What are the early symptoms of rickets?

Written by Tong Peng
Pediatrics
Updated on December 15, 2024
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The early symptoms of rickets are mainly due to the inadequate intake of vitamin D in children, leading to disturbances in the body's calcium and phosphorus metabolism. Early signs usually appear around three months of age in infants, characterized by changes in mental state, restless sleep, frequent crying, and excessive sweating. Increased sweating is often accompanied by cradle cap, where circular bald patches appear on the back of the head. In such cases, it is important to include vitamin D-rich foods in the diet and supplement with vitamin D. Continued breastfeeding, engaging in outdoor activities, and exposure to sunlight are recommended to promote the body’s own synthesis of vitamin D. Regular physical examinations are also advised, and if symptoms of rickets occur, an appropriate increase in vitamin D intake may be necessary.

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Written by Li Jiao Yan
Neonatology
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Can rickets be cured?

The rickets we commonly talk about is nutritional Vitamin D deficiency rickets, which is due to a deficiency of Vitamin D in the body leading to a disorder of calcium and phosphorus metabolism. This results in a systemic nutritional disease characterized by skeletal lesions. If rickets is caused by insufficient intake, it can be self-healing and is a self-limiting disease. Once infants and young children spend enough time outdoors and receive physiological doses of Vitamin D treatment, rickets can be treated. However, treatment becomes significantly challenging in cases of congenital developmental abnormalities causing skeletal lesions, or any genetic diseases that lead to Vitamin D absorption disorders. Such cases often result in severe complications, including prominent kidney dysfunction leading to further disturbances in calcium and phosphorus metabolism, as well as liver function abnormalities causing Vitamin D synthesis disorders. Therefore, it is important to understand the specific causes of Vitamin D deficiency in children, and if the deficiency is due to common reasons that can be promptly controlled, then supplementation with Vitamin D and trace elements like calcium can effectively treat the condition.

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Written by Tong Peng
Pediatrics
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Does rickets have anything to do with milk powder?

Rickets is not necessarily linked to formula milk. Rickets is mainly a metabolic bone disease caused by a deficiency of vitamin D in the body, while the main components of formula milk are various nutrients, including trace elements and vitamins. If the formula contains insufficient calcium, it may exacerbate the symptoms of rickets. Therefore, the main requirement is to intake enough vitamin D. National child healthcare guidelines require that children be supplemented with 400 to 800 units of vitamin D daily from two weeks after birth until the age of two. Additionally, it is important to get ample sunlight in daily life and engage in reasonable outdoor activities to promote calcium absorption, which can effectively prevent rickets. The amount of vitamin D and calcium in formula milk cannot meet the growth and developmental needs of children, so additional supplementation is necessary. Thus, there is a certain connection between rickets and formula milk, but it is not inevitable.

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Written by Yao Li Qin
Pediatrics
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The main manifestations of rickets in the early stage

Rickets generally refers to vitamin D deficiency rickets, mainly due to insufficient vitamin D in children, leading to calcium and phosphorus metabolism disorders. It is a chronic nutritional disease characterized by skeletal lesions. The main manifestations are changes in the fastest growing parts of the skeleton, which can also affect muscle development and changes in neural excitability. The initial symptoms of rickets are common in infants, especially those under three months old. The main symptom is increased neural excitability; the child is particularly prone to being agitated, irritable, crying, sweating, and shaking their head due to scalp stimulation, but these are not specific symptoms of rickets. Therefore, blood tests are still necessary in the early stages, showing decreased levels of 25-hydroxyvitamin D3, blood calcium, and blood phosphate, increased PTH, normal or slightly elevated alkaline phosphatase activity, and normal or slightly blurry calcification zones in skeletal X-rays. These are the early manifestations of rickets.

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Written by Liu Li
Pediatrics
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What foods should not be eaten with rickets?

Patients with rickets should not eat some cereal foods, such as millet, rice, wheat, corn, and other foods. Cereal foods also contain vitamin D and calcium, and eating too much of these foods can exacerbate the disease. Patients with rickets should eat more light, low-fat, and easily digestible foods. They should control the intake of high-fat content daily and avoid eating stimulating and spicy foods. At the same time, they should increase their intake of vitamins, encourage the child to eat more fruits and vegetables to ensure an adequate supply of vitamins, and patients can also exercise more. More physical activity can help boost the immune system.

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Written by Li Jiao Yan
Neonatology
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Can rickets be treated by injection?

Rickets is primarily caused by a deficiency of vitamin D, leading to a disturbance in calcium and phosphorus metabolism in the body, which results in abnormal bone development. It is a systemic nutritional and chronic disease. The main treatment is to supplement a sufficient dosage of vitamin D, generally administered orally. The choice of vitamin D formulation, dosage, duration of treatment, whether it is administered once or multiple times, and whether supplementation is oral or intramuscular, should be determined based on the specific situation of the child. Relevant tests are generally required, and the doctor will develop a treatment plan based on the child's condition. The route of administration should also be decided based on the condition of the disease.