Signs of rickets in infants. Prevention and treatment of rickets

The article will describe the first signs of rickets.

There are some diseases that have long been considered “diseases of the last century,” but medical practice shows that they are not so rare today and may not depend on the standard of living, child care, and nutrition. Such pathologies include rickets in infants.

Signs of rickets should be known to all parents.

Causes of the disease

There are only two prerequisites for the development of rickets in a child - malnutrition and a lack of vitamin D (calciferol) in the body, which is involved in a number of important metabolic processes, and this, in turn, becomes the main cause of the development of rickets in bone tissue. This vitamin comes with several products, and can also be produced in the skin under the influence of solar radiation.

If the child’s diet is poor in foods containing vitamin D, and the child himself rarely goes for walks in sunny weather, then pathological phenomena in the bones, internal organs and muscles become inevitable for him.

However, such causes are easily eliminated. It is enough to adjust the child’s diet by adding more milk, butter, fish oil, boiled beef or poultry liver to it. Frequent walks are also a prerequisite.

Internal pathologies and genetic abnormalities as a cause of rickets

The situation is much more complicated with those children who have had some pathologies of internal organs since the birth: intestines, liver, and kidneys.

Impaired absorption of nutrients in the intestines, obstruction of the biliary tract, some genetic diseases that interfere with the absorption of vitamin D - all this leads to the first symptoms of rickets in infants, and this pathology with concomitant diseases is very difficult to treat.

Signs and symptoms of rickets are important to identify in a timely manner.

Other factors of rickets

Artificial feeding and prematurity are two other equally important factors affecting the metabolic process in the child's body and the absorption of substances from food.

For example, in a premature baby, the need for vitamin D is significantly higher than in those babies who were born on time, so very often food does not cover the deficiency in this vitamin, and rickets it only worsens if you do not notice its signs and change the system feeding.

Artificial feeding children suffer from rickets due to the fact that the proportions of phosphorus and calcium, the most important elements for building bone tissue, are violated in goat and cow milk, as well as in artificial mixtures.

Mothers who do not feed their children with natural breast milk should know that there are no ideal artificial mixtures today, so the nutrition of artificial children should be organized so that a deficiency of vitamin D, phosphorus and calcium can be constantly covered with additional complementary foods.

Signs of rickets in infants will be presented below.

Disease classification

The classification of rickets existing in modern pediatrics is associated with the effectiveness of treatment with calciferols. In this case, the following varieties of this disease are distinguished:

1. The most common is the classic D-deficient rickets.
2. Secondary.
3. Vitamin D-resistant.
4. Vitamin D-dependent.

The classic type of rickets is also subdivided depending on changes in the concentration of phosphorus and calcium in the blood, therefore, there are its phosphopenic and calcium-penic varieties, which indicate a significant deficiency of these elements. Sometimes the classic form of rickets occurs with normal concentrations of phosphorus and calcium.

The course of the D-deficient form of rickets is acute, recurrent and subacute. This disease goes through several stages: the initial stage, the height of the disease, recovery, stage residual effects.

The acute form is observed in apparently healthy babies: they grow well, gain weight, but still suffer from a similar pathology. It occurs due to a lack of calciferols in a uniform carbohydrate diet and is characterized by bright, violent symptoms from the nervous and autonomic nervous systems, as well as severe changes in bone tissue.

With a subacute form, the symptoms of rickets are more smooth and moderate. This variant of the disease is observed in those children who have previously been given specific prophylaxis with mixtures containing vitamin D.

When a relapsing form occurs, which is characterized by periods of exacerbations and remissions of rickets, it is most often observed in children from dysfunctional families, in the absence of proper care, proper feeding and sufficient air exposure.

Secondary rickets develops due to impaired absorption of vitamin D in the intestine, as well as obstruction of the bile ducts, kidney diseases, which are associated with metabolic disorders. It also occurs in children who take anticonvulsant drugs, diuretics and hormones for a long time. There is a likelihood of secondary rickets in children who are on parenteral feeding in hospitals.

Vitamin D-dependent form of rickets is of two types and is caused, as a rule, by a defect in the synthesis of calciferols in the kidneys and a lack of receptors that are responsible for their absorption.

Vitamin D-resistant rickets occurs against the background of orphan pathologies of a congenital nature - with Debreu-Fanconi syndrome, phosphate diabetes, hypophosphatasia - a violation of bone mineralization, etc.

These pathologies are very rare and they are accompanied, as a rule, by many other serious changes in mental and physical development.

The main signs of rickets

This disease occurs in three stages:

1. The first stage is characterized by the initial manifestations of the disease with minimal symptoms.
2. The second stage is a moderate course of the disease.
3. The third stage is severe rickets, in which pronounced changes are observed at the physical level and lag in mental and mental development.

The first stage of rickets

Parents, in the first place, should be alert for signs of rickets in infants, which include:

1. Increased sweating of a child with a pungent pungent odor.
2. Baldness of the neck, often accompanied by severe itching.
3. The occurrence of sweating (small rashes on the skin).
4. A tendency to develop constipation while observing a normal drinking regimen.

Additional signs of rickets include the following:

1. Spontaneous muscle twitching.
2. Fear of the light.
3. Increased irritability of the child.
4. The occurrence of difficulties with falling asleep.
5. Decreased appetite.

Rickets of the first degree in infants begins, as a rule, in the third month, and in premature babies even earlier.

Second stage

The further course of this pathology is complicated by the emergence of new signs. Rickets in infants who have not received treatment for this disease in the first stage develops as follows:

1. Softening of the cranial bones in the fontanel - craniotabes.
2. A change in the shape of the nape is a flattening of his bones.
3. Also a common sign of rickets in infants at 3 months of age is a deformation of the chest - “shoemaker’s chest” if it is slightly depressed, or “chicken breast” if it is protruded.
4. Curvature of tubular bones: “X” -shaped or “O” -shaped legs.
5. The appearance on the wrists of a specific “rosary” of rickets.
6. The beginning of violations in the work of internal organs.
7. Late fontanelle closure.
8. Teething delay.

Notice the signs of rickets in infants in 3 months is simple.

Rickets of the second degree in infants is usually accompanied by increased vegetative and neurological symptoms - lethargy, drowsiness, excessive fatigue, excessive sweating, especially when screaming and other stresses. Such children are very behind their peers not only in physical development, but also in psychomotor and mental.

The third stage of rickets

Rickets of the third stage is most often the result of a lack of therapeutic measures when the child is deprived of parental attention and the supervision of doctors. In this case, the question does not even arise how to determine the first signs of rickets in such a child - his neglected symptoms are so pronounced and severe. You can notice the following pathological conditions:

1. Gross violations of bone and muscle tissue.
2. Weakness of the ligamentous apparatus.
3. Delays in motor activity.
4. Extremely severe dysfunctions of the internal organs, frequent pneumonia and bronchitis.

Typically, these signs of rickets appear after a year.

In all children who have ever been ill with a severe or moderate degree of this disease, changes in the bones remain, as a rule, for life:

• deformed limbs;
• convex or hollow chest.

Girls often have rickets of the pelvic bones. In this case, the pelvis becomes flat, which subsequently causes various birth injuries at the birth of their children.

Signs of pathology in children from one to two years

The baby becomes restless, tearful, shy - after 2 years, the symptoms intensify. The innervation of the liver leads to the fact that hepatocytes are affected, the destruction of the liver tissue begins, pathological foci of the scar tissue overgrow.

Signs of rickets in a child at 2 years old can scare parents.

Autonomic disorders accompany vasomotor reactions. If you drag your finger across the skin, you will notice red linear stripes. Vegetative-vascular problems become stronger after feeding the baby. Red vesicles appear on the back of the head on the skin. There is severe itching.

Another sign of rickets in a child at 2 years old is hyperesthesia. Hypersensitivity to skin receptors irritates the baby.

CNS diseases accompany pathology of reflexes with inhibition, motor activity. With rickets, changes in the muscles appear.

Looseness of joints, curvature of the legs appear after a year when the child learns to walk.

We examined the main signs of rickets in children after a year.

Treatment of rickets at an early stage of its occurrence

Therapy of rickets in infants is a very long process, since it takes months, and in some cases even years, to restore bone tissue. Treatment methods are selected depending on the severity of symptoms and the severity of the disease.

Non-specific therapeutic methods include:

1. Eliminate loud noise and bright light in a child’s room.
2. Long daily walks, as well as sun and air baths, are seasonal.
3. Hardening in the form of rubbing with cool and warm water.
4. Coniferous and salt baths to correct the process of inhibition and excitation in the nervous system.
5. Therapeutic gymnastics and massages.
6. Diet.

About the diet should be said separately: it remains the main factor for further recovery. The treatment of rickets at an early stage requires a review of the usual diet:

1. Replacing plain water with fruit and vegetable decoctions.
2. Early introduction of protein foods in the form of cottage cheese and egg yolk.
3. Appointment of vegetable food in the form of mashed potatoes from stewed and boiled vegetables, grated raw vegetables.

After diagnostic procedures that detect a deficiency of phosphorus and calcium, children are prescribed a course of vitamins C, A, B, as well as calcium drugs.

Assessing the severity of the disease, the doctor can add elements of specific treatment to non-specific therapy, which include:

1. Irradiation with ultraviolet for 20 days with the selection of individual bio-dosage.
2. Oily, alcoholic or aqueous solutions of vitamin D - “Videhol”, “Ergocalciferol”, “Videin”, “Cholecalciferol”, “Aquadetrim”, etc.

The drug "Ergocalciferol" is prescribed, as a rule, to all children, regardless of the severity of the pathology.

To exclude relapses of the disease, infants from the risk category are often prescribed medications with a vitamin D content for 4 weeks daily to prevent signs of rickets. Komarovsky (a famous pediatrician) recommends the following preventive measures.

Prevention of rickets

Prevention of this disease in infants begins in the period of intrauterine development. At the same time, pediatricians recommend that mothers observe the following rules:

1. Periodically, preferably in courses, give the child special multivitamin complexes.
2. Adhere to a special diet, that is, such a baby's diet that will satisfy his need for calcium and phosphorus.
3. Frequent walks in the fresh air in any weather.

Prevention of this disease during pregnancy is carried out by taking a single dose of vitamin D of 200,000 IU at the seventh month of gestation.

It is necessary to recognize the signs of rickets in infants in 4 months in a timely manner. From the very birth of a child, it is required to carefully monitor his nutrition and daily routine. It is advisable to breastfeed it, because only in breast milk are all the substances necessary for the baby that cannot be replaced with any artificial mixture existing today.

In addition, the child needs daily walks, and during the season you can keep the baby naked for some time in the shade of the trees. Wellness massage is also recommended for 20 minutes a day, intermittently. If necessary, pediatricians advise parents to introduce early protein and vegetable complementary foods.

It will also be very advisable to use a citrate mixture, which is based on the use of 2.1 g of citric acid diluted in 100 ml of water. The resulting solution must be given to the child a teaspoon three times a day for 10 days, followed by a repeat of the course after one month.

Specific prophylaxis of this pathology is also necessary: ​​healthy children are prescribed a course of exposure to a UV lamp in the amount of ten sessions in winter, autumn or spring. In summer, such UV therapy sessions are usually not carried out. After them, dosage forms of vitamin D are canceled for 2 months. For children at risk, such exposure is carried out from a fortnight.

Medications containing vitamin D are prescribed, as a rule, at a dosage of 400 IU in the form of an oily or aqueous solution throughout the first year of life for specific prophylaxis for children born on time. For premature babies, this dose is slightly higher and amounts to 1000 IU.

It must be remembered that vitamin D medications are not always helpful. Their use is prohibited in the following pathological situations:

1. After undergoing fetal hypoxia during pregnancy.
2. After intracranial birth injury.
3. With the small size of a large fontanel.
4. With nuclear jaundice.

With caution, calciferols are also prescribed for children who received adapted milk formulas containing vitamin D.

Walking with the baby should be daily, and this should be done in any weather. If the street is cold and frosty, the walk should last at least one hour, if it is sunny and warm - at least 3-4 hours. The exception is only a strong wind, even in the warm season, when it is strictly forbidden to take a baby out onto the street.