How to determine if a baby has rickets

Written by Tong Peng
Pediatrics
Updated on May 21, 2025
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The diagnosis of rickets in infants should rely on the level of 25-hydroxyvitamin D3 in the blood and the examination of the long bones through X-rays imaging, rather than early symptoms. However, due to the young age of infants, it is recommended to supplement vitamin D within two weeks after birth. If the supplementation is not timely, some early clinical manifestations may appear occasionally, such as brachycephaly, bowed legs, and pigeon chest in infants. Additionally, there may be abnormalities in the nervous system, such as unstable sleep, easily startled and crying, and increased excitability. Therefore, it is necessary to identify the condition through the aforementioned tests and then proceed with symptomatic treatment.

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Written by Tong Peng
Pediatrics
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Will the frontal bossing from rickets get better?

Rickets, if presenting with frontal bossing, can recover depending on the specific condition and age of the child. Rickets is often divided into four stages, with sequelae usually occurring after the age of three. Therefore, if symptoms of rickets are present before the age of three, they can be alleviated through supplementation with vitamin D, calcium, and other trace elements. Symptoms of rickets include craniotabes, Harrison's groove, beading of the ribs, pigeon chest, everted ribs, bowlegs, and knock-knees. Frontal bossing is often a manifestation of craniotabes, which usually occurs during infancy. Supplementing with vitamin D during this period can greatly alleviate the condition. At the same time, it is important to also expose the child to sunlight and engage in outdoor activities to promote the bones' absorption of vitamin D and calcium, preventing the recurrence of symptoms.

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Written by Li Jiao Yan
Neonatology
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How to treat rickets in a 2-year-old baby?

Rickets in two-year-old infants is caused by a deficiency in vitamin D leading to a disturbance in calcium and phosphorus metabolism, resulting in abnormal skeletal development. This class of systemic, chronic, nutritional diseases typically manifests in two-year-olds who are able to walk and stand. Due to the force of gravity, lower limb deformities may develop, leading to bowlegs or knock-knees, and possibly even a 'K'-shaped limb deformity. The spine may also develop kyphosis or scoliosis. Around the age of two, it is generally the residual stage of the disease, which often does not require pharmacological treatment. For mild to moderate cases, physical exercise should be enhanced, and active or passive rehabilitation methods should be used to correct skeletal deformities. It is recommended to seek treatment in the pediatric rehabilitation department; severe skeletal deformities may require surgical correction.

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Written by Li Jiao Yan
Neonatology
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Which department should I go to for rickets?

Rickets is a nutritional disease caused by a deficiency in vitamin D, leading to disturbances in calcium and phosphorus metabolism and resulting in abnormal bone development. During the early and active stages, the X-ray shows no obvious abnormalities in bone development; it is primarily a conceptual metabolic disorder along with low levels of vitamin D. At this time, it is advisable to consult an endocrinology department. If there are sequelae and mild to moderate sequelae, rehabilitation methods are needed for correction, and at this point, a rehabilitation department should be consulted. If there are severe skeletal deformities, surgical correction may be necessary, and at this time, an orthopedic department should be consulted.

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Written by Tong Peng
Pediatrics
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Can rickets with rib eversion in babies be cured?

Babies with rib flaring can be treated, but it requires assessment based on relevant clinical symptoms and laboratory tests. First, it is necessary to understand that rickets is a metabolic bone disease caused by a deficiency of vitamin D, which often results not only in rib flaring but also in square skull, pigeon chest, and either bowlegs or knock-knees. Neurologically, symptoms may include night sweats, easy startling during sleep, and poor sleep quality. When these conditions occur, a physical examination by a specialist is essential, along with comprehensive tests, including measuring the specific levels of vitamin D, and selecting appropriate vitamin D supplements. If the symptoms of rib flaring are severe and accompanied by a noticeable pigeon chest, orthotic supports may also be necessary for correction. If rib flaring affects normal breathing, severe cases may require surgical treatment. Therefore, the extent of severity based on clinical symptoms will dictate the treatment approach—whether it is oral medication, orthotic correction, or surgery.

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Written by Li Jiao Yan
Neonatology
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How should children with rickets supplement calcium?

Rickets is a nutritional disease caused by a deficiency in vitamin D, leading to disturbances in calcium and phosphorus metabolism in the body, which results in abnormal bone development. It is mainly due to a lack of vitamin D, so the primary treatment is supplementing with vitamin D. Dairy is a reliable source of calcium nutrition for infants, and generally, it is not necessary to supplement calcium for the treatment of rickets; attention should be paid to supplementing with vitamin D according to the severity of the condition, and spending more time in the sun. For children who have started eating complementary foods, or older children, it is generally recommended to fully supplement vitamin D levels, spend more time in the sun during summer, and consume high-protein nutrients. Additionally, eating more vegetables and appropriately supplementing with calcium supplements in the winter is advised. The dosage should be based on the child's internal levels of calcium and phosphorus, with calcium supplementation adjusted accordingly.