Vitamin D – rickets deficiency.
Rickets in a child: forewarned is forearmed!
What is rickets?
Children's health is a close focus of parents' attention. For a growing organism to form correctly, it needs the whole complex vitamins and minerals. The child receives most of them through breastfeeding or feeding with an adapted formula. But the need for vitamin D is not always met even if these rules are followed, so many mothers know firsthand what rickets is.
Rickets is a metabolic disease that occurs when there is a deficiency of vitamin D (calciferol) in the body, and it affects musculoskeletal system child, internal organs, nervous, and endocrine systems.
Causes of rickets in children
According to various sources, symptoms of this disease are observed in approximately 40 percent of children under one year of age. In countries where there is a shortage sunlight, this figure is higher.
Most often, rickets in children under one year of age occurs because, while still pregnant, the woman did not pay due attention to her lifestyle and health. For example, if future mom had a hard time with it recent months pregnancy, she had late toxicosis, or she was too keen on diets, limiting the consumption of foods containing animal proteins.
IN postnatal period Premature babies, babies born in the cold season, artificial babies and babies living in unfavorable conditions are at risk of developing rickets. Rickets in infants can be caused by the mother's unhealthy diet: if, for fear of gaining excess weight, she eats too little, prefers low-calorie foods, and limits the consumption of milk, meat and fish.
In addition to this, there are following reasons rickets:
- insufficient stay for the child fresh air in general and the sun in particular;
- tight swaddling and limited motor activity of the child;
- absence breastfeeding, early transition to mixed or artificial feeding (mothers who use unadapted milk formula are especially at risk);
- gastrointestinal tract disorders, congenital pathologies (celiac disease, lactase deficiency, dysbacteriosis);
- tendency to frequent illnesses;
- taking anticonvulsants;
- rapid weight gain in a child (at the same time the need for calcium increases).
How to determine rickets in a baby - SYMPTOMS
The disease manifests itself gradually.
The first symptoms of rickets can be detected at 4-8 weeks of a baby’s life:
- the child does not eat well: his appetite decreases, his usual portion is not fed, and the feeding process itself takes less time than usual;
- the baby becomes restless: shudders for no reason, often tosses and turns during sleep, becomes more capricious and fearful;
- sleep disorders: the baby does not fall asleep well, often wakes up for no reason, shudders or cries loudly in his sleep, the sleep itself is short and superficial;
- sweating increases: even in cool weather, the child gets wet, wakes up in wet clothes, sweat has a specific sour smell and taste, diaper rash and prickly heat appear again after healing;
- the hairs on the back of the head fall off. ;
- stool abnormalities are noted: Despite the usual diet, diarrhea and constipation may occur.
If this is ignored, after a few weeks infants develop following signs rickets:
- The muscles are in low tone;
- The baby does not hold his head well, is in no hurry to roll over on his stomach, crawl, or walk;
- Later teeth erupt;
- Later the fontanel closes;
- The shape of the skull may change: the head becomes elongated, the back of the head becomes flat, frontal tubercles appear;
- Bloating;
- The chest is deformed, the pelvis becomes narrow, and the legs become bent.
Severe forms of rickets are imposed on physical state, and on the child’s psyche: there is a noticeable lag in development. Severe deformations occur chest, skull bones, limbs.
In some particularly advanced cases, children cannot sit and stand up on their own. From the outside of cardio-vascular system difficulty breathing and tachycardia are observed. The liver increases in size.
It is possible to cure rickets - TREATMENT
It is easier to cure any disease if you start doing it right away. early stage Therefore, if you suspect rickets, you should consult a pediatrician. It is he who will establish final diagnosis and will tell you how to treat rickets.
Even if this disease has reached a severe stage, doctors rarely resort to hospitalization. They usually prescribe procedures that can be done at home, designed to eliminate the lack of vitamin D and correct disorders that have occurred in the body.
Treatment of rickets is based on a set of procedures for correcting the daily routine, physical activity (walking) and diet of mother and child.
It is necessary to take your baby for walks in the fresh air more often. If the weather cooperates, you can take air baths, . Sunbathing MOST effective, but in hot weather overheating must be avoided ().
The child's diet should contain sufficient quantity protein and minerals (calcium and phosphorus are especially important), vitamins.
Massage
Has a positive effect on health physiotherapy, massage. Such a complex should include breathing exercises, stroking the legs, arms, feet, abdomen, chest and back. To strengthen the baby's muscles, you need to turn him from his back to his tummy, strengthen the walking and crawling reflexes (while supporting the baby, give him the desired position). Rocking on a fitball or in your arms will help calm the child’s nervous system.
Video
To overcome tearfulness, lethargy, irritability, normalize mental condition child should be protected from excessive impressions and external stimuli(noise, bright light).
Bathing
Good for increased excitability of the baby therapeutic effect Baths with the addition of pine needle extract (per 10 liters of water at room temperature - 1 teaspoon) can help. They are indicated for excitable children. If muscle tone The baby is depressed and lethargic; baths containing sea salt can help. To prepare the solution you need 10 liters warm water add 2 tablespoons of salt. 10–12 procedures are enough to ensure a positive effect.
Note to moms!
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Medicines for rickets - VITAMINS
Take all medications only as prescribed by your doctor!
Medicines:
- Aquadetrim — water solution vitamin D3 (colecalciferol)
- Devisol, Vigantol, Videin- Oil solutions of vitamin D3
Among the medications taken for rickets, vitamin D solution is considered the most effective.
But here, too, there are nuances: vitamin D3 is more effective than vitamin D2, and an aqueous solution has a longer lasting effect and is absorbed by the body better than an alcohol or oil solution.
In any case, vitamins for rickets should be prescribed by a pediatrician, who will select the type of drug, its dosage, and determine the timing of treatment.
Often, a therapeutic dose of vitamin D (it is 2000–5000 IU) should be taken for 30–45 days, and then a maintenance (preventive) dose of 400 to 500 IU should be taken daily. One drop oil solution Vitamin D3 contains approximately 420 IU of cholicalciferol.
Vitamin D intake should be accompanied by constant monitoring of urine analysis to avoid overdose, because large doses can have adverse effects. toxic effect on the body. An overdose of this drug can cause decreased appetite, nausea, vomiting, urinary retention, constipation, and even limb cramps.
If anemia occurs due to rickets, it is treated with iron supplements in the form of syrup or drops.
By following all the requirements, you can very quickly improve the child’s condition.
Preventing rickets is easier than treating it - PREVENTION
The health of the child must be taken care of long before his birth - during planning, as well as during pregnancy. Around 28 weeks intrauterine development The child’s body begins to actively store vitamins. Vitamin D accumulates in the liver, fat and muscle tissue of the fetus. During this period, a pregnant woman should pay special attention to her lifestyle:
- regularly visit a antenatal clinic doctor;
- eat regularly and nutritiously;
- spend more time in the fresh air;
- protect yourself from colds and infectious diseases;
- walk a lot.
Prevention of rickets is carried out from the birth of a child and is especially necessary for premature babies, with insufficient weight, in the first months of life, as well as for those born in the autumn-winter and even spring periods. It is enough to follow the regime, take long walks in the fresh air, get a lot of sun, strengthen and physically develop the child.
Prevention of rickets video:
Breast-feeding – best protection from many diseases, but only if your menu contains the required amount useful substances. A nursing mother needs to streamline her diet: consume more dairy and fermented milk products, take multivitamins (). If your baby is “artificial,” you need to choose an adapted milk formula that closely resembles the composition of human milk. ()
In the future, when introducing complementary foods, it should be taken into account that vitamin D is found exclusively in products of animal origin (meat, liver, butter, egg yolk) and systematically offer them to the baby. You should not overuse semolina porridge. Besides the fact that it can cause allergic reactions, it also interferes with the absorption of calcium in the small intestine.
Fish fat
Children from the “risk group” are recommended to undergo drug prevention of rickets. One of the most popular means– fortified fish fat. It can be given to children starting from four one week old, gradually increasing the dose.
It should be remembered that prevention is carried out under the supervision of a local pediatrician.
For the purpose of prevention, medications (vitamin D, fish oil) should be given for a certain period.
There is a so-called rule of the letter “r” - take vitamins in those months of the year that have the letter “r” in their names. May and the summer months are usually sunny, so drug prevention the need disappears.
Rickets cannot be left to chance - CONSEQUENCES
Consequence of rickets Most often, rickets does not pose a threat to the child’s life. But if you do nothing, the symptoms go away, but the consequences of rickets remain. Often children who have had this disease suffer from dental caries and permanent teeth. Curvature of the legs. There may be developmental delays.
Due to changes in the skeleton, scoliosis, flat feet, and pelvic deformity may occur. In schoolchildren, the effects of rickets manifest themselves in the form of myopia, anemia, reduced immunity and pain ( frequent bronchitis and pneumonia).
In people mature age Osteoporosis may develop.
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Kazakhstan, Almaty (Alma-Ata)
Good evening Evgeny Olegovich! I'm a big fan of yours!!! I have a question: can there be an overdose of vitamin D3, how dangerous is it? The neurologist prescribed us three drops of vitamin D 3 whole month. At the very beginning, after we left the maternity hospital, we were at home for a month, we didn’t go for walks or drink vitamin D (we were born in November, we were afraid of catching the virus), when we turned a month old, we went to see the doctors. Then only the orthopedist told us that for prevention we should drink one drop at home, which is what we did. Then they took an ultrasound of the head and diagnosed us with hydrocephalus, we were treated by a private neurologist, then after treatment we went to another private one, where they told us that according to the first ultrasound we didn’t have hydrocephalus as such, now it’s just some kind of spasm. Prescribed for us general massage 15 days and take three drops of vitamin D a month, medical withdrawal from vaccinations. We are now 4 months old. At five let's go for months appointment with a neurologist, I really want to get vaccinated. One says there is hydrocephalus, the other says no, that it’s just a spasm. Is it possible to get vaccinated in this case and how to avoid catching something before because you are not vaccinated.
12/11/2012 20:13
Russia, Chelyabinsk
Hello! My daughter is 7.5 months old, we were diagnosed with rickets of the 2nd degree and low hemoglobin. The child eats very little, sleeps poorly and often wakes up at night. My forehead is sweating. We were prescribed aquadetrin 2 drops a day, and ferum lek in syrup to increase hemoglobin. Soon deformation of the bones may begin, and the child is already standing on his feet. Dysbacteriosis was also discovered. We still don't have teeth. Tell me what should we do in this situation?
24/10/2010 13:48
The child was diagnosed with rickets at 2 months, and the child weighed 5 kg and was gaining quickly, sweating on the back of the head, but the temperature was +40, I was also sweating in the back of the head, does that mean I have rickets? - the doctor just mumbled to this, the child is completely on breastfeeding, my nutrition is correct. I went to another pediatrician and heard that I eat too much dairy and because of this the fontanel closes too quickly, I don’t need to give anything to the child! I think that the first doctor’s diagnosis is complete nonsense!
14/10/2010 15:06
Hello dear doctors! My child is 9 months old. To prevent rickets, the doctor prescribed us to take Aquadetrim one drop per day. I breastfeed my baby and take Elevit vitamins, which also contain vitamin D3. Tell me, is there any danger of overdosing on this vitamin? And if instead of one drop you accidentally drop 2-3 drops, is it okay?
21/09/2010 01:29
The hairs on the back of our heads were also rolling out, our arms and legs were sweating. The clinic prescribed vitamin D. But our fontanel was quickly closing and the visiting pediatrician forbade us to give it, and to walk outside as much as possible (although we were in autumn and there wasn’t enough sun). And then we had to supplement with formula. Moreover, I didn’t give vitamin D, although the clinic again insisted. I said yes, yes, yes, but I did what I thought was necessary. We are almost a year old and everything is OK: our hair is almost shoulder-length, the proportions ideal (as they said at the clinic) and even arms and legs. If the issue is urgent, then it is better to consult. The pediatrician leading us said that an overdose of vitamin D is a very unpleasant thing. In her opinion, it is better not to add more than to develop hypervitaminosis.
11/08/2010 23:34
We are 1.5 months old. The baby was prescribed Aquadetrim after the doctor said that the baby’s forehead was very pronounced! prescribed for prophylaxis. 3 days after we started taking the drops, a nightmare began! It’s like they replaced the baby - she doesn’t sleep, she doesn’t eat well, she’s crying so hard that her hair stands on end! I called my sister in America (she is a doctor) and she scolded us so much that we listen to all the nonsense of our doctors! We stopped the drops and the baby is back to normal! You shouldn’t do everything our doctors say; it’s better to consult more than one doctor. Good luck everyone!
07/06/2010 15:39
my daughter is 4 months old. There is a bald spot, but in addition, she turns her head a lot when she falls asleep.... as Komarovsky wrote - If a child is tossing around in bed and erasing the hair on the back of her head, there are no questions. So does this mean my child has rickets? I give Vit D for 2 months... when I went to the doctor, out of fear because of our bald spot, she prescribed Vit D 3 times a day. Holy crap, I’m a sane person (I thought to myself) and I raise my child according to the EOC method, so I won’t do anything, when the child sits down, the bald spot will grow back! What do you think is correct? Because it’s still scary inside
07/04/2010 19:16
more about rickets, if possible.
son was born in December. He is now 4 months old. His feet and palms are cold and often sweaty. The back of his head recently shuffled, although he sleeps peacefully and does not shake his head.
My son is not freezing and feels fine. When he suckles, he gets warm all over.
I didn’t attach much importance: I thought it was growing, the blood circulation was just developing (and I myself always have them freezing, maybe it’s heredity). We recently went for a massage, and even the massage therapist couldn’t warm them up. the doctor says “rickets” and prescribes (like everyone else, it seems) AquaDetrim.
1. rickets or not?
2. if rickets, then which drug is better to choose?
29/03/2010 10:33
You DO NOT always need to listen to doctors, especially those who do not quite understand the concept of “rickets”. But there are very few people like Dr. Komarovsky in our pediatric pediatrics. Otherwise they begin to treat it for no apparent reason, the child becomes disabled, and then the parents are to blame, you see, they didn’t look at it in time. And the fact that the pediatrician does not distinguish between “rickets” and just a bald spot on the back of the head is “normal”. Not everything your local pediatrician tells you is true. And this must be understood, and first of all, the parents themselves need to learn a little about medicine.
The World Health Organization recommends taking 400-500 IU of vitamin D per day (, - 1 drop) to prevent rickets. Most of Russia is located in northern latitudes. If you take 1 drop of vitamin D per day, 80% of children will develop rickets.
— We are diagnosed with rickets. And all my friends are also diagnosed with rickets. I have not yet seen a single child who was not diagnosed with rickets. Some kind of epidemic? (Julia)
— I’m wondering if there were people who weren’t diagnosed with rickets??? (Valya)
— Rickets is a problem of our climate, I speak for St. Petersburg and Moscow. We don't get enough sunshine, which is why 99% of children have rickets. Southerners have this less problems. (Mara)
In France, all children under 2 years old receive vitamin D in a dose of 1200-1500 IU (3 drops) per day. In England and Germany - 1000 IU (2 drops) daily. In the USA - 800 IU (2 drops) per day. In Poland, vitamin D is prescribed to all children under 3 years of age in a dose of 500-1000 IU (1-2 drops) per day. sunny days and 1000-1500 ME (2-3 drops) on cloudy days.
— I realized that everyone drinks AquaDetrim constantly, 2 drops (prevention). And the pediatrician told me: “Only 1 month and that’s it. Overdose is more dangerous." Now I don’t even know?.. (Katerina)
— To have an overdose of vitamin D, you need to drink one bottle of AquaDetrim a day for a month. Then there will be an overdose. And 2 drops a day is a minuscule amount. (Svetlana the doctor)
Preventative doses of vitamin D
- premature babies take 1000-1500 IU (2-3 drops) of vitamin D from 7-10 days of age;
- Full-term babies take 1000-1500 IU (2-3 drops) from 3-4 weeks.
To prevent rickets, children should spend a lot of time outdoors. In summer, children are taken out into the fresh air from the first days of life, and in cold weather - from 2 weeks of age at an air temperature of at least minus 5°C.
Important!!! All children under 2 years of age should take prophylactic doses of vitamin D. Prophylactic doses are given if there are no signs of rickets (see. If a child has signs of rickets, it is necessary to switch to TREATMENT DOSES.
Treatment of rickets in a child
When signs of rickets appear, they switch to therapeutic doses of vitamin D (see Signs of rickets). Therapeutic doses of vitamin D are at least 3000-5000 IU per day (AquaDtrim, 6-10 drops). Course duration is 30-40 days. Then they switch to a prophylactic dose - 1000-1500 IU per day (AquaDtrim, 2-3 drops). Three months after the main course, treatment with vitamin D is carried out at a dose of 2000-4000 IU per day (AquaDtrim, 4-8 drops) for a monthly course.
Rickets I degree: Signs of rickets from the nervous and skeletal system weakly expressed. At proper treatment Traces of rickets do not remain.
Daily dose: 4000-5000 ME (AquaDtrim, 8-10 drops).
Course dose: 300,000-400,000 ME.
Rickets degree II: Changes in two parts of the skeleton - for example, a flat occiput and rachitic rosary on the ribs. Decreased tone muscles and joint laxity.
Daily dose: 5000-10000 ME (AquaDtrim, 10-20 drops).
Course dose: 400,000-500,000 ME.
— Little girls, what do ADULT people look like who have not had rickets treated? My husband is thin, has a square head, a small hole in the sternum and a pot-bellied appearance. It seems to me that in childhood he was seriously ill with rickets. Or is this body structure abnormal for a 25 year old guy??? (Vasilina)
Rickets III degree: Develops in 10-12 months. On the part of the skeletal system, the changes are pronounced and reach the level of ugliness: square head, “chicken breast”, “shoemaker’s breast”, X-shaped and O-shaped legs. Reduced muscle tone - a large “frog” belly, separation of the rectus abdominis muscles, a “jackknife” symptom (the legs are easily pressed to the head, and the child does not experience anxiety). Delayed motor development. Dyspnea. Tachycardia. Enlarged liver and spleen.
Daily dose: 10000-15000 ME (AquaDtrim, 20-30 drops).
Course dose: 600,000-800,000 ME.
Calcium for the treatment of rickets in children
If the blood biochemistry shows a decrease in general and ionized calcium, take medications orally at the rate of 75 mg of calcium per kg of body weight per day:
- 1 ml of 10% calcium lactate solution contains 16 mg of calcium (75 mg calcium = 4 ml of 10% calcium lactate solution with milk);
- in 1 ml of 10% calcium chloride solution - 36 mg of calcium (75 mg of calcium = 2 ml of 10% calcium chloride solution with milk);
- in 1 ml of a 10% solution of calcium gluconate - 9 mg of calcium (75 mg of calcium = 1.5 teaspoons of a 10% solution of calcium gluconate with milk).
Important!!! Intravenous calcium preparations are administered only for hypocalcemic convulsions: 10% calcium gluconate solution (0.2 ml per kg body weight) diluted 5-10 times in glucose, administered slowly. In premature infants, this route of administration can cause necrosis in the liver and necrotizing enterocolitis.
Ultraviolet irradiation (UVR) for the treatment of rickets in a child
The therapeutic effect can be achieved by ultraviolet irradiation: 20-25 sessions, starting from 1/4 biodose to 3 biodoses. It is not recommended to prescribe ultraviolet radiation and vitamin D at the same time.
Prescribed for the treatment of rickets therapeutic doses vitamin D, however, it should be noted that due to excess this drug the child may also have serious complications (e.g. kidney dysfunction, allergic attacks, liver disorders). To avoid such consequences, before giving your child vitamin D, you should carefully read the doctor’s instructions and, if necessary, consult directly with a specialist.
What are the severity levels of rickets?
There are the following degrees of severity of rickets:
- first degree ( light);
- second degree ( moderate severity);
- third degree ( heavy).
| Severity of rickets | Clinical manifestations |
| First degree (light) | Affected nervous system, and minor changes are also observed bone structure. Manifestations of the first degree of severity of rickets are:
|
| Second degree (moderate severity) | It is characterized by more pronounced damage to the bone, muscle and nervous systems. With the second degree of severity of rickets, the child experiences the following manifestations:
|
| Third degree (heavy) | Long ones are affected tubular bones, and there is also a worsening of all of the above symptoms. With the third degree of rickets, the following pathological changes are formed:
|
Depending on the severity of rickets, therapeutic doses of vitamin D2 are prescribed in the following order:
- with rickets of the first degree of severity prescribed two to four thousand international units per day for four to six weeks; The course dose is 120 – 180 thousand international units;
- with rickets of the second degree of severity prescribed four to six thousand international units per day for four to six weeks; The course dose is 180 – 270 thousand international units;
- with rickets of third degree of severity prescribed eight to twelve thousand international units per day for six to eight weeks; The course dose is 400 – 700 thousand international units.
What types of rickets are there?
There are the following types of rickets:
- vitamin D-deficient ( classical) rickets;
- secondary rickets;
- vitamin D-dependent rickets;
- vitamin D-resistant rickets.
| Types of rickets | Description |
| Vitamin
D-deficient (classical)rickets | This type of rickets most often occurs in the first years of a child’s life. The period of children's development from two months to two years is considered the most dynamic, and the growing body's need for phosphorus and calcium increases. Vitamin D-deficient rickets occurs when the child’s body does not receive the necessary resources due to insufficient intake of vitamin D from food or due to a violation of the system that ensures the delivery of phosphorus and calcium. The occurrence of classic rickets is accompanied by such predisposing factors as:
|
| Secondary rickets | This type of rickets develops against the background primary disease or a pathological process existing in the body. There are the following factors contributing to the development of secondary rickets:
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| Vitamin D-dependent rickets | This type of rickets is a genetic pathology with an autosomal recessive mode of inheritance. With this disease, both parents are carriers of the defective gene. There are two types of vitamin D-dependent rickets:
|
| Vitamin D-resistant rickets | The development of this type of rickets is facilitated by such background diseases How:
|
What are the first signs of rickets?
Most often, the development of rickets is observed in children aged three to four months. When there is a lack of vitamin D, the child’s nervous system is the first to suffer. A child with rickets is usually restless, irritable, whiny, sleeps poorly and shudders in his sleep. Also noted increased sweating, which occurs most often during feeding and sleeping of the child. Due to metabolic disorders, the child’s sweat, like urine, acquires an acidic character and a corresponding sharp sour odor. Due to sweating and friction of the head on the pillow, the child experiences baldness at the back of the head. “Acidic” urine, in turn, irritates the baby’s skin, causing diaper rash. also in initial stage rickets, the child loses his skills acquired by three to four months. The baby stops walking and rolling over. There is a delay in the child's psychomotor development. Subsequently, such children begin to stand and walk late and their first teeth, as a rule, appear later.
If you do not pay attention to the first manifestations of rickets in time, then the subsequent development of this disease may lead to more serious violations from the skeletal and muscular systems.
Besides clinical symptoms the diagnosis of rickets is confirmed by biochemical laboratory research. These tests determine the amount of phosphorus and calcium in the child's blood. With rickets, the above indicators ( phosphorus and calcium) are reduced.
When the first signs of rickets appear, it is strongly recommended:
- consult a doctor immediately;
- refrain from self-medication;
- ensure that the child receives the dose of vitamin D strictly prescribed by the doctor;
- regularly take walks with your child in the fresh air;
- monitor the child’s nutrition, it should be regular and rational ( increase intake of foods rich in vitamin D);
- regularly massage and exercise your baby;
- observe the work and rest schedule.
Lack of which vitamin leads to rickets?
Rickets is considered to be a “classical” disease childhood, in which a metabolic disorder occurs in a young body - calcium and phosphorus. Particularly dangerous this disease in the first year of a baby’s life, when active formation occurs bone tissue. Developing rapidly, this disease usually leads to serious changes in the child’s bone structure, also affecting his nervous and muscular systems. These pathological changes occur due to a lack of vitamin D, which, in turn, is a regulator of metabolism in the human body.
Vitamin D is considered universal. This is the only existing vitamin that can enter the human body in two ways - through the skin under the influence ultraviolet rays, as well as through the mouth, entering the body with food containing this vitamin.
Highlight following products Vitamin D rich foods:
- fish fat;
- fish roe;
- butter, margarine;
- vegetable oil;
- sour cream, cottage cheese, cheese;
- egg yolk;
- liver ( beef, pork, chicken).
This is why vitamin D is prescribed in the last trimester of pregnancy, since during this period of time a woman prepares her body not only for birth, but also for further feeding of the child.
A prophylactic dose of vitamin D is also given to the baby immediately after birth. It is taken from October to May, that is, in those months when there is not enough sunlight. From May to October, vitamin D is usually not prescribed, but it is strongly recommended that you take your child for regular walks in the fresh air.
The individual dose of vitamin D prescribed will depend on the following factors:
- child's age;
- genetic features;
- type of feeding of the child;
- severity of rickets;
- presence of other pathological processes in organism;
- season ( weather of the area where the child lives).
For any pathology daily norm Vitamin D is prescribed by a doctor.
It should be noted that an overdose of vitamin D can lead to serious consequences. Therefore, in order to avoid this complication, it is recommended that the child undergo the Sulkovich test once every two to three weeks. This test consists of determining the presence and level of calcium in the urine being tested.
Urine for this sample is collected in the morning, before meals.
The results of the study are determined depending on the degree of turbidity of the urine:
- minus is negative result, in which the child may have a deficiency of vitamin D;
- one or two pluses are considered normal;
- three or four pluses indicate increased secretion calcium.
What care does a child need with rickets?
Child care is important aspect treatment of rickets. At the same time, high-quality child care should be provided both in the hospital and at home. When caring for a child with rickets, medical staff must do the following:
- monitor the child’s behavior;
- inspect and palpate the fontanelles ( big and small);
- check the fusion of cranial sutures;
- carry out a thorough examination of the chest of children four to six months old in order to determine the pathological thickening of the costosternal joints;
- monitor thickening of the epiphyses of the bones of the lower leg and forearm, as well as curvature of the bones in children older than six months;
- determine motor activity child, as well as the state of muscle tone;
- make adjustments to the child’s diet;
- teach the rules of care for the parents of the baby.
- Therapeutic doses of vitamin D are prescribed;
- a child in the third or fourth month of life, who is on natural feeding, juices, fruit decoctions, vegetable purees, yolk and cottage cheese are introduced into the diet ( children on artificial and mixed feeding, the first complementary foods are introduced one month earlier);
- Enzymes are prescribed along with food ( e.g. pancreatin, pepsin) And hydrochloric acid, which the child needs to improve digestion processes;
- Also, in order to reduce the degree of acidosis, B vitamins are prescribed along with nutrition ( B1, B2, B6), vitamin C and citrate mixture ( a product that contains lemon acid, sodium citrate and distilled water);
- nurse monitors calcium levels in urine ( using the Sulkowicz test);
- calcium is prescribed in the form of a five percent solution, which is given to children orally ( in the mouth) at the first signs of bone softening;
- Physical therapy and massage are regularly performed;
- coniferous and saline are prescribed medicinal baths (the course includes ten to fifteen baths);
- course is being conducted ( consisting of 20 – 25 sessions) ultraviolet irradiation at home, in winter period time.
- Daily walks with your child in the fresh air. Wherein total time time spent outdoors should be at least five hours a day summer period time and about two to three hours in winter ( depending on temperature). When walking with a child, you need to make sure that his face is open.
- Regular gymnastic exercises. It is recommended to perform flexion and extension movements of the child’s arms and legs, as well as to perform adduction and abduction of the baby’s limbs.
- Regular hardening child. It is necessary to harden the baby gradually. For example, while swimming warm water, at the end it is recommended to rinse the child with water one degree lower. Then, as you get used to it, during subsequent bathing the water temperature can be reduced lower.
- Proper organization daily routine for the child.
- Monitor regularity and rationality of nutrition. Complementary foods that are introduced must be appropriate for the child’s age. It is also necessary to increase the consumption of foods rich in vitamin D ( for example, liver, fish, egg yolk, butter, cottage cheese).
- Accurate implementation of actions as prescribed by the doctor.
Is it possible to cure rickets?
Rickets can be completely cured, but to do this you will need to do the following:
- It is very important to detect the first symptoms of this disease in a timely manner, since treatment of rickets at an early stage helps speedy recovery child. The first manifestations of rickets are usually excessive sweating, mainly observed at night and after feeding the baby, anxiety and irritability, tearfulness, sleep disturbance, manifested by frequent startlings, itchy skin, as well as baldness of the back of the head.
- If you suspect rickets, you should immediately consult a pediatrician. Self-medication in this case is strictly contraindicated. The doctor, in turn, can immediately diagnose rickets based on clinical manifestations of this disease or prescribe certain diagnostic procedures to identify pathology. Once rickets is confirmed, the child will be prescribed appropriate treatment.
- Treatment of rickets includes rational feeding of the baby, organization moving image life, vitamin therapy, regular walks in the fresh air, as well as eliminating the causes of the disease. In this case, all stages of treatment should be performed strictly as prescribed by the doctor.
The child's food should be complete. It must contain all the necessary nutrients. Especially for rickets, food rich in vitamins and microelements is useful. Most the best food in this case is the mother's breast milk, which is rich in vitamins, amino acids, enzymes and immune bodies. The composition of breast milk is optimal for the baby, as it best suits his nutritional needs. In case of forced transfer of the baby to mixed and artificial feeding It would be more rational to use adapted milk formulas, the nutritional composition of which is as close as possible to nutritional composition breast milk.
Among the adapted milk formulas, the following can be cited as an example: trade marks How:
- "Detolact";
- "Baby";
- "Vitalact".
Organization of an active lifestyle
This includes massage, as well as the use of various gymnastic exercises ( e.g., arm adduction and abduction, and flexion exercises of the upper and lower extremities). These procedures have a beneficial effect on metabolic processes in the skin, thereby increasing the production of vitamin D. Massage is usually done two to three times a day for eight to ten minutes.
Regular walks in the fresh air
You should walk with your child every day for at least two to three hours, especially on sunny days. This procedure promotes the formation of vitamin D in the child, which is synthesized in the skin under the influence of ultraviolet rays.
Vitamin therapy
The main method of treating rickets is therapeutic use vitamin D. When used this tool It is necessary to strictly follow the doctor’s recommendations, since an overdose of vitamin D may cause intoxication of the body.
What changes in the head are observed with rickets?
At the beginning of the disease no major changes no head happens. During this period, the child has increased sweating, especially in the scalp area ( in 90% of children). In this regard, during sleep, friction between the back of the head and the pillow is created and, due to hair loss, the baby develops areas of baldness with a clearly visible venous network. With subsequent progression of the disease, there is some softening of the edges of the greater fontanelle, as well as the bones at the site of the sagittal ( located between the parietal bones) and occipital sutures.
The height of the disease is characterized by thinning and softening of the bones of the skull ( craniotabes). These pathological changes in bones are especially pronounced in the area of the greater and lesser fontanelles, as well as in the area where the sutures of the skull pass. In this regard, the child’s large fontanelle closes quite late, by the age of two to three years. The baby also shows alignment of the parietal and occipital bones.
From the bone side facial section the following changes are observed:
- incorrect jaw relationship ( top and bottom);
- malocclusion;
- narrowing of the palate;
- possible narrowing of the nasal passages.
It should also be noted that as the disease progresses, the frontal and parietal tubercles increase, due to which the head increases in size and externally takes on a square shape.
The development of these pathological changes in the head largely depends on:
- child's age;
- severity of the disease;
- individual characteristics baby's body.
Is it necessary to take calcium for rickets?
Calcium plays an indispensable role in the growth of a child. Thanks to calcium, the bone skeleton becomes strong and can withstand heavy loads. In addition, the participation of calcium is indispensable in the processes of blood clotting, as well as in the functioning of the nervous system. The need to take calcium supplements occurs when a child has hypocalcemia ( decrease in certain calcium levels in the blood plasma). With rickets, this condition can occur with active bone mineralization, as well as in premature or low-birth-weight children.
It should also be noted that calcium supplements for rickets can be prescribed if the child has various changes skeletal system.
Rachitic changes in the skeletal system can occur due to:
- delayed bone formation ( hypogenesis);
- excessive formation of osteoid tissue ( osteoid hyperplasia);
- softening bones ( osteomalacia).
Among calcium preparations, examples include Calcium gluconate and Complivit. For complete absorption, calcium supplements are usually prescribed in combination with vitamin D.
Among the foods rich in calcium are the following:
- processed cheese;
- cottage cheese;
- sour cream;
- feta cheese;
- beans;
- peas;
- almond;
- pistachios.
Vitamin deficiencyD- the main cause of the development of rickets. Vitamin deficiency can be acquired or caused by genetic disorders.
Note that rickets can also develop with normal level vitamin D. In this case, other processes are involved in the pathogenesis of the disease, leading to pathological changes in bone tissue.
Reader Questions
18 October 2013, 17:25 my question will concern vitamins. I am 19. my hair has always been long and thick and healthy in structure, now it has become thinner and is falling out (I am taking care of pharmacy shampoo And burdock oil and all sorts of infusions and serums).. the nails are normal, but small island-like dots have appeared and do not disappear (I began to paint less often). Well, the pressure began to drop catastrophically, with a height of 167 and a weight of 60 every day 80-90 per 50... I I started thinking about taking vitamins. Previously (about a year ago) I took AEvit (from the 14th day of the cycle until the start of the next one), Pregnavit (from the 1st to the 14th day of the cycle), fish oil and the result was good (but I also had the hepatoprotector Karsil). Now I’m doing the same I’m thinking about these drugs, but I would like to consult about the correct solution to my problem, and about the schedule for taking and dosages of the above vitamins. I’m waiting for an answer
Ask a QuestionVitaminDin the treatment and prevention of rickets
One of the key components specific treatment Rickets is caused by taking vitamin D supplements. Drug therapy should be carried out in combination with gymnastics, sunbathing, Ural Federal District, and other general strengthening measures.
Prevention of rickets should be carried out during pregnancy. A young mother should spend more time in the fresh air, and also include fermented milk products, butter and vegetable oil, fish, meat and a sufficient amount in her diet. fresh vegetables and fruits. In winter, when solar activity is low, it is recommended for pregnant women.
Postnatal prevention of rickets includes:
- breastfeeding the baby;
- balanced diet nursing mother;
- regular gymnastics and massage for the baby;
- taking vitamin D (as prescribed by a doctor).
Vitamin overdoseD
As mentioned above, vitamin D is a fat-soluble vitamin. This means that it can accumulate in fatty tissues. While water-soluble vitamins are excreted within 24 hours, fat soluble vitamins are retained in the body, and when high concentrations may have a toxic effect.
With an overdose of vitamin D in children, an increase in body temperature is also observed. Excess vitamin D inhibits nervous and muscular system, negatively affects liver function and can also provoke allergic attacks.
