Rickets is a disease caused by a lack of vitamin D. Vitamin D is produced by the skin under the influence of ultraviolet rays, and is also found in certain foods: fish oil, egg yolk, and dairy products. Vitamin D actively promotes the absorption of calcium from the intestines and its proper distribution in the body, which is very important for the development of bone tissue, the functioning of the central nervous system, and other organs.

Vitamin D deficiency in the body can occur during the cold season, when there is not enough solar ultraviolet radiation, also when vitamin D is not absorbed from the intestines (this does not often happen with dysbacteriosis and various fermentopathies).

Rickets often occurs in young children, i.e. in the first three years of life. There is rickets in older babies and even adults. During rickets, several stages are distinguished. At the initial stage of vitamin D deficiency in children under one year old, there is a decrease in appetite, high sweating (especially on the palms, feet and scalp), anxiety, high excitability, sleep deterioration, and nape baldness. Parents can notice these signs, and the doctor, when examining the baby, will also pay attention to the compliance of the edges of the large fontanel, a decrease in muscle tone.

If preventive and treatment measures are not taken during the appearance of the initial signs of rickets, the next stage develops in a few weeks – the peak period. At this stage of the disease, bone deformities begin: a change in the shape of the skull (flattening of the occiput, elongation of the skull in the upper direction, the appearance of frontal tubercles); chest deformity (indentation – “shoemaker’s chest” or bulging – “chicken breast”); curvature of the bones of the legs, especially if the baby is already walking – X- or O-shaped curvatures are found; there is also a narrowing of the pelvis, the appearance of bone growths in the form of “bracelets”, “strings of pearls”, “rachitic beads”, which are clearly visible on radiographs.

In addition to bone deformities, tooth growth slows down, serious violations of the work of various organs occur: the work of the heart and lungs is disrupted, dysfunction of the gastrointestinal tract (often constipation), vegetative-vascular changes (very strong sweating, marbling of the skin) occur. Children with rickets in the height stage begin to lag behind in development.

In urine tests with rickets there will be an increased content of phosphorus, in blood tests – a reduced amount of phosphorus, calcium – normal or increased. The diagnosis is mainly based on the combination of clinical manifestations.

At some point, the signs of the peak of rickets pass, the child begins to feel better, but the consequences of the transferred rickets can remain for life in the form of deformed bones: crooked legs, an ugly shape of the skull, a narrow, irregularly shaped pelvis, which is fraught for girls – expectant mothers complications during pregnancy and childbirth. In addition, children who have had rickets in the peak stage recover for a very long time and are at risk for the development of chronic diseases or often become ill.

That is why it is not necessary to bring the situation to the height of rickets, but to engage in prevention until the appearance of clinical manifestations in the autumn-winter-spring period or when the initial signs of rickets appear. Among the measures that prevent the development of rickets are the establishment of proper nutrition, the correction of intestinal dysbacteriosis, the introduction of dosage forms of vitamin D.

Proper nutrition implies feeding with breast milk, as far as possible, the timely introduction of complementary foods (not earlier than 4-5 months), the use of only adapted mixtures for supplementary feeding, the introduction of yolk, butter, liver, and meat into the diet. Correction of violations of the intestinal microflora is also very important, since the absorption of vitamins and trace elements from the intestine is largely carried out by this microflora.

From medications for the prevention and treatment of rickets, vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol) products can be distinguished. There are oil and water solutions. The main points of using vitamin D products can be noted:

  • vitamin D3 products are more physiological and more effective than vitamin D2 products;
  • aqueous solutions are less toxic than oil ones, so if you need to give a large dose of vitamin D, it is advisable to give preference to them;
  • probably long-term continuous use of prophylactic doses during the entire cold period (from late autumn to spring); when using doses higher than prophylactic doses, it is advisable to take short breaks of 5-7 days after every 3-4 weeks of using these products;
  • the use of adapted formulas for feeding a baby does not exclude the use of dosage forms of vitamin D for prevention and treatment;
  • taking multivitamin products does not preclude taking vitamin D products for treatment and prevention.

One of the modern approaches to the treatment and prevention of rickets is the appointment of a course dose (200 thousand units) once with a repetition in six months. Thus, a depot of vitamin D is created in the liver, and the body uses it as it needs, as a result, a normal balance of vitamin D is maintained.

It is possible, without consulting a doctor, to start giving your child a prophylactic vitamin D product when cloudy weather sets in in the fall. Prevention of rickets should be carried out for all children under 3 years old, especially premature, weakened, children of the first months of life born in the autumn-winter-spring period. But if signs of incipient rickets are found, it is necessary to consult a doctor to adjust the treatment.

In the summer, if the condition is that it is warm and sunny outside, the use of vitamin D products is not recommended. Under the influence of ultraviolet rays, the skin produces its own vitamin D. At the same time, it is not necessary that the child be in direct sunlight, it is enough that he be as open as possible (short-sleeved shirt, Panama, short pants; in warm weather, you can be completely naked, but with headgear).

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