How to prevent skeletal deformities in rickets

Written by Wang Xiao Jing
Pediatrics
Updated on January 12, 2025
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Rickets is mainly caused by a deficiency of vitamin D. Therefore, within half a month after a child's birth, a preventive dose of oral vitamin D should be administered. Continue breastfeeding, allow the baby to get plenty of sunlight when the weather is warm, and timely introduce calcium-rich supplementary foods. In the early and active stages of rickets, appropriate supplementation with calcium and vitamin D can prevent the occurrence of skeletal deformities caused by the disease.

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Written by Yao Li Qin
Pediatrics
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Clinical manifestations of rickets

Rickets, also known as vitamin D deficiency rickets, occurs because children do not supplement vitamin D in a timely manner after birth, leading to a deficiency of vitamin D in the body and resulting in a nutritional metabolic disease primarily involving skeletal changes. In the early stages, children mainly show symptoms related to mental and emotional state, such as irritability, crying, excessive sweating, shaking their heads back and forth, and rubbing their heads. Subsequently, symptoms like bald patches on the back of the head and softening of the skull bones may appear. As children grow, they may develop conditions such as a square-shaped skull, beaded ribs, pigeon chest, funnel chest, and bracelet-like deformities around the wrists and ankles. In severe cases, children may later develop X-shaped legs and O-shaped legs. If rickets is suspected, it is crucial to promptly conduct a blood test to measure the vitamin D level. If the level is below normal, it is essential to actively treat the diagnosed rickets.

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Nursing Measures for Children with Rickets

Rickets requires relevant home care. During the active phase of rickets, it is best to avoid early sitting, standing, and walking. For chest deformities, prone neck lifting and chest expansion exercises can be performed. For lower limb deformities, muscle massage can be done. For bow legs, massage the outer leg muscles and perform abductive and external rotation exercises after massaging both knee joints. For knock knees, massage the inner muscle group and perform internal rotation exercises after massaging both ankle joints. For posterior protrusion of the lumbar spine, massage the lumbosacral area and frequently lie prone to increase muscle tone, assisting in the recovery of deformities. For mild to moderate bow legs, it may be appropriate to slightly elevate the outside of the shoe by about 0.5 cm. For mild to moderate knock knees, it may be appropriate to slightly elevate the inside of the shoe by about 0.5 cm. Observe for one to three months and adjust the padding height as necessary, which generally can correct the condition. Additionally, children should be exposed to more outdoor sunlight and have a rich nutritional intake, including nutrient-rich proteins and dairy products to aid in recovery from the disease.

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Written by Zhang Xian Hua
Pediatrics
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Is pillow baldness rickets?

Balding at the back of the head is a common clinical manifestation of rickets, but it does not mean that balding at the back of the head is equivalent to rickets, as there are many causes for this condition. In children with rickets, due to a lack of vitamin D leading to calcium deficiency, their neural excitability increases, which can affect the baby's sleep and cause restless sleep leading to balding at the back of the head. However, children who are in poor nutritional condition might also experience deficiencies in trace elements, such as a lack of zinc or iron, which can also lead to sleep disturbances and balding at the back of the head, indicating that the cause may not necessarily be rickets. Additionally, a small number of children might have an inherent condition of increased neural excitability that affects sleep, leading to balding at the back of the head, which also isn't due to rickets. Therefore, if balding at the back of the head occurs, it is advisable to visit a hospital’s pediatric healthcare department or pediatric outpatient clinic for a consultation and check-up, to actively treat and manage based on the underlying cause.

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Can rickets be vaccinated against?

Children with rickets can be vaccinated, as rickets is not listed among the contraindications for vaccination. Rickets is a disease caused by a deficiency of vitamin D, a nutritional issue. Once diagnosed with rickets, it is essential to treat the child promptly by supplementing vitamin D. Generally, if treated early during infancy, rickets can be cured. To prevent rickets, all children should supplement with the physiological requirement of vitamin D from birth, engage in outdoor activities, and get ample sunlight to thoroughly prevent the occurrence of rickets. Rickets does not affect the administration of vaccines, nor does vaccination exacerbate the symptoms of rickets. Therefore, it is clear that children with rickets can be vaccinated.

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Neonatology
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How is rickets treated?

How is rickets treated? Rickets is caused by a lack of vitamin D, leading to disturbances in calcium and phosphorus metabolism. The common nutritional deficiency of vitamin D, primarily due to insufficient intake, results in abnormal bone development. At this time, effectively supplementing vitamin D, engaging in appropriate outdoor activities, and receiving ample sunlight can treat rickets in children. However, there are some special cases, such as significant abnormalities in liver or kidney function, where treatment should be targeted based on the cause of the condition. In addition, some congenital genetic abnormalities causing disturbances in calcium and phosphorus metabolism can make treatment more challenging. Therefore, the treatment of rickets should be based on specific conditions. Generally, if it is simply a case of nutritional deficiency of vitamin D, the treatment outcome is quite favorable and the condition is considered self-limiting. Thus, if a vitamin D deficiency is detected, it is important to supplement promptly to prevent further abnormal bone development.