Medical Specialties: Family practice, Orthopedics, Pediatrics

Clinical Definition

Rickets is a deficiency disease resulting from a lack of vitamin D, calcium, or phosphorus, all crucial for normal growth and development of bones. Stooped posture may be a symptom; contributing factors include poor diet, lactose intolerance, low calcium intake, lack of sun exposure and long-term breastfeeding, as breast milk has low levels of vitamin D. Blood tests and X-rays confirm the diagnosis. If supplementation with vitamin D and calcium are initiated, the long-term prognosis is good.

In Our Own Words

Rickets is a bone disease in children, usually the result of not getting enough vitamin D, calcium or phosphorus, which are all needed to build strong bones. Breastfed infants may be vulnerable, even in the U.S., as breast milk contains low vitamin D levels. Having rickets makes the bone soften, and that can raise the risk of fracture.  Children may have stooped posture, bowlegs or delayed development.

Diagnosis is done by observation and blood tests to evaluate calcium, phosphorus and vitamin D levels, as well as bone X-rays.  Treatment involves supplementing with vitamin D and calcium, which helps bones get stronger.  Pediatricians generally recommend infants get 400 IU a day of vitamin D, to guard against rickets, while children 1-18 years of age should get 600 IU of vitamin D a day.

Relevant Conditions
  • Vitamin D deficiency
  • Hereditary rickets
  • Breastfeeding
  • Osteomalacia
Side Effects
  • Drowsiness
  • Weak muscle tone
  • Decreased growth
  • Seizures
  • Stooped posture
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  • Centers for Disease Control and Prevention. "Vitamin D Supplementation." Breastfeeding. Oct. 2009. http://www.cdc.gov/breastfeeding/recommendations/vitamin_D.htm. Accessed Sept. 2013.
  • [Ross AC, Manson JE, Abrams SA, et al. The 2011 report on dietary reference intakes for calcium and vitamin D from the Institute of Medicine: what clinicians need to know. J Clin Endocrinol Metab. 2011;96(1):53-58. http://www.ncbi.nlm.nih.gov/pubmed/21118827. Accessed October 2013.]
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