Rickets is a disease of growing small children, associated with metabolic disorders and vitamin D deficiency, and affects primarily bone and the nervous system.
Rickets was known in ancient times. In the second century BC Soran Efessky and Galen described the rachitic changes in the skeletal system. About the XV-XVI centuries rickets was a fairly common disease among young children, especially those from large (for the time) cities of Europe. Not accidentally, many famous Dutch, Flemish, German and Danish artists of the time often portrayed in their works of children with typical signs of rickets (overhanging brow ridges, rounded head, flattened belly, twisted limbs, etc.).
And even now, rickets is a fairly common disease. It affects 20 to 60 percent of Russian children. This is especially true living in the Northern regions and major polluted cities, rural children and southerners get sick less.
Rickets – pictures, images, photos
To the child’s body was formed correctly, it needs the whole package of nutrients. Part of their child receives from the mother’s milk or adapted mixture. However, the need for vitamin D is not always filled. If the body lacks, developing rickets.
Often rickets occurs in children who are born weak, and too much or too little weight.
The symptoms of rickets in children:
The lack of important vitamin in the first place reacts nervous system of the child. He often cries, less sleep and eat. You notice increased sweating ( especially on the forehead ) while crying, sucking. And during sleep around baby’s head is formed a wet spot. He roll down the back of my hair, and it forms a small had. This is one of the most typical indicators of early stages of rickets in children.
At a later stage occurs muscular hypotonia. These children later others begin to hold her head up, roll over from back to tummy, not in a hurry to crawl and walk. The fontanel is not closed. Teeth erupt behind schedule.
Often occurs anemia. Thorax with rickets protrudes thicken the edges, there are thickenings near the wrist joints. If your baby starts walking, he bent leg bones.
Treatment of rickets in children:
In rickets in children, doctors often resort to hospitalization. Usually there is an intensive treatment at home under the supervision of a pediatrician. It aims to correct vitamin D deficiency and correct violations that have already occurred in the body. The sun is an important component of successful treatment of rickets in children.
Treatment of children with manifestations of rickets should be comprehensive, taking into account the causes that led to the development of the disease. And to start the treatment is necessary when the first symptoms of the disease and hold it for a long time, achieving a complete cure of the child. Treatment of rickets is prescribed by the pediatrician. It is necessary to distinguish specific and nonspecific methods of treatment of rickets.
Among non-specific methods aimed at overall strengthening of the body, of great importance are:
- well-organized routine with sufficient exposure of the child to fresh air;
- power, aimed at normalization of disturbed metabolic processes in the body of a baby;
- having regular exercises, massage, diving.
Children should be outdoors at least 2-3 hours. Remember that children’s skin because of its features (reduced ability to produce pigment melanin) are very sensitive to UV rays. In this regard, in the summer the children in the first year of life contraindicated direct sunlight. To in the skin of the baby has developed enough vitamin D, enough walks in the so-called “Lacy” the shade of the trees and not out in the sun.
Optimal for the child’s first year of life breastfeeding is. If the kid is forced to get artificial feeding, it is necessary to give preference to the milk mixture as close as possible (adapted) in composition to women’s milk. As children with manifestations of rickets, lack of calcium and phosphorus and vitamins (not only vitamin D, but vitamins A, C, b) exchange, it is crucial to enter in the food fruit and vegetable purees, juices, cereals, meat, cheese. As a first feeding to children suffering from rickets, recommended vegetable puree (4-6 months) followed by the addition thereto of egg yolk at 7-8 months, rich in calcium, phosphorus, vitamins and trace elements. Adding to the nutrition of cereals, cheese, meats will help ensure adequate intake of complete proteins child. But the excessive consumption of bread, flour products, fat must be avoided, as they impair the absorption of calcium in the intestine.
Mandatory in the treatment of rickets is the prescription of vitamin D and of calcium and phosphorus, in other words, specific treatment.
Vitamin D supplementation, calculation of therapeutic doses and duration of treatment is defined only by the pediatrician with regard to the severity of rickets in the child, as well as the presence of concomitant conditions such as prematurity, anemia (decrease of hemoglobin in the blood), goiter, diseases of the skin, liver, kidneys, etc.
It should be noted that medications can contain vitamin D in the form D2 (ergocalciferol) or D3 (cholecalciferol), be in the form of oil, water or alcohol solution. Vitamin D is measured in international units (ME). Before you start giving the vitamin D to the child, parents should pay attention to the content in one drop of the solution that must be marked on the bottle: 1 drop of oil solution contains about 650 IU of vitamin D; in 1 drop of an aqueous solution – 500 ME; in 1 drop of alcohol solution is approximately 4000 ME.
Recently the doctors prefer the prescription of vitamin D3(Vigantol, Videhol, Aquadetrim) and primarily water-soluble forms (Aquadetrim). They are better absorbed in the intestine of the baby, have a longer-lasting effect in the body, compared with oil solutions.
Alcohol solution of vitamin D is not widely applied due to its large doses of vitamin. In addition, due to the evaporation of the alcohol (if loosely covered vial) and increasing the concentration of the solution potential overdose of vitamin D. now Rarely used and preparations of fish oil because they have a specific taste and smell that ingestion sometimes causes a negative reaction in the child.
The important point in the treatment of rickets is the correct calculation of the therapeutic doses of vitamin D. recently, doctors are wary of the designation as overly high doses, and shock methods of treatment of rickets (a method in which a single child receives very high doses of vitamin equal doses, for the whole course of treatment), as this may lead to the development of severe disease – hypervitaminosis D. an overdose of vitamin D there is a weakness, loss of appetite, nausea, vomiting, diarrhea, weight loss, sharp pains in the joints, cramps, fever, slow pulse, difficulty breathing. In addition, individual sensitivity of the child to vitamin D. Therefore, if after a few days of taking the vitamin D the baby begins to refuse food, and he develops nausea or vomiting, you must consult the doctor may of these signs is a result of drug overdose.
At the same time, don’t worry if mom accidentally dripped one drop instead of two. In this case, the next time the drug need to not give the next day, and the next day. Cases of overdose are more common if the baby daily, instead of oil or water give the alcoholic solution by mistake. So you need to be very careful when buying the drug to adhere strictly to the prescribing physician.
At the end of treatment course of vitamin D switch to prolonged use of prophylactic doses of vitamin – 400 ME a day that continues throughout the year, except for the warm months (May to September).
About Rickets in children
Sometimes receiving therapeutic doses of vitamin D may not be as effective, and is often caused by deficiency of several vitamins in the child’s body (geopoliittinen), especially deficiency of vitamins C and B2, which are directly involved in the formation of active metabolites of vitamin D. in this regard, In the treatment of rickets include multivitamin preparations (Polivit baby, Biovital gel, Multi Tubbs and others), containing including and vitamin D in moderate dose.
Earlier in the treatment of active rickets were assigned artificial ultraviolet radiation (UVR) of the skin. However, given the possible carcinogenic effect – the likelihood of developing cancer, recently this method of treatment in children do not use. Calcium and phosphorus is of no independent value in the treatment of rickets. However, some groups of children (premature infants, children with pronounced softening of the skull bones, the reduction of calcium in the blood) have their appointment within 2-3 weeks. Useful massage and medical gymnastics. Children over 6 months of age administered therapeutic bath salt, pine.
Children sluggish, sedentary recommend salt bath (2 tablespoons of sea salt per 10 liters of water, a temperature of 35-36°C). The first bath should take no more than 3 minutes later no more than 5. Baths spend a day, a course – 10 procedures. Coniferous baths (1 teaspoon of liquid or 1 bar briquette of coniferous extract on 10 l of water, the temperature is 36°C) is shown to children with increased nervous excitability. Start taking baths of 5 minutes, gradually increasing the time to 10 minutes, on a course of 10-15 baths every other day.
Rickets is not a contraindication to the appointment of vaccination, however, their conduct in kids is possible not earlier than 2-3 weeks after the start of treatment, because after this time, the body adapts to the baby started treatment.
Prevention of rickets should begin from the first days of a child’s life (the so-called postnatal prophylaxis). It includes:
- proper daily routine with daily walks in the fresh air;
- balanced diet of the child in accordance with his age needs. Optimal is the preservation of breastfeeding, timely introduction of complementary food (no later than 4-6 months of life). If the baby in the first year of life suffers from allergies and had to get a less varied diet, the doctor may recommend courses of reception of multivitamin preparations for infants. It should be noted that vitamin complexes, which accepts a nursing mother, only provide her needs, and despite the drugs the mother, the baby should receive preventive doses of vitamin D, you also need regular exercises, massage with a gradual and uniform increase of the load.
Given the condition, the district where the baby, as well as time of year, the pediatrician will help to resolve the issue of the preventive role of vitamin D. Healthy term infants in the first year of life for the purpose of prevention of rickets get the vitamin D in doses over 400 IU in day, starting at 4-5 weeks of life during the whole autumn-winter-spring period. As has been said, one drop of aqueous solution contains 500 ME to give the baby 400 ME, you need to drip a drop of the drug on a spoon, to give the baby medicine from a spoon – we can assume that the rest of the product contains 100 IU of vitamin D. However, during the summer period when there is insufficient number of Sunny days (cloudy, rainy summer), especially in the Northern regions, as well as when feeding the kids whole milk, it is advisable to take vitamin D as a preventive dose.
Pay special attention to premature babies who have rickets prevention is carried out from 2-3rd week of life during the first 2 years, excluding the summer months. While prophylactic dose of vitamin a can be higher than in full-term children, and to decide this can only be a pediatrician. Full-term newborns prophylactic doses of vitamin D typically prescribed after month.