Osteomalacia & Rickets

Osteomalacia is a softening of the bones. When it occurs in children, it is called rickets. Symptoms include bone pain or tenderness, bone deformities such as curvature of the spine, dental defects, growth problems and an increased risk of bone fracture. (Read about "Curvature of the Spine" "Bone Fractures")

There are many things that can cause this condition. One, for example, is a shortage of vitamin D. (Read about "Vitamins & Minerals") Vitamin D is necessary for the body to properly absorb and use calcium. (Read about "Calcium") Both calcium and vitamin D contribute to the formation of strong bones, therefore a shortage of either one can lead to bone weakening. You can have a vitamin D deficiency due to inadequate diet and/or insufficient exposure to sunlight. Digestive problems or kidney disease can cause this condition as well. (Read about "Digestive System" "Kidney Disease")

The American Academy of Pediatrics (AAP) recommends that all children, beginning in the first few days of life, get vitamin D supplementation to prevent rickets and vitamin D deficiency. This includes children who are breastfed. (Read about "Breastfeeding")

For children over the age of one, the Institute of Medicine (IOM) recommends 600 international units (IUs) of vitamin D per day to maintain health. You should discuss with your healthcare provider what your child's needs are. For those over the age of one, IOM also says the upper intake level for vitamin D is between 2500 and 4000 IUs per day. Once again, it depends on age and other health factors how much vitamin D your child should be getting. Upper intake levels represent the upper safe boundary and should not be misunderstood as amounts people need or should strive to consume, according to IOM.

Concerns are growing as recent studies are showing an increase of rickets, particularly in urban areas. By the time rickets is diagnosed, the damage is often done. Sunlight can be a major source of vitamin D, but sunlight exposure is difficult to measure. Factors such as the amount of pigment in a baby's skin, and skin exposure, affect how much vitamin D the body produces from sunlight. (Read about "Children and Sun") Sun exposure is, of course, a double edged sword. Too much sun in a person's childhood years can result in skin damage and even skin cancer (Read about "Skin Cancer") later in life. AAP says children should wear sunscreen (Read about "Sunscreen") when they are out in the sun. Sunscreen, however, prevents the skin from making vitamin D.

Exclusively breastfed infants are also at increased risk of vitamin D deficiency and rickets, according to AAP. This is because human milk typically contains only small amounts of vitamin D, insufficient to prevent rickets.

A problem with fat absorption can also contribute to osteomalacia. If the body cannot absorb fats, it has problems utilizing vitamin D. Kidney disease can also cause this condition. (Read about "Kidney Disease") Depending on the cause, treatment options can include oral supplements of vitamin D, as well as calcium, and phosphorus. If rickets is not corrected promptly in a child, he or she may have permanent skeletal problems.

Related Information:

    Skeletal System