Very rarely do you see little kids and/or adults walking around sporting a super sunburn in these early summer months as we did years ago, with the increased use of sunblock…which is awesome that people are using sunblock to prevent skin cancer and sunburns but it can lead to a lack of vitamin D, which has its own set of issues. There is an increase in prevalence, specifically in children, of rickets, which has been more of a rarity of a childhood disease.
What is Rickets?
Rickets is a deficiency of vitamin D, calcium, or phosphate which leads to a softening or weakening of bones. Vitamin D assists with the absorption of calcium and phosphate from the GI tract, so when a vitamin D deficiency is present, we cannot adhere as much calcium and phosphate to our bones and they become weakened. If left untreated, it can lead to long-term bone deformities, dental issues, failure to grow appropriately, breathing problems and chronic pneumonia, and seizure disorders.
Some common signs and symptoms of rickets:
Delayed growth
Pain in pelvis, spine, legs (different from growing pains which are quick and go away)
Muscle weakness
Curved legs (bowed)
Curvatures of the spine
Thickened wrists and ankles
Breastbone projection
What are causes and prevention?
Well, obviously the cause is a lack of vitamin D and that can be due to a lack of absorption of sunlight by the skin. When sunlight is absorbed by the skin, it produces Vitamin D, and when people lather up in SPF 50 at all times and avoid direct sunlight, they can become deficient, as SPF helps to block the rays that can trigger vitamin D production. Also we can be missing vitamin D in our food sources. Milk, cereal, and some juices are fortified with Vitamin D to ensure that kids are taking in enough, but it is also naturally present in egg yolks, fatty fish, and fish oils. Sometimes getting fish (especially fatty fish) in kids can be tough, but eggs can be easier, which is one of the reasons other foods were fortified. Any diseases that prevent absorption of foods can cause a vitamin D deficiency, like; celiac disease, inflammatory bowel disease, kidney disease, and cystic fibrosis.
What are risk factors?
Children between the ages of 6 and 24 months old are at higher risk due to fast skeletal development
Exclusively breastfed babies are not getting vitamin D from breast milk (formulas are fortified)
Dark skinned people, as darker skin doesn’t react to produce as much vitamin D as lighter skin does
Living in Northern latitudes because there is less available sunshine throughout the year due to being further from the equator.
Premature babies, they don’t seems to absorb the vitamin d from GI tracts as well and are at higher risk
Some anti-seizure medications can interfere with vitamin D absorption.
What are the treatments?
Rickets are diagnosed through x-rays, physical assessment, and blood and urine samples to assess vitamin D levels. Once diagnosed, the treatment is vitamin D and calcium supplementation. You can also get sunlight exposure (outside of the hours of 10am-2pm when the sun is strongest). If the bones are very deformed, your HCP may order special braces to correct the deformities.
As with any disease, prevention is key! Make sure that you and your children are taking in adequate amount of vitamin D through fortified foods (milks, cereals, juices) and through taking in egg yolks, fatty fish, and/or taking fish oil supplements. Also, I am totally behind the whole prevention of skin cancer, do not get me wrong, but at 4pm, if you kid is going out to the park, you can lay off the SPF 50 and let them absorb some direct sunlight, I promise they will appreciate not being super lubed up AND it is actually healthy for them so they can absorb some of that vitamin D….actually when they don’t have bowed legs, they will really give you a thank you for skipping the late day SPF! Keep it in the back of your mind, and think about your child’s nutritional status and what they eat, if you are at all concerned talk to your HCP and they can test them for their vitamin D and calcium levels and add some supplementation if you re worried they aren’t getting enough. I know, one more thing to think about!
Yours in Good Health
B
