Rickets in infants. Rickets in infants: photos, symptoms, treatment and prevention of the most common disease in infants Causes of rickets in children

The diagnosis of “rickets” made by a doctor to a 3-4 month old child takes parents by surprise. Despite the fact that many people have heard the name of the disease, few can accurately determine its symptoms. A detailed study of the disease, finding out the reasons leading to the unpleasant diagnosis, and effective methods treatment of the disease.

What is rickets?

Doctors mean by rickets a disorder in the development of a child’s bone tissue. Failures in the metabolic process of phosphorus and calcium lead to a lack of vitamin D; the child’s intestines poorly absorb calcium ions, which affects the baby’s bones. Their gradual demineralization and curvature occur, acquiring large volumes when the treatment of the disease is neglected. Changes can last a lifetime if not stopped early.

Progressive changes cause osteomalacia (softening of bones) and osteoporosis (thinning of long bones). All these negative processes lead to noticeable curvature of the bones.

Rickets in infants is often diagnosed at a very young age, at 2-3 months. Rickets is detected in children even at 2 years of age, but children under 1 year of age are most vulnerable to the painful disease. Much in the fight against rickets depends on the parents, so it is important for them to know both its causes and the symptoms of the disease.

Causes of disease in infants

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How much vitamin D a child’s body needs depends on many factors - there is no single norm. When calculating the indicator of an element, doctors take into account the specific nutrition of children, their place of residence, climatic conditions, characteristics of the child’s body, race, weight. People living in the north of the country receive less sun than people living in the south. Obviously, their production of vitamin D is different. Let's look at common factors that contribute to the development of rickets.

If a child grows up in northern latitudes, he may have a lack of vitamin D

What are the main reasons?

The risk of developing rickets exists at any stage of a child’s development. The causes of the development of the disease can be:

• Artificial feeding, when the baby is given formula with insufficient amounts of calcium, vitamin D and phosphorus. Breastfed babies suffer less from rickets because they receive all these elements in sufficient quantities from mother's milk. Today there are many types available baby food with a rich content of the three most important elements, but imperfect digestive system crumbs may not digest them well.
• Premature birth. A premature baby suffers from enzyme deficiency and metabolic problems, which leads to unstable absorption of vitamin D even when the baby gets enough of it.
• Colds. When you have a cold, the need for vitamin D increases, and it is absorbed more slowly. In addition, children are taken outside less, which affects the level of insolation (the child receives sunlight).
• Genetic predisposition. Poor absorption of vitamin D may be hereditary. Hypothetically, experts note that rickets is detected more often in children with blood group II. A tendency has also been established that boys suffer from the disease more often than girls.

Who is at risk?

Especially for parents, we have compiled a list of signs according to which children may be at risk for predisposition to rickets. Let's consider them:

• Overweight infants for whom it is difficult to calculate the correct dose of vitamin D.

Overweight children absorb vitamin D worse

• Children who receive little ultraviolet radiation. Most of the vitamin enters our body through sunlight. A child born in winter or autumn does not receive enough of it. The body also receives little ultraviolet radiation when walking on the balcony: glass prevents the full penetration of ultraviolet radiation. Only when it comes into direct contact with the skin does proper absorption of vitamin D occur.
• Dysbacteriosis. Microflora disturbances lead to disruptions in the gastrointestinal tract, the production of enzymes deteriorates, metabolism is destabilized, vitamin D is poorly absorbed, and a deficiency occurs. The consequence of such violations is a weakening of the protective properties of the child’s body. Frequent illnesses reduce the number of walks.
• Race and skin color. The mechanism of vitamin D absorption in white-skinned and fair-haired people is faster than in those with dark and black skin. Melanin, responsible for dark color skin, prevents cells from properly producing the vitamin.
• Physical inactivity. Dr. Komarovsky argues that inactivity due to lifestyle, lack of physical activity or disorders in the nervous system, also causes rickets.

Symptoms of the disease by stage

It is not easy to detect signs of rickets in children, especially at an early age (more details in the article:). The newborn tightens his legs and arms, which looks natural for him, so it is impossible to identify the beginning curvatures. The first symptoms can be identified only by 4 months, during active formation bone tissue. The body reacts sharply to the lack of what the bones need building material and clearly signals dangerous manifestations. The development of the disease follows an increasing trajectory, passing through several stages. Let's look at each of them in more detail.

Stage 1

The development of rickets begins at the age of 2 months and lasts for 2-4 weeks. Doctors define this period as the initial stage of rickets, which is characterized by temporary disruptions in the central nervous system (irritation, cramps) and muscle tone. The initial stage does not cause irreversible consequences and can be successfully treated. Identified by the following symptoms:

• the child’s behavior changes, he often gets irritated for no reason or, on the contrary, becomes lethargic and apathetic;
• the baby’s body reacts with increased and frequent sweating;
• skin itching begins, the baby rubs the back of his head on the pillow, and a bald spot forms from the friction.

The symptoms described do not have a direct connection with rickets; profuse sweating may be a consequence of too dry air, and the appearance of bald spots may be due to excessive activity of the baby. However, they should not be ignored; it is necessary to show the baby to the pediatrician in order to protect him from illness. Research using analyzes will help to correctly identify the culprits of such changes and avoid their progression.

Stage 2

A moderately severe disease is manifested by a decrease in hemoglobin levels, disturbances in muscle tone, and a slight enlargement of internal organs. The disease provokes the destruction of bone tissue and is expressed in other noticeable changes:

• the fontanel does not overgrow, and in some cases even begins to enlarge (we recommend reading:);
• the tummy becomes rounded and protrudes, the functioning of the intestines is disrupted;
• The head grows disproportionately in relation to the body, the forehead becomes convex;

A convex forehead and a large head are a sign of rickets in a child

• thickenings (“rachitic rosary”) form in the wrist area and on the lower ribs;
• the baby does not sit or crawl due to weakness of the ligaments and muscles.

Agree, such changes are difficult not to notice, so all the blame lies with serious condition the child falls on the parents.

If symptoms are severe, a visit to the doctor cannot be postponed; the child requires urgent and serious help. The average severity of the disease requires a long course of treatment. If parents do not notice the development of rickets in time, the disease may progress to stage III, the most severe stage of the disease.

Stage 3

The most serious form of the disease, marked by severe disorders of bone and muscle tissue, serious disruptions in the functioning of the central nervous system and other organs. The progression of the disease leads to curvature of the entire skeleton of the child. Accompanied by the following unpleasant symptoms:

• the child is lagging behind in mental and motor development;
• the legs bend, taking the shape of the letter “X” or “O”;
• the disproportion of the torso and head is noticeable;
• the chest is depressed or becomes convex, the stomach is strongly rounded (see also:).

To be fair, we note that a severe form of the disease is diagnosed very rarely. What kind of negligence must parents have in order to bring the baby’s condition to a terrible state? Obviously, this situation can develop in dysfunctional families where little attention is paid to the child. However, visits by a pediatrician to such a family can prevent exacerbation of the disease.

The severe stage is rarely diagnosed: scheduled visits pediatricians help to identify rickets in time

Experts point to the periodicity of rickets, which means that the disease has periods of exacerbation or complete disappearance of its symptoms. However, such frequency does not guarantee freedom from relapse of the disease. The disease can manifest itself in cold weather. It is criminal to allow such negligence in relation to the health of the baby; it must be immediately shown to doctors and treatment must begin.

What to do if rickets is diagnosed after a year?

An advanced form of rickets inevitably leads to severe disorders throughout the child’s body. If these disorders are not so noticeable in a baby, then for a one-year-old baby they become a real disaster. The child is severely delayed in development, he cannot crawl and walk, flat feet develop, and deformation occurs hip bones, legs become bent. Having affected the baby at an early age, rickets leads him to myopia, malocclusion, scoliosis.

Close supervision of specialists is also required for a 3-year-old child with rickets. If parents do not persist in the fight against dangerous illness, if they provide their baby proper nutrition and playing sports, the disease will recede without leaving serious consequences.

Fresh air and adequate sports activities are an excellent prevention of rickets for older children.

Chances of success and dangerous consequences

When rickets is diagnosed at the very beginning of its development, the chances of a full cure are very high if treated in a timely manner. The high development of medicine allows you to quickly identify the disease and take effective measures to eliminate it. Looking at the eloquent photos, it becomes clear that a severe form of the disease or time lost by parents for treatment leads to irreversible changes in infants:

• the baby is not growing well, his height remains low compared to his peers;
• tubular bones are significantly bent;
• kyphosis (poor posture) develops;
• the oral cavity is affected, the teeth become uneven, a bad bite is formed, and the tooth enamel, caries appears;
• skeletal muscles remain underdeveloped;
• The pelvic bones in girls narrow, which leads to problems during childbirth.

How is rickets diagnosed?

Diagnosis of the disease begins with establishing a complete medical history based on the results of an interview with parents. Held visual inspection little patient. The doctor examines the baby's legs, arms, spine and head. The picture of clinical symptoms is determined. Special additional studies help to recognize the severity of the disease:

• a blood test is taken to determine the degree of anemia;
• blood biochemistry to detect levels of calcium, magnesium, phosphorus, creatinine and activity alkaline phosphatase;
• X-ray of the lower leg, wrist, forearm;
• ultrasonography;
• The level of vitamin D metabolites is checked.

For diagnosis, a blood sample will be required from the child.

Treatment of rickets

In an effort to cure rickets in infants, doctors resort to a long-proven method - taking vitamin D solutions (more details in the article:). Why was this chosen? dosage form? The vitamin in soluble form is quickly absorbed by the child’s body and is excreted well by the kidneys. The following solutions are prescribed:

• "Aquadetrim" - the medicine contains vitamin D3 (colecalciferol) (we recommend reading:). Normalizes the exchange of phosphorus and calcium. Produced in the form of drops. The dosage is individual and depends on the child’s body weight, stage of the disease, nutritional characteristics, the baby’s lifestyle and other factors. Duration of use – up to 1.5 months, 6-10 drops. To prevent the disease, the drug is given 2-4 drops.
• "Devis Drops" (drops) - the drug is developed for small patients who do not suffer from dysbacteriosis and other gastrointestinal disorders. Dosage – 5 drops. Used in the prevention of illness in newborns. Analogues of the product are produced: “Videin” and “Vigantol” (we recommend reading:).
• “Ergocolciferol” is the main element of the drug vitamin D2. Serves as a preventive measure.
• Multivitamin complex – for infants and children up to 2 years old. Helps restore metabolism, contains a sufficient dose of vitamin D.
• Calcium gluconate - the drug serves as an additive and is taken simultaneously with vitamin D for 2 weeks. Often recommended for premature babies.

Ergocalciferol is used for the prevention and treatment of the disease

What to do to prevent the disease?

Prevention of rickets in children should begin in the first months of pregnancy. This means that the expectant mother takes responsibility for giving birth to a healthy baby. Pediatricians divide the prevention of rickets in infants into two phases: antenatal and postnatal. During the antenatal (before childbirth) phase, a pregnant woman should:

• go for a walk every day fresh air;
• take sunlight in moderation;
• drink special vitamin complexes;
• choose foods with big amount vitamin D ( oatmeal, egg yolk, any fermented milk products, fish dishes, potatoes, butter and vegetable oil, parsley).

Procedures under a lamp and taking vitamin solutions are not prescribed to pregnant women due to possible intrauterine disorders in the fetus. After the baby arrives preventive measures supplemented by:

• desirable breastfeeding;
• prolonged exposure to the street;
• hardening the child;
• physical exercises (gymnastics);
• sunbathing (without direct sunlight);
• taking vitamin D in prophylactic doses.

For infants The prophylactic dose of vitamin D does not exceed 1-2 drops, one-year-old babies are given 400 IU, from one year to 2-3 years - 500-600 IU. In the spring, the dosage of the drug is significantly reduced or not taken at all.

Useful clarifications

If from birth the baby receives essential vitamin from mother's milk, then after six months, when the moment of complementary feeding comes, it is necessary to monitor his diet. Make sure your child's diet includes fish and meat dishes. Gradually accustom your baby to creamy and vegetable oil, diversify your dairy menu with cottage cheese, kefir, and yoghurts.

RICKETS. Etiology. One of the main factors is hypovitaminosis D, a deficiency of vitamin D of exogenous or endogenous origin. In addition to improper feeding and nutritional deficiency of vitamin D, it can also be caused by impaired formation of its active forms in the body due to a lack of ultraviolet rays (in winter and autumn, in cities), liver and kidney diseases (the formation of active forms of the vitamin occurs in them). Prematurity (immaturity of enzyme systems), rapid growth of the child, diseases accompanied by acidosis, and insufficient intake of calcium and phosphorus salts play a certain role.

Pathogenesis. Vitamin D is a steroid compound and is known as vitamin D2 (ergocalciferol) and vitamin D3 (cholecalciferol), which are very similar in structure, physical and chemical properties and influence on the human body. Vitamin D supplied from food is converted in the liver and kidneys, resulting in the formation of 1,25-dihydroxy vitamin D, which has a hormone-like effect. This compound affects the genetic apparatus of intestinal cells, thereby increasing the synthesis of a protein that specifically binds calcium and ensures its transport in the body. With a lack of vitamin D, the absorption and metabolism of calcium is impaired, its concentration in the blood drops, which causes a reaction parathyroid glands and increased secretion of parathyroid hormone, which regulates the metabolism of calcium and phosphorus. Excessive secretion of parathyroid hormone leads to the mobilization of calcium from bone tissue, suppression of phosphate reabsorption in the renal tubules, and therefore the content of inorganic phosphates in the blood decreases. At the same time, the activity of alkaline phosphatase increases sharply. Disorders of phosphate-calcium metabolism lead to the development of acidosis, which is accompanied by impaired excitability nervous system.

Clinical picture. According to severity, the following degrees of rickets are distinguished: 1st degree (mild) - minor changes in the nervous and muscular systems; does not produce residual effects; II degree (moderate) - pronounced changes in the bone, muscle, nervous and hematopoietic systems, moderate dysfunction of internal organs, a slight increase in the size of the liver and spleen, anemia; III degree (severe) - pronounced changes in the central nervous, skeletal and muscular systems, internal organs. Complications are common.

The initial period is most often observed in the 2-3rd month, but can manifest itself throughout the entire first year of life. Sweating, balding of the back of the head, anxiety, muscle dystonia; unsharp softening of the edges of the large fontanel. Duration 2-3 weeks. Biochemical studies: reduced amount of phosphorus, increased phosphatase activity. There are no radiological changes.

During the height of the disease, along with the phenomena of inhibition of the nervous system, changes appear in the bones; craniotabes, changes in the bones of the skull, chest, limbs. Bone changes, subtle in grade rickets and distinct in grade II, turn into deformation in grade III rickets. Violations of static functions, functions of internal organs, muscle hypotonia are detected, and anemia occurs. With rickets of II and III degrees, the spleen and liver are enlarged. On radiographs, the contours of the bones are blurred. The epiphyses of the tubular bones are goblet-shaped, the edges of the metaphyses are fringed. In the 2-3rd year of life there are only consequences in the form of bone deformations, sometimes anemia.

In the acute course, rapid development of symptoms of rickets is noted. In the initial period - pronounced anxiety, sudden sweating, biochemical changes in the blood, at the height of the disease, significant softening of the bones, severe muscle hypotension. The acute course is observed more often in the first months of life, especially in premature and rapidly growing children. The subacute course is characterized by a slower development of the process. It is observed more often in children older than 6-9 months, as well as in children with malnutrition. The phenomena of bone softening are much less pronounced. Osteoid hyperplasia predominates over osteomalacia; frontal and parietal tubercles, beads on the ribs, and thickening of the epiphyses of tubular bones are noted. The recurrent course is accompanied by intermittent conditions: usually improvement in summer and worsening in winter. Radiographs show stripes that correspond to zones of calcification in the metaphyses during the repair period.

Late rickets includes rare cases of the disease when its active manifestations are observed after the age of 4 years. Late rickets, observed during the war and early post-war years, was characterized by the presence common symptoms diseases (anorexia, sweating, leg pain, fatigue). Bone deformities were noted only in some cases. Of particular importance are signs such as hypophosphatemia, and from the bone side - osteoporosis and changes in areas of calcification.

The diagnosis, in addition to clinical symptoms, is confirmed by examining the content of calcium, phosphorus, and alkaline phosphatase in the blood; X-ray data are important.

Differential diagnosis. Rickets is differentiated from a number of rickets-like diseases of hereditary nature - phosphate diabetes, renal tubular acidosis, Debreu-de Toni-Fanconi syndrome (see), as well as from congenital dislocation hip, chondrodystrophy, osteopathy in chronic renal failure, congenital bone fragility.

Treatment. Important role rational nutrition, normalization of the regime with sufficient time in the fresh air, massage, and gymnastics play a role. At initial manifestations full-term infants are prescribed vitamin D2 supplements at 300-800 IU/day, for a course of 400,000-600,000 IU; during the peak period for moderate and severe rickets, 10,000-16,000 IU/day is prescribed in 2-3 doses, for a course of 600,000-800,000 IU.

The loading dose method, used for severe complicated forms of rickets, is not currently used. Vitamin D supplements should be given with meals. Sometimes vitamin D2 is combined with a 25% solution citric acid, 20% sodium citrate solution (an easily soluble and well-absorbed calcium citrate complex is formed in the intestine) orally, 20 ml per day.

During treatment, it is necessary to carry out simple monitoring of the sensitivity of the child’s body to vitamin D using the Sulkovich test to prevent hypervitaminosis.

Ultraviolet therapy has a beneficial effect in the initial period and in the subacute course of rickets in children early age. The method and dosage of irradiation depend on the age of the child, his physical condition, conditions external environment, phases and severity of rickets. It is recommended to carry out ultraviolet irradiation in a course that includes 15-20 sessions, prescribed every other day, with a gradual increase in exposure. The first session for children under 3 months begins with 1/8 biodose, for children over 3 months - with 1/4 biodose. During subsequent treatment, every 2 sessions the exposure is increased by 1/8 or 1/4 of the biodose. In case of insufficient exposure to the open air, artificial feeding, or recurrent rickets, the course of treatment is extended to 25 sessions and repeated after 2 months. During the initial phase of rickets, irradiation is often limited to one course, consisting of 15-20 sessions; in the peak phase, the course is increased after 2-3 months. In the intervals between irradiation courses, specific prevention vitamin D2 or fish oil.

Massage and gymnastics are used at any period, but not in acute cases.

The prognosis for timely treatment and elimination of the cause is favorable. At severe course delayed psychomotor development, skeletal deformation and poor posture are possible.

Prevention. Balanced diet, sufficient insolation, sanitary and hygienic regime, hardening, proper education.

Antenatal prophylaxis in pregnant women in the last 2-3 months of pregnancy with vitamin D, 500-1000 IU/day, is advisable. For antenatal prophylaxis, ultraviolet irradiation of pregnant women can be used. Necessary long stay outdoors, balanced diet.

Vegetables and fruits should be introduced into the child’s diet in a timely manner. Complementary foods must contain sufficient quantity vitamins, salts. Importance have products containing natural vitamin D3 (egg yolk, fish fat).

Adding citric acid to the diet of an artificially fed baby (25% solution, 1 teaspoon 3 times a day) promotes the formation of easily absorbed calcium citrate, and therefore the absorption of phosphorus. Flour dishes and cereals contain phosphorus in a form that is poorly digestible by the child and can contribute to the development of rickets, so it is advisable that their amount in the daily diet of a child of the 1st year of life does not exceed 180-200 g.

In the autumn-winter period, ultraviolet irradiation of children with for preventive purposes it is necessary to start from 1-1.5 months of life. Two courses should be carried out with an interval of 2 months. The physiological need for vitamin D of a healthy full-term baby in the 1st year of life ranges from 400-500 IU/day. In cases where the child for some reason does not receive ultraviolet irradiation for prophylactic purposes, an artificial preparation of vitamin D2 or D3 should be prescribed. For the purpose of antenatal prophylaxis in the last 3-4 months of pregnancy, Gendevit is recommended, 1-2 tablets per day (250- 500 IU vitamin D2), and at unfavorable conditions- 4 tablets per day. Contraindications: maternal age over 30 years, maternal illness. Postnatal prophylaxis is carried out from 2-3 weeks of age at 500 IU per day (1 drop of videohol), for a course of 150,000-200,000 IU.

Rickets in a child: forewarned is forearmed!

What is rickets?

Children's health is a close focus of parents' attention. In order for a growing body to form correctly, it needs a whole complex of vitamins and minerals. The child receives most of them through breastfeeding or feeding with an adapted formula. But the need for vitamin D is not always met even if these rules are followed, so many mothers know firsthand what rickets is.

Rickets is a metabolic disease that occurs when there is a deficiency of vitamin D (calciferol) in the body, and it affects musculoskeletal system child, internal organs, nervous, and endocrine systems.

Causes of rickets in children

According to various sources, symptoms of this disease are observed in approximately 40 percent of children under one year of age. In those countries where there is a shortage of sunlight, this figure is higher.

Most often, rickets in children under one year of age occurs because, while still pregnant, the woman did not pay due attention to her lifestyle and health. For example, if the expectant mother had a hard time enduring the last months of pregnancy, she had late toxicosis, or she was too keen on diets and limited the consumption of foods containing animal proteins.

In the postnatal period, premature babies, babies born in the cold season, artificial babies and babies living in unfavorable conditions are at risk of developing rickets. Rickets in infants can provoke an unhealthy diet for the mother: if, for fear of gaining excess weight, she eats too little, prefers low-calorie foods, and limits the consumption of milk, meat and fish.

In addition to this, there are following reasons rickets:

1. insufficient exposure of the child to the fresh air in general and the sun in particular;
2. tight swaddling and limited motor activity of the child;
3. lack of breastfeeding, early transition to mixed or artificial feeding (mothers who use unadapted formula are especially at risk);
4. violations gastrointestinal tract, congenital pathologies (celiac disease, lactase deficiency, dysbacteriosis);
5. tendency to frequent illnesses;
6. taking anticonvulsants;
7. rapid weight gain in a child (at the same time the need for calcium increases).

How to determine rickets in a baby - SYMPTOMS

The disease manifests itself gradually.

The first symptoms of rickets can be detected at 4-8 weeks of a baby’s life:

• the child does not eat well: his appetite decreases, his usual portion is not fed, and the feeding process itself takes less time than usual;
• the baby becomes restless: shudders for no reason, often tosses and turns during sleep, becomes more capricious and fearful;
• sleep disorders: the baby does not fall asleep well, often wakes up for no reason, shudders or cries loudly in his sleep, the sleep itself is short and superficial;
• sweating increases: even in cool weather, the child gets wet, wakes up in wet clothes, sweat has a specific sour smell and taste, diaper rash and prickly heat appear again after healing;
• the hairs on the back of the head fall off. ;
• stool abnormalities are noted: Despite the usual diet, diarrhea and constipation may occur.

If this is ignored, after a few weeks infants develop following signs rickets:

• The muscles are in low tone;
• The baby does not hold his head well, is in no hurry to roll over on his stomach, crawl, or walk;
• Later teeth erupt;
• Later the fontanel closes;
• The shape of the skull may change: the head becomes elongated, the back of the head becomes flat, frontal tubercles appear;
• Bloating;
• The chest is deformed, the pelvis becomes narrow, and the legs become bent.

Severe forms of rickets are imposed on physical state, and on the child’s psyche: there is a noticeable lag in development. Severe deformations of the chest, skull bones, and limbs occur.

In some particularly advanced cases, children cannot sit and stand up on their own. From the outside of cardio-vascular system difficulty breathing and tachycardia are observed. The liver increases in size.

It is possible to cure rickets - TREATMENT

It is easier to cure any disease if you start doing it right early stage Therefore, if you suspect rickets, you should consult a pediatrician. It is he who will make the final diagnosis and tell you how to treat rickets.

Even if this disease has reached a severe stage, doctors rarely resort to hospitalization. They usually prescribe procedures that can be done at home, designed to eliminate the lack of vitamin D and correct disorders that have occurred in the body.

Treatment of rickets is based on a set of procedures for correcting the daily routine, physical activity (walking) and diet of mother and child.

It is necessary to take your baby for walks in the fresh air more often. If the weather cooperates, you can take air baths. Sunbathing MOST effective, but in hot weather overheating must be avoided ().

The child's diet should contain a sufficient amount of protein and minerals (calcium and phosphorus are especially important), and vitamins.

Massage

Has a positive effect on health physiotherapy, massage. Such a complex should include breathing exercises, stroking the legs, arms, feet, abdomen, chest and back. To strengthen the baby's muscles, you need to turn him from his back to his tummy, strengthen the walking and crawling reflexes (supporting the baby, giving him the desired position). Rocking on a fitball or in your arms will help calm the child’s nervous system.

Video

To overcome tearfulness, lethargy, irritability, and normalize the child’s mental state, you should protect him from excessive impressions and external stimuli(noise, bright light).

Bathing

Good for increased excitability of the baby therapeutic effect Baths with the addition of pine needle extract (per 10 liters of water at room temperature - 1 teaspoon) can help. They are indicated for excitable children. If the baby’s muscle tone is reduced, he or she experiences lethargy, baths containing sea salt can help. To prepare the solution you need 10 liters warm water add 2 tablespoons of salt. 10–12 procedures are enough to ensure a positive effect.

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Medicines for rickets - VITAMINS

Take all medications only as prescribed by your doctor!

Medicines:

• Aquadetrim — water solution vitamin D3 (colecalciferol)
• Devisol, Vigantol, Videin- Oil solutions of vitamin D3

Among the medications taken for rickets, vitamin D solution is considered the most effective.

But here, too, there are nuances: vitamin D3 is more effective than vitamin D2, and an aqueous solution has a longer lasting effect and is absorbed by the body better than an alcohol or oil solution.

In any case, vitamins for rickets should be prescribed by a pediatrician, who will select the type of drug, its dosage, and determine the timing of treatment.

Often, a therapeutic dose of vitamin D (it is 2000–5000 IU) should be taken for 30–45 days, and then a maintenance (preventive) dose of 400 to 500 IU should be taken daily. One drop of vitamin D3 oil solution contains approximately 420 IU of cholecalciferol.

Vitamin D intake should be accompanied by constant monitoring of urine analysis to avoid overdose, because large doses can have adverse effects. toxic effect on the body. An overdose of this drug can cause loss of appetite, nausea, vomiting, urinary retention, constipation and even limb cramps.

If anemia occurs due to rickets, it is treated with iron supplements in the form of syrup or drops.

By following all the requirements, you can very quickly improve the child’s condition.

Preventing rickets is easier than treating it - PREVENTION

The health of the child must be taken care of long before his birth - during planning, as well as during pregnancy. At approximately 28 weeks of intrauterine development, the child’s body begins to actively store vitamins. Vitamin D accumulates in the liver, fat and muscle tissue fetus During this period, a pregnant woman should pay special attention to her lifestyle:

• regularly visit a antenatal clinic doctor;
• eat regularly and nutritiously;
• spend more time in the fresh air;
• protect yourself from colds and infectious diseases;
• walk a lot.

Prevention of rickets is carried out from the birth of a child and is especially necessary for premature babies, with insufficient weight, in the first months of life, as well as for those born in the autumn-winter and even spring periods. It is enough to follow the regime, take long walks in the fresh air, get a lot of sun, strengthen and physically develop the child.

Prevention of rickets video:

Breast-feeding– the best protection against many diseases, but only if your menu contains the required amount of nutrients. A nursing mother needs to streamline her diet: consume more dairy and fermented milk products, take multivitamins (). If your baby is “artificial,” you need to choose an adapted milk formula that closely resembles the composition of human milk. ()

In the future, when introducing complementary foods, you should take into account that vitamin D is found exclusively in products of animal origin (meat, liver, butter, egg yolk) and systematically offer them to your baby. You should not overuse semolina porridge. In addition to the fact that it can cause allergic reactions, it also interferes with the absorption of calcium in the small intestine.

Fish fat

Children from the “risk group” are recommended to undergo drug prevention of rickets. One of the most popular remedies is fortified fish oil. It can be given to children starting at four weeks of age, gradually increasing the dose.

It should be remembered that prevention is carried out under the supervision of a local pediatrician.

For the purpose of prevention, medications(vitamin D, fish oil) should be given over a certain period.

There is a so-called rule of the letter “r” - take vitamins in those months of the year that have the letter “r” in their names. May and the summer months are usually sunny, so drug prevention the need disappears.

Rickets cannot be left to chance - CONSEQUENCES

Most often, rickets does not pose a threat to the child’s life. But if you do nothing, the symptoms go away, but the consequences of rickets remain. Often children who have had this disease suffer from caries of milk and permanent teeth. Curvature of the legs. There may be developmental delays.

Due to changes in the skeleton, scoliosis, flat feet, and pelvic deformity may occur. In schoolchildren, the effects of rickets manifest themselves in the form of myopia, anemia, reduced immunity and pain (frequent bronchitis and pneumonia).

In people mature age Osteoporosis may develop.

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Rickets is a disease common in children. small age, which manifests itself when there is insufficient intake into the growing children's body vitamins belonging to group D. These vitamins are very necessary for children, as they help maintain calcium and phosphorus levels. The latter are an integral element of the full functioning of the nervous system and the development of bone tissue.

Rickets occurs in babies who lack vitamin D

Causes of rickets

The causes of rickets are:

Insufficient amount of sun (ultraviolet rays help the production of vitamin D) - for example, in autumn - winter, especially in the city, there is little sun, which is why few D vitamins are formed;
- maternal illness during pregnancy (for example, gestosis);
— difficult birth;
— artificial feeding, excessive amounts of cereals (slow down the absorption of calcium by the intestines);
— insufficient motor activity (reduces blood supply to the legs);
- other diseases of the child (for example, an abnormality of the kidneys, when they secrete an excessive amount of phosphate into the urine, which leads to its decrease in the body. The lack of phosphates leads to weakening of the bones, or gastrointestinal diseases, when the absorption of calcium and phosphorus is difficult);
- dark skin of the child (reduced production of vitamin D by the body).

Remember that rickets is not congenital; it always develops against the background of illness. Regardless of the causes, the signs of rickets in children are the same, and the symptoms of rickets in children appear extremely early, already in the first year of life. The manifestation of symptoms of rickets depends on the stage of development of rickets.

Stages of disease development

There are several stages in the development of rickets in children:

1. Elementary
2. High period
3. Convalescence stage
4. Residual effects

At 2-4 months, children usually experience the initial stage of rickets. Signs of rickets at 4 months are:

- decreased activity;
— increased excitability;
- baby's anxiety;
- loss of appetite;
- bad sleep;
- the baby rubs his head on the pillow - this is how bald spots appear;
— increased sweating;
- urine and sweat are characterized by a sour odor.

Signs of rickets in premature infants appear as early as 2-3 weeks of age. In this case, the symptoms of rickets are also caused by disorders of the central nervous system and autonomic changes. The following signs of rickets appear in premature infants:

Babies with rickets develop bald patches

- restlessness, moodiness;
- with loud sounds - flinching;
- increased irritation from bright light;
- sleep disturbance;
- sweating (especially of the head);
- bald patches on the back of the head;
— after a few weeks, the bones of the skull soften and muscle tone decreases.

The initial period of rickets in infants lasts up to a month, and then progresses to its height.

The height of the period is characterized by changes in the skeletal system, which intensify compared to initial stage rickets. Signs of rickets in infants during this period are bone deformations, namely:

Deformation of the skull (asymmetrical shape of the head, flattening of the occiput, enlargement of the frontal bone);
- deformation of the chest (it bulges or is pressed in, the places where bone tissue transitions into cartilaginous tissue become denser);
- deformation of the lower extremities (if the child stands and walks, then curvature of the leg bones is possible);
- rachiocampsis.

The convalescence period is a period of gradual recovery. There is an improvement general condition in children – the functioning of the cardiovascular system is normalized, respiratory system, pass neurological, autonomic disorders, the level of phosphorus and alkaline phosphatase is normalized, and uneven compaction of bones is noted in the areas of their growth.

Residual effects are the consequences of rickets in children under one year of age, which remain virtually for life and are noticeable in adults.

Degrees of rickets

There are also three degrees of severity of rickets, which manifests itself in children:

• 1st degree – severity mild illness;
• 2nd degree – moderate severity;
• Stage 3 is the most severe degree of the disease.

Rickets of the first degree. Rickets of the 1st degree at 2-3 or 3-4 months of a child’s life is characterized by symptoms of rickets from the head, at 4-6 months - from the chest, and after 6 months - deformation of the limbs and spine.

At 3-4 months, children with 1st degree of rickets experience a symptom called “craniotabes” - this is a symptom of rickets caused by thinning internal surfaces bones, as well as symptoms of rickets in infants become softening of the parietal, occipital bones, and sometimes the frontal, parietal tubercles. At 4-6 months, children with 1st degree of rickets experience changes in the chest:

- “rib beads” (look like thickenings at the transition points from bone tissue to cartilaginous tissue, squeezing from the sides of a child’s chest);
- “Harrison's groove” (appears from the fact that the chest is retracted at the site of attachment of the diaphragm).

Rickets of the 1st degree is characterized by severe muscle hypotonia, absence of impairment of psychomotor development.

Rickets of the second degree. Average severity of rickets (grade 2) is characterized by:

Rickets causes severe skeletal deformities in children

Diagnostics

Diagnosis of rickets disease in children is carried out by using laboratory research methods, during which the content of calcium, phosphorus, vitamin D metabolites in the body, and the activity of alkaline phosphatase in the blood are determined. X-ray studies examine the epiphyses of tubular bones. In addition, diagnosis is also based on medical history, symptoms of damage to the muscular, nervous, and skeletal systems of the body, and the state of psychomotor development.

Treatment of rickets

Remember that if you suspect the first signs of rickets, you should immediately consult a doctor, whose prescribed treatment will help avoid worsening the development of the disease.

Drug treatment the occurrence of rickets in children includes the use of vitamin D preparations and its metabolites. Doses of medications are prescribed exclusively by a pediatrician, who takes into account the severity and course of rickets in a particular child. Sometimes, in in some cases(for example, frequently ill children) are specific treatment rickets are anti-relapse courses prescribed 3 months after the end of the main course.

Drugs prescribed for rickets: capsules 500 mg, dragees 500 IU, aqueous solution of vitamin D, or tablets 50 mcg, oil solution 0.25%. In addition to vitamin D, vitamins B2, A, B6, E, a citrate mixture, magnesium preparations, Asparkam, and preparations with phosphorus are also prescribed. Also required massotherapy, baths with sea ​​salt or pine extract, exercise therapy.

In the treatment of rickets in children great value given to massage

Massage is very important for rickets, which activates metabolic processes, improves tissue trophism, strengthens muscle and skeletal system. The massage must be carried out in a gentle manner, since with this disease the bones are softened and brittle.

A child with rickets is prescribed a regimen appropriate for his age, which takes into account maximum exposure to fresh air. When walking, the child's face must be open so that ultraviolet rays promote the production of vitamin D3 in the skin.

To prevent the occurrence of bone deformities, the child should be placed on a hard and flat playpen (for example, on a sheet of plywood suitable for the size of the crib). Such activities are especially important when children are awake. It is necessary to encourage the baby to be physically active; for example, toys are used for this.

Prevention of bone deformities also requires limiting prolonged sitting or standing for children (if such skills already exist). There is also no need to sit the child down or put him on his feet if he does not know how to do this.

Diet for rickets

Children suffering from rickets are prescribed special diets. The best option is breast-feeding. To reduce acidosis, children are prescribed a diet in which vegetable and fruit dishes predominate. For example, children already 5 months old can cook porridge with vegetable broth (rice, oatmeal, buckwheat). You can use porridges rich in iron, microelements, and vitamins that do not require cooking.

They are also preparing vegetable purees, where the use of zucchini, cabbage, cauliflower, carrots, pumpkin, turnips, and some potatoes is recommended. It is important to give children the proteins they need, which can come, for example, from meat, cottage cheese, yolk, fish, green peas). Yolks should be given to children from 5 to 7 months (half a mashed yolk). Feed minced meat A child with rickets is treated one and a half months earlier than a healthy child. If the child is artificially fed, use modern adapted formulas.

Prevention

Although no one dies from rickets, the prospect of leaving a child, in case untimely treatment rickets, disabled for life is far from better. So parents need to take the prevention of rickets in infants seriously. Start preventing the disease even if there are no signs of it - this way you will protect your baby from possible illness.

It is necessary to begin the prevention of rickets during pregnancy

It is necessary to start preventing rickets even before the baby is born - for example, especially in the third trimester, a pregnant woman must receive a sufficient amount of vitamins, and most importantly, vitamin D. Then the child will have time to stock up on a sufficient amount of this substance, which after birth will help him develop normally.

The expectant mother will receive vitamin D by walking in sunny weather, as well as by eating right. From 32 weeks of pregnancy, it is recommended to take 500 IU of vitamin D daily. This should not be done before the 32nd week, because an excess of the vitamin will harm the placenta (therefore, modern multivitamin preparations should also be taken in the third trimester).

If pregnancy is complicated by some disease, the dose of vitamin D is increased, but only on the recommendation of a doctor. Prevention of rickets in infants begins from the first days of life. The first three weeks, when the baby has accumulated a sufficient amount of vitamin D, requires nonspecific prophylaxis:

- breastfeeding or special adapted formulas are necessary;
- avoid meals with large amounts of carbohydrates (unadapted mixtures), which only aggravate rickets;
- a nursing mother needs to take multivitamin preparations that enrich breast milk minerals, vitamins;
- the child needs air baths, gymnastics, massage, hardening - they stimulate the development of the musculoskeletal system;
— all year round(2-3 years) to full-term healthy children exposed to minimal risk rickets, you need to take 500 IU;
- For premature babies, to prevent rickets, certain drugs are prescribed by a doctor, who determines the dose and prescribes calcium supplements.

Folk remedies for rickets

How to treat rickets in infants is also suggested ethnoscience, which has an abundance of folk methods used for rickets. We offer such folk remedies in the treatment of rickets:

- a decoction of the tripartite series, taken by the child three times a day in a large spoon. The decoction is prepared as follows: a large spoonful of herbs is boiled for about 15 minutes in a glass of water, infused for 3-4 hours, then filtered;
- peppermint infusion (a tablespoon of leaves is infused in a glass of boiling water for about half an hour, then filtered, and then taken three times a day, a teaspoon, each time half an hour before meals;
- infusion walnut(its leaves), which is prepared as follows: place a tablespoon of leaves in a preheated bowl, pour in a glass of boiling water, then leave for up to an hour, filter. Children take this infusion three times a day before meals;
- prepare a decoction of carrots, white cabbage, beets, which are boiled for about an hour, and then children take it several times a day;
- decoction of strawberry herb (two teaspoons of chopped strawberry herb are boiled in a glass of water for about 15 minutes, then drunk like tea, half a glass at a time). In addition, you can eat berries;
- burdock decoction (a tablespoon of burdock is boiled for about 15 minutes in a glass of water, and then consumed three times a day, a large spoonful);
- burdock root juice (drink fresh three times a day, 25 drops).

With decoctions of oat straw (a kilogram of chopped straw is boiled in a bucket of water for about an hour, filtered, poured into the bath);
- with a decoction of hay dust (200-300 grams of hay dust is boiled for up to 15 minutes in three liters of water over low heat, then filtered and poured into the bath;
- with infusion pine needles(50-100 grams of dry pine needles are infused for about 8 hours in a bucket of water, then filtered and added to the bath). This bath is alternated with baths using other means.

Another remedy is eggshells. Hungarian doctors have found that egg shells contain a lot of calcium carbonate, which is well accepted by the child’s body. The shell also contains other necessary microelements - copper, fluorine, sulfur, phosphorus, iron, zinc, molybdenum, silicon. Eggshell is identical in composition to human bones and teeth, improves hematopoietic function bone marrow. It is recommended to take the product from eggshells for children after a year, when a constant supply of calcium is required. To prepare eggshells for use, you need to hard-boil the eggs, then grind the shells in a mortar. The child should be given this powder three times daily. Depending on age and weight, the dosage ranges from 1 to 3 grams.

Video

There are diseases that have long been considered “pre-revolutionary” and obsolete, but, as shows medical practice, they are not so rare and may sometimes not depend at all on the family’s standard of living, infant care and nutrition. This includes infants.

Now let's look at this in more detail.

What is rickets?

Internal diseases and genetic abnormalities

The situation is more complicated with children whose internal organs are sick from birth:

• intestines,
• liver,
• kidneys

Malabsorption in the intestine, obstruction biliary tract, genetic diseases, preventing the absorption of vitamin D - all this ultimately leads to the appearance of the first signs in infants, which is very difficult to treat.

Other factors

Prematurity and artificial feeding are two more important factors that directly affect metabolic processes in the body and the absorption of nutrients from food.

The fact is that premature babies have a significantly higher need for vitamin D than those born at term, so very often food does not cover the vitamin deficiency: it only grows and gets worse if the signs are not noticed in time and the nutrition system is not changed.

Artificial children suffer due to the fact that in cow's, goat's milk, artificial mixtures the proportion of calcium and phosphorus, the most important building elements for bone tissue, is disturbed.

It is important for mothers whose children do not receive breast milk to know: ideal formulas and animal milk do not exist, therefore the nutrition of an artificial child should be structured so that the deficiency of vitamin D, calcium and phosphorus is constantly covered by complementary foods.

Classification of rickets

The classification of rickets existing in domestic pediatrics is associated with the effectiveness of vitamin D therapy. The following types of disease are distinguished:

• Classic D-deficiency is the most common;
• Secondary;
• Vitamin D dependent;
• Vitamin D-resistant.

In turn, the classic one is subdivided according to changes in the concentration of calcium and phosphorus in the blood, so there are calciumpenic and phosphopenic forms, which indicate a significant deficiency of these important elements. Sometimes the classic flows with normal indicators calcium and phosphorus.

They are also prescribed with caution to children receiving adapted milk formulas that already contain vitamin D.