortness of breath appears, anxiety.
- Breathing becomes uneven, knocked down - due to deformation of the chest and diaphragm with abundant growth of the lower ribs.
- The phalanges of the fingers increase.
If at the same time you do not pay attention to the health and condition of the baby, then rickets will progress further. When the baby does go, a progressive curvature of the lower extremities begins, it can be noted:
- Slowed bone growth - the body is growing, but the legs are not.
- The legs will begin to bend - an arc or "X".
- The pelvis may become flat.
- Bones of the lower extremities will become wider.
Children with rickets begin to walk much later than their peers. This is due to the curvature and thinning of bones, which is difficult to maintain body weight. The muscles of sick children are lethargic and weak. For this reason, the baby will begin to move independently later.
Symptoms of rickets in children are noticeable when walking. The gait is unstable, knocked down, the steps are narrow, and the legs can beat against each other. The foot is also deformed, when walking it is noticeable that the baby is clubbing. After walking, the child may complain of severe fatigue and pain in the legs. Often these children ask for their hands after a short walk.
Symptoms of rickets in children are noted during drawing, modeling and other activities in which fine motor skills of fingers is involved. The baby may not be able to completely hold the brush, pencil, he will not be able to roll a ball of plasticine - all this because of the deformation of the bones and joints.
The level of calcium can become low not only in bone tissue, but also in the blood. In such a situation, rickets in children can manifest as bouts of seizures. Doctors call this condition spasmophilia, and it appears most often in the spring season.
Stage of recovery
The child begins to recover on their own in the third year of life. The spine is leveled, the bones, joints, expanded during the disease, are restored, the legs become smooth.
Leg pain disappears after walking and physical exertion, fine motor skills are restored.
If at 4-5 years the baby still has a curvature of the legs, then this is called protracted rickets. In this case, the bones will still grow slowly, the developmental delay of the motor apparatus will continue.
A reasonable question arises: if a low level of vitamin D is to blame for the development of the disease, then why not assign it to all infants? This will not solve the problem, and rickets will continue to be relevant. The fact is that with our lifestyle, when it is not possible to go on frequent walks with the child in the sun, ultraviolet light cannot give the necessary amount of this vitamin. Even when walking, dust and dense buildings interfere. Living in the private sector, one also cannot "fry" in the sunlight for a long time - this is contraindicated not only for infants, but also for adults.
The faster the child grows, the greater his need for vitamin D. Its lack can be caused by the untimely introduction of complementary foods - mashed potatoes, juices, cottage cheese. There is a lot of vitamin D in fish, but it is forbidden to give it to a child up to a year. Fish oil again appeared on sale, but it does not give a good result either in the prevention or treatment of rickets in children.
What will help get rid of the disease and prevent its development?
Why doesn't the pediatrician prescribe vitamin D?
Many doctors, seeing signs of rickets in a child (the photo can be seen in the article, they are really pronounced), stubbornly do not want to prescribe vitamin D, which is sold in the pharmacy. Usually motivate refusal to accept the following:
- Vitamin is synthesized in the body from provitamin, you just need to walk more in the sun;
- the baby is fed a mixture that is enriched with vitamin D;
- the mother breast-feeds the baby, and she takes the vitamin complex;
- it is better to introduce cottage cheese into the food, in which there is a lot of calcium, and also give a few drops of fish oil.
But the vitamin obtained from the mixture, breast milk, cottage cheese and fish oil is not able to compensate for its lack in the body. Even a prophylactic dose of vitamin D (1-2 drops per day) will not cure the already developing rickets.
Having been born, the baby has a small supply of vitamin, which is transmitted from the mother. But by the month of life, its lack arises, which needs to be replenished.
Prevention of rickets in children
There are many supporters of taking vitamin D for prophylaxis when children are given a drop of the drug every day or every other day. But this method of prevention is wrong, it will not give a result.
The course dosage of vitamin D for the prevention of childhood rickets is 200,000-400,000 IU. That is, the calculation should be carried out not drop by drop, but namely by the amount of vitamin D contained in the purchased preparation, which is calculated in IU (thousands of international units).
Vitamin D 2 accumulates in the liver, so it is recommended to give it to children from 1-1.5 months. The course is 20-25 days at 8000-12000 IU per day.
Two months after the completion of the course, when the baby is no longer receiving additional vitamin, his condition is assessed and the issue of continuing the prevention or treatment of rickets in children is decided.
If there are no signs of rickets, then the preventive course is repeated in the second half of life.
Vitamin D 3 is an aqueous, not an oily solution that does not accumulate in the liver, but is quickly eliminated from the body. It should be given more often. One drop of the solution contains 500 IU of vitamin, but only the doctor will prescribe the dosage, starting from the age, weight of the child, as well as from his nutrition and development.
It is useful for the child to stay in the sun. It is the safest and most useful until 11 am and after 5 pm. But at the same time, Panama should cover the baby’s head, and the face and handles can be fully exposed to the sun's rays.
After six months, the child needs to introduce cottage cheese, juices, mashed potatoes (vegetables, meat, from poultry liver, from fish) into the food, hake, cod and pike perch are especially useful. Also give butter, egg yolk (boiled).
If the baby eats porridge more than once a day, then he is more in need of preventing rickets.
Treatment of rickets
How to treat rickets in a child when the disease still began to develop? This is a long process that will take several months, and not a couple of weeks, as with ARVI.
During treatment, general medication and orthopedic measures are prescribed. Recommended spa treatment, massage, bath and sun exposure.
During the treatment of rickets, not only vitamin D is prescribed, but also preparations containing a large amount of calcium. The method of taking vitamins and dosage is prescribed by the attending pediatrician.
In addition to medicines, massage of the legs, back, buttocks is prescribed. One session should take 20-25 minutes, and the course will last from 4 to 5 weeks - massage daily. Many parents are skeptical of this event. But massage with rickets is required, it tones the muscles, normalizes blood circulation. The specialist will twist and twist the legs, rub the back, which helps to correct the curvature.
A child with rickets needs peace and the absence of great physical exertion. In the stage of active development of the disease, when there is a risk of fractures, tires and orthoses are used. A Thomas apparatus is also assigned, which removes loads from the legs and hips.
Children are prescribed preventive shoes that should be worn even at home. Sandals can be canceled only after recovery.
With significant curvature of the hips and lower legs, an operation is performed to affect the bone growth zone. With the help of the operation, it is possible to correct the curvature and prevent the development of new ones.
The time of treatment and the result depends on when treatment began. The sooner you take measures to eliminate the disease, the faster you can get rid of it, and there will be a minimum of consequences.