why does a vitamin d deficiency cause rickets


Children need vitamin D for bone growth and development. So do babies developing in the womb. Vitamin D helps us absorbP. Serious vitamin D deficiency can causeP, delayed motor development, muscle weakness, aches and pains, and fractures. Vitamin D deficiency in adults has also been linked to osteoporosis, some cancers, heart disease andP. If women dont get enough vitamin D during pregnancy, their children might develop neonatal hypocalcaemia (not enough calcium in the blood) or rickets later in childhood. Your child needs sunlight on her skin for her body to make vitamin D. She gets about 80% of her vitamin D this way. Scientists arent sure exactly how much sun Australian children need for good levels of vitamin D. But we do know that the amount of sun your child needs depends onP
where you live in Australia and the time of year. P It also depends a bit on your skin colour. People with naturally very dark skin need 3-6 times more sun to make vitamin D than the amount fair-skinned people need. How much sun is enough? In Brisbane and Darwin, right through the year, a few minutes most days of the week should be enough. In Canberra, Perth and Sydney in June and July, 2-3 hours per week should be enough in summer, a few minutes most days of the week should be enough. In Adelaide, Hobart and Melbourne from May to August, 2-3 hours per week should be enough in summer, a few minutes most days of the week should be enough. Be sun smart No matter where you live in Australia, you have to be careful about how much sun your child gets on her skin. Too much sun can lead to sunburn, skin damage and even skin cancer. This is why its important to use sun protection. During summer, especially between 10 am and 4 pm, make sure your child staysP Pwith sunscreen, a hat, sunglasses, clothing that keeps the sun off and access to plenty of shade. Most children wont get enough vitamin D from food alone. But food with lots of vitamin D can add to the vitamin D your child gets from sunshine. Foods naturally containing vitamin D Pinclude fresh fatty fish (salmon, herring, mackerel and sardines), liver, some mushrooms and egg yolks. Some foods have vitamin D added to them.


PThese include some low-fat dairy products, breakfast cereals and margarine. All infant formula contains vitamin D. have a condition affecting how the body controls vitamin D levels for example, liver disease, kidney disease, conditions that cause problems with absorbing food (likeP Por ), and some medicines can affect vitamin D levels have been breastfed for a long time and have a mother whose vitamin D is low. Signs of vitamin D deficiency Pinclude rickets, delayed motor development, muscle weakness, aches and pains, and fractures. Talk with your GP if youre worried about your childs vitamin D levels, or youre pregnant and think you might have low vitamin D. Your GP can order a blood test, which is the best way to check vitamin D levels. ForP mild deficiencies, your GP might say that your child needs to get a bit more sun. If you or your child has aP severe vitamin D deficiency, your GP might say you or your child should take vitamin D supplements, as well as getting more sun. If you or your child cant get more sun, the GP might say that takingP vitamin D supplements Pis the best thing to do. You might take a vitamin D supplement in one large, single dose, or you might take a supplement for several weeks or months. You can also talk to aP Pabout vitamin D supplements. Vitamin D, pregnancy and breastfeeding A babys vitamin D stores go up during development in the womb and go down after birth until the baby starts getting vitamin D from sunlight along with diet. Breastfeeding babies dont get much vitamin D from breastmilk, because breastmilk doesnt have much. And if a breastfeeding mum has low vitamin D, she might not pass on enough vitamin D to her baby. Its recommended that breastfed babies with at least one other risk factor for low vitamin D, like dark skin, take aP vitamin D supplementP of 400P Por 10P Pa day. Its a good idea to talk with your GP if you think your baby is at risk of vitamin D deficiency. Infant formula has higher levels of vitamin D, so formula-fed babies dont usually need a supplement. Most cases of rickets in Australia are in children who have dark skin. This is because women who have dark skin particularly those who wear covered clothing have been found to have a high risk of vitamin D deficiency and dont pass on adequate amounts of vitamin D to their children.


What are osteomalacia and rickets? These are disorders caused by insufficient levels of vitamin D in the body. They are really the same condition: rickets is the name used when it occurs in children whereas osteomalacia is the term used for adults. Where do we get vitamin D from? formation in the skin through exposure to sunlight. There are few dietary sources of vitamin D. The best ones are fatty fish such as salmon, tuna and sardines. Margarine and a few other foodstuffs are supplemented with vitamin D. Milk contains added vitamin D in the USA but not in the UK. Human milk is a poor source of vitamin D, but infant formula is fortified with vitamin D. Most people even in the UK get most of their vitamin D from exposure of the skin to sunlight. The average person has enough vitamin D stored in their body to last for two or three years. Who is at risk of vitamin D deficiency? People who get little exposure to sunlight are most at risk of vitamin D deficiency in the UK. Immigrants from Asia and Africa, particularly women and children, are at risk, as are elderly people who are housebound or confined to residential and nursing homes. Anyone whose illness or lifestyle makes outdoor activities difficult is at risk. Recent surveys have shown that significant vitamin D deficiency is not uncommon in the general population. Some people with intestinal problems, such as, and, may also become short of vitamin D, as do some patients with liver disease. An infant\’s vitamin D status is entirely dependant on that of its mother. If a mother is deficient, the infant may be born with rickets or have fractures in early life. What are the symptoms of osteomalacia and rickets? Osteomalacia: bone pains and muscle weakness are the classical symptoms. Fractures can occur. Fractures may take place with little or no recognised trauma. Nowadays increasing numbers of patients without any symptoms are identified after the finding of a low bone density. Rickets: aches and pains, and sometimes visible enlargement of bones at joints, such as the wrists.


Fractures may occur without recognised trauma. Some infants with rickets have convulsions. How do we test for vitamin D deficiency? Simple for levels of calcium, phosphate and alkaline phosphatase are often helpful in pointing to osteomalacia in adults. More specific blood tests are needed to confirm the diagnosis. These include measurements of the levels of 25- hydroxyvitamin D, the main form of vitamin D in blood, and of parathyroid hormone. Some patients but not all have a reduced bone density on. In children, particularly of the wrists and knees, are useful. But normal appearances do not exclude rickets. The blood calcium level may be low but tests for levels of phosphate or alkaline phosphatase may be difficult to interpret in children. Blood tests for 25-hydroxyvitamin D and parathyroid hormone are also important. What treatment is available? Regular daily supplements of vitamin D with or without calcium are usually used for people with simple vitamin D deficiency. An alternative is a single large oral dose or injection of vitamin D. This is stored in the body and can last up to a year before another injection may be needed. People with vitamin D deficiency due to intestinal problems are best treated with calciferol injections. Most people with osteomalacia find their pain is reduced about two weeks after the injection. Extra calcium may also be needed while bone is healing. Are there forms of rickets not caused by lack of vitamin D? Infants born prematurely sometimes have a bone problem, including spontaneous fractures in the first few months of life. This condition, bone disease of prematurity, is sometimes referred to as rickets. But there is no evidence that lack of vitamin D is the cause. Uncommon types of rickets are caused by inborn defects in the way vitamin D is handled in the body. X-ray changes similar to those of rickets result from phosphate depletion, usually because of inborn renal defects. : who is at risk of vitamin D deficiency? : what do doctors examine in the blood? : what are the symptoms of kidney stones? Last updated 09. 10. 2012

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