Causes, symptoms and treatment of rickets in infants

Rickets is a diagnosis that is most often made to children aged 1-12 months. Recently, this disease has become quite rare, as pediatricians pay special attention to prevention. If the child still has characteristic symptoms, parents should know the basic rules for treating rickets in infants. A timely reaction will help to avoid complications at an older age.

What is rickets

The medical term "rickets" is understood to mean a pathological disorder of bone formation and insufficiently intense bone mineralization. Such changes are associated with impaired absorption of vitamins and minerals in the body of the child.

If there is a lack of vitamin D in the body, calcium absorption is impaired, which immediately affects the condition of growing bones. They become brittle, brittle and subject to curvature. Timely treatment of rickets in infants eliminates pathological changes and serious complications at an older age.

Most often, this pathology is diagnosed in young children up to 1 year old. In some cases, rickets can occur at the age of 2-3 years.

Vitamin D Norm

Vitamin D is obtained in two ways: when exposed to sunlight on the skin (natural production occurs) and with nutrition. In medicine, there is a concept of a lack of vitamin. Moreover, the concept of a certain norm of this vitamin is absent. The fact is that each person has individual needs. Speaking about the norms of vitamin D content in a child’s body, doctors take into account many factors:

• climatic conditions of the region of residence;
• features of children's nutrition;
• race
• weight and body features.

One of the main sources of vitamin D is sun exposure. Moreover, people living in regions with a sunny warm climate have higher levels of this vitamin than those living in the northern regions. A noticeable difference in the level of vitamin produced is also present among representatives of different races.

Causes of Vitamin D Lack

To know how you can protect yourself from the disease, you need to understand the main causes of its development. Vitamin deficiency in a child’s body can occur for several reasons.

1. The lack of vitamin D in the diet. Most often, rickets in infancy are observed in children who are breast-fed. This is because children get all the necessary vitamins and elements with mother’s milk. The amount of nutrients included in baby food may not be enough for a particular child.
2. Premature birth. Children born earlier than expected may suffer from metabolic failure and enzyme deficiency. This is explained by the fact that in the womb some organs did not have time to fully form. The peculiarity of this case is that the body does not absorb vitamin D even with sufficient intake.
3. Genetic predisposition. In medicine, there is a theory about the possible genetic inheritance of rickets in newborns. In infants with blood group II, this disease is detected much more often. This fact partially confirms the theory of a genetic predisposition to the disease. It should be noted that among all patients with such a diagnosis, most are boys.
4. Frequent colds. During colds, the child’s body needs an increased dose of vitamin D, but it is at this time that the absorption rate of this element decreases. As a result, an acute deficit occurs, which after a while can cause rickets.

Risk groups

There are several groups of children who need increased attention from doctors and parents.

1. Children with dark skin. People with fair hair and skin are capable of rapidly absorbing vitamin D. For dark skin owners, melanin slows down vitamin absorption.
2. Excess body weight often affects the appearance of rickets in infants and children up to a year. Such children need more careful observation.
3. Dysbacteriosis Disorders of the intestinal microflora are manifested by loose stools and digestive disorders. This leads to the fact that vitamins and trace elements do not have time to be absorbed.
4. The lack of ultraviolet radiation. Children who walk a little in the fresh air are also at risk. This often includes those born in the cold season.
5. A short gap between a woman’s pregnancy. During this time, the body does not have time to recover, which often becomes the cause of pathologies.
6. Multiple pregnancy.

The first symptoms of rickets

The development of the disease most often begins when the child reaches 2-3 months. At the same time, it is almost impossible to accurately diagnose rickets at this stage. Firstly, at this time, vitamin D deficiency and poor digestibility of calcium are only beginning to appear and no major changes in the body occur. Secondly, the age of the child is important.

In medicine, the first signs and symptoms of rickets in infants are described:

• bad sleep;
• frequent moods;
• lethargy;
• decreased appetite;
• increased sweating;
• baldness of the nape.

The above conditions of the child should alert parents. Frequent crying, refusal to eat, increased irritability are signs of any pathological changes in the body of children. Meanwhile, these features do not apply to the main symptoms of rickets in infants. Sweating can be caused by dry indoor air. The balding nape often accompanies children with increased activity.

Distinctive signs of rickets in infants

If no treatment is given, the disease continues to progress. In this case, after 2-3 months, the following signs of rickets in infants occur.

1. Softening the fontanel edge. A lack of calcium prevents the normal overgrowth of the fontanel. The process is delayed for a long time.
2. Bone deformation. The bones become soft, which leads to their deformation. In children with the naked eye, one or more changes are noticeable. Perhaps the appearance of neoplasms on the ankles, wrists. The chest changes: it becomes concave or convex. There is a curvature of the clavicle, a change in the shape of the head.
3. A bulging belly (“frog”) appears.
4. Teeth erupt much later than other children.
5. Reaction to sounds. A child can wake up and startle even from quiet familiar sounds.
6. Decreased immunity. Children with rickets often have acute colds.
7. Developmental delay.

Stage 1 Rickets

In medicine, it is customary to divide the course of the disease into stages. During the differentiation, the main signs of rickets in infants are taken into account. Stage 1 is also called easy. Most often, this period occurs at the age of 2-3 months and lasts for several weeks. The main feature is that timely treatment completely eliminates the symptoms of the disease and blocks subsequent complications. Doctors call signs of the disease.

1. Small changes occur in the bone tissue on the head, limbs and chest.
2. Muscle tissue tone is impaired, muscle hypotension is possible.
3. Temporary malfunctions in the central nervous system are observed, which is manifested by the occurrence of seizures.

At this stage, the psychomotor state is not involved in the process, that is, it remains in a normal state.

Stage 2

At that stage, a serious emergency treatment of rickets in infants is required. Symptoms in children are already more pronounced. Parents can identify the pathology by the following signs:

• the child holds his head poorly, rolls slightly on his stomach, does not sit and crawl;
• bone thickenings appear on the wrists (doctors call them “rickety rosary”);
• the head takes an unusual shape (the nape becomes angular, and the forehead is excessively convex).

Stage 3

This stage of rickets is called severe, since there is a neglected course of the disease. In such cases, multiple bone deformities, a pronounced developmental lag, and symptoms of central nervous system damage are diagnosed.

1. The baby’s legs are in the shape of an “x”.
2. The lag in development (motor, mental) is pronounced.
3. The head becomes disproportionately large.
   

It should be noted that the detection of rickets at the last stage is a rarity.

Possible consequences

You need to contact a pediatrician as soon as the first signs of rickets in infants appear. Treatment is selected according to the stage of the disease. Failure to follow the doctor's recommendations can cause serious consequences:

• strong growth lag;
• pronounced kyphosis (impaired posture);
• curvature of the tubular bones (legs and arms);
• underdeveloped skeleton muscles;
• dental diseases (bad bite, caries, destruction of tooth enamel).

Diagnostic Methods

Diagnosis begins with an initial examination of a small patient. The doctor examines the condition of the fontanel, the shape of the head, examines the arms and legs for the presence of neoplasms and curvatures, and clarifies with the parents the complaints, especially the nutrition and the daily routine of the child. Thus, the pediatrician identifies the possible causes and symptoms of rickets in infants. Diagnostics hereinafter includes the following methods:

• Analysis of urine;
• biochemical blood test;
• computed tomography of bone tissue;
• X-ray
• densitometry.

Using these laboratory and hardware diagnostic methods, it is possible to identify pathological changes in the child's body. In the list of basic characteristics indicating the presence of rickets, they call:

• hypophosphatemia (low levels of phosphates in the blood);
• hypocalcemia (low calcium);
• acidosis (a change in the acid-base balance of the body towards increased acidity);
• high alkaline phosphatase activity;
• low rate of calcitriol.

Drug treatment

Treatment of grade 1 rickets in infants does not require serious interventions. It is enough to take medications prescribed by your doctor. Medicines are aimed at correcting the condition.

1. One of the most sought after is Aquadetrim. The product is released in the form of drops, so it is easy to dose and use for small children. “Aquadetrim” compensates for the deficiency of vitamin D3 and restores the proper metabolism of calcium and phosphorus in the body.
2. Oil-based medicines with vitamin D3. The list can include “Devisol”, “Videin”, “Wigantol”.
3. Remedies with Vitamin D2. They are prescribed as a prophylaxis of rickets.
4. Multivitamin complexes for children 0-2 years old. Such additives contain all the necessary minerals, trace elements and vitamins.
5. Calcium gluconate. It is prescribed as part of a comprehensive treatment with vitamins of group D.

Physiotherapy sessions

Drug therapy is often supplemented with other treatments. With symptoms of rickets in infants, doctors can prescribe a physiotherapeutic effect. Among the most effective procedures:

• electrophoresis (using calcium and phosphorus compounds);
• baths with ultraviolet light;
• massotherapy;
• balneotherapy;
• special charge for children up to a year.

This effect accelerates the effect of drugs. Exercise and massage are necessary for the proper development of joints and restoration of normal muscle tone.

Surgery

Surgical treatment is prescribed for 3 stages of the disease with pronounced symptoms of rickets in infants. The reasons for therapy with surgery are that serious changes have already occurred in the bone tissue. Curved bones need to be restored, and to do this with the help of medications alone will not work.

Massage and exercise

To strengthen muscles, doctors recommend regular sessions of massage of the arms, legs, back. In addition, it is very important to lay the baby on the stomach frequently. During the period of illness, any motor activity of the child should be supported. Parents should encourage frequent changes in the child’s posture, stimulate independent head holding, walking reflexes.

Combined therapy has a positive effect and allows you to quickly eliminate the cause of the disease and block symptoms.

Folk remedies for rickets

Alternative recipes can be included in the list of basic methods for the prevention and treatment of rickets in infants.

Treatment with folk remedies should be used only as an addition to the main therapy. The use of a particular prescription is allowed only after consulting a doctor.

1. Bath with needles. With increased excitability, warm baths are often used with the addition of 1 tbsp. l needles (per 10 liters of water). Periodic bathing of the child has a mild sedative effect, and enhances immunity.
2. Baths with sea salt. Sea salt has long been known as a powerful firming, tonic. 10 liters of warm water requires 2 tbsp. l sea ​​salt. Before bathing a child, you need to make sure that all salt crystals have dissolved.
3. A decoction of vegetables. Children aged 5-6 months can be introduced as a complementary food a small amount of vegetable broth. It contains important vitamins and minerals. In addition, the decoction has a positive effect on the condition and functioning of the gastrointestinal tract.

How to cook a vegetable broth

For children under 5 months of age, it is not recommended to introduce such decoctions into the diet. For complementary foods to benefit the child, you need to prepare the broth according to all the rules.

1. Cooking vegetables should choose the highest quality.
2. Before cooking, the products are soaked in cold water. This is necessary in order to eliminate nitrates and other chemical elements.
3. Vegetables are placed in a container, poured with water and put on a slow fire. In this case, no foam will form, and the broth will be transparent.
4. The cooking time should be at least 30-40 minutes.
5. It is not necessary to salt the vegetable broth.
6. After cooking, the vegetables are discarded, and the liquid is filtered if necessary.

Different products may be used as a base. As products suitable for first feeding, you can name:

• onion;
• carrot;
• a stalk of celery.

Prevention

Preventive measures are aimed at eliminating primary development and relapse after treatment of rickets in infants. In medicine, there are 2 types of prevention:

• antenatal (includes preventive measures during pregnancy);
• postnatal (measures taken after the birth of a child belong to it).

During pregnancy, a woman should pay a lot of attention to her health. It is especially important at this time to observe the correct lifestyle. There are a few simple rules that can help you reduce the risk of vitamin D and calcium deficiencies in your mother and baby.

1. Proper nutrition. While the baby is in the womb, he receives all the necessary substances from the mother. The diet of a pregnant woman should be as diverse as possible and include: fish, meat, a large number of vegetables, fruits and cereals.
2. Daily walks. If weather permits, the pregnant should regularly walk in the fresh air. At this time, the sun is exposed to the skin and vitamin D is produced in the body.
3. Taking multivitamins. Such an additive makes up for the lack of important elements. Before use, consult your doctor.

Postnatal prophylaxis includes the following measures.

1. Baby food. Doctors consider breastfeeding the best prevention of rickets. If the child’s food includes a baby formula, then to supplement important trace elements, you can introduce complementary foods from vegetable decoctions, fruit and vegetable juices.
2. Regular walks in the fresh air. If the weather is hot outside, it is better to take a walk in the evening.
3. Regular ventilation of the room in which the child is located. The room should not be hot and stuffy. In this case, drafts should not be allowed.
4. Promotion of motor activity. Pediatricians recommend free swaddling for children older than 2 months. This means that the child’s hands should be left free. This contributes to the active development and strengthening of muscles, ligaments and joints.
5. Vitamin D intake. Doctors may prescribe medications used to treat rickets in infants.

It is strictly forbidden to use medicines containing vitamin D without the recommendation of a doctor.

An excess of any vitamins (as well as their deficiency) causes multiple pathologies in the work of various body systems.

The prognosis of treatment of rickets

In itself, this disease is not life threatening, but it can have multiple consequences. The complex treatment of rickets in infants at an early stage allows you to completely get rid of symptoms and serious complications.

If the disease was detected later (at 2 stages), then at older children some pathological changes are possible. The right approach to therapy avoids curvature of the limbs. In this case, children who had rickets in childhood often have stunted growths, advanced caries, and multiple colds (due to low immunity).

Running cases of rickets, which are accompanied by curvature of the limbs, are also treatable. Leg and arm alignment operations are performed at an older age. This process is very complex and lengthy. Moreover, an important stage is the recovery period.

It is easy for parents to identify the first symptoms of rickets in infants, and treatment in this case will be short-term and highly effective. Help in prevention can be provided by experienced pediatricians. For this reason, parents with children under one year old should regularly visit the doctor’s office. The article examined what rickets in infants are, symptoms, causes and treatment.