24.11.2020

Prevention of rickets in children

During the first year of life lays the foundations for the future health of the child, and the special role in this matter is given to parents. Special attention in this period should be given to the prevention of such serious diseases as rickets.

It should be noted that rickets, the mankind knows not one century, but, despite this, his symptoms at the present time are diagnosed in infants in almost any country in the world. But the development of rickets it is really to warn, not even putting much effort. According to experts, it is enough to provide children with adequate care and timely use of vitamin D.

The development of rickets

For anybody not a secret that any disease is much easier to prevent than to treat, and rickets in this case is no exception. Timely taken preventive measures is the ability not only to prevent the formation of severe bone changes, but also to forget about this illness.

Parents should understand that rickets develops gradually in several stages.

The first signs of rickets in children the first year of life

Early signs of the disease doctors generally exhibit in the first months of baby’s life.

Most often the suspicion of the development of rickets set in the presence of the following symptoms:

  1. Loss of appetite.
  2. Increased moodiness, fearfulness of the baby. The child becomes more restless, it may be unreasonable jerk during sleep.
  3. Violation of sleep mode. The child is difficult to sleep, often wakes up and cries. The sleep becomes short and shallow.
  4. Excessive sweating, which affects the child even when he is in the room with normal humidity and temperature.
  5. Violation of the chair.
  6. “A stall of hair” on the back of the head.

If the first symptoms to ignore and not to take the necessary measures, in a short time the baby may develop the following signs of rickets:

  1. Low muscle tone.
  2. The lag in physical development.
  3. Problems with the dentition: the teeth appear much later than established norms, and their eruption may be accompanied by severe pain.
  4. Late closure of Fontanelle.
  5. Bloating of the abdomen.
  6. Changing the shape of the skull, starts the process of deformation of the chest, curvature of the feet and the narrowing of the pelvis.

In more complex cases, deteriorating not only the physical but also the mental state of the child. It should be noted that the development of this disease are most predisposed children aged from 2 months to 2 years.

The factors contributing to the development of rickets

The increased risk of rickets is significantly influenced by the following factors.

From the mother of the child:

  • early bird (before 18 years) and late (after 35 years) pregnancy;
  • the presence of complications during pregnancy;
  • disease (pathology of the kidney, dysfunction of the digestive system, problems with metabolism);
  • the lack of a balanced diet during pregnancy.

From the kid:

  • small or large (more than 4 kg) weight at birth;
  • prematurity is the birth of a previously proposed period;
  • is fast gaining body weight during the first three months after birth;
  • the child was born during the period from June to December;
  • the baby spends very little time in the fresh air, moves a little and catches colds frequently;
  • for breastfeeding using authentic mixture;
  • health problems, in particular with the liver and bile-excreting ways.
Types of prevention of rickets

A reasonable approach is considered when the prevention of rickets of a child begins during pregnancy and continues after birth. Compliance with all the recommendations allows you to virtually eliminate the risk of developing this disease.

Overall, experts are divided prevention of rickets in children:

  • antenatal (prenatal), which takes place during pregnancy;
  • postnatal carried out after the child born.

In this case, each of these types of prevention contains specific and nonspecific measures. Next, take a closer look at what constitutes the prevention of rickets.

Features of antenatal prevention of rickets

In the third trimester of pregnancy to the child’s body for normal development requires large amounts of calcium (up to 290 mg per day). And because he receives the necessary minerals through the placenta from the mother, her calcium-phosphorus exchange have to adapt to the growing needs of the baby. To provide the fetus with the required calcium and vitamin D in full, in the body of the future mother have to mobilize all their internal resources. Therefore, it is very important that at this crucial period in the life of a pregnant woman was available the sources of all the necessary trace elements.

An important role in the antenatal prevention of rickets play non-specific methods that, in principle, the default should be an integral part of the lives of all pregnant women.

Such methods include:

  1. Corresponding to the position order of the day, which should provide adequate night and day sleep. No less important a daily walk in the fresh air. Experts recommend expectant mothers to carry out on the street in the daytime at least two hours a day.
  2. Easy physical exercise (swimming, exercise, yoga, etc.).
  3. A balanced diet containing all essential micro and macronutrients. Especially should pay attention to the foods that supply building materials such as calcium, phosphorus and protein.

Under specific antenatal prevention means additional intake pregnant vitamin D, which is assigned usually at the beginning of the third trimester, and exclusively by the attending physician.

Pregnant women over the age of 30 experts usually do not prescribe additional vitamin D because it increases the risk of calcification in the placenta, which in turn is the cause of development of fetal hypoxia.

The main indications for the appointment of additional intake of vitamin D:

  1. The last trimester falls in winter. In such situations, expectant mothers who have no health problems, ranging from 32 weeks, taking the vitamin at a dose of 400 IU per day.
  2. The expectant mother is suffering from somatic diseases, such as nephropathy, rheumatism, diabetes, hypertension.
  3. A pregnant woman has a pathology of organs of small pelvis.

In the latter two cases at any time of the year doctors prescribe to pregnant women with the onset of the third trimester vitamin D dose of 1000 IU per day.

Components of postnatal prevention of rickets in children

Preventive measures for the prevention of rickets should begin immediately after birth.

In General, the basis of postnatal prophylaxis is a few components:

  1. Nonspecific methods of prophylaxis:
      • catering;
      • complete care for the child and compliance with age-appropriate routines.
  2. Specific prevention includes supplementation of vitamin D.
The impact of child nutrition on the development of rickets

During established breastfeeding as the only additional source of vitamin D supports breast milk. That is why it is very important that the diet mom was the most balanced and contain all the necessary nutrients in sufficient quantities. In addition, according to the recommendations of professionals after childbirth should continue taking a complex vitamin until the end of the breastfeeding period (subject to normal tolerance of their child).

It should be noted that in the process of examining whether the baby is being breastfed, in addition to take vitamin D, you will encounter two diametrically opposed views. Many domestic experts believe that breast milk with all its benefits, can not cover the demand rapidly growing for vitamin D, because the contained cholecalciferol typically less than 100 IU. In addition, the level of vitamin D in breast milk depends on how well carried out the antenatal prevention of rickets. And since most parents think about prevention only after the baby is born, breast-feeding, according to experts, it can be one of the reasons for the development of rickets, especially in the cold season.

Their opponents adhere to a completely different position, which, by the way, today is gaining popularity. According to them, healthy infants without primary signs of rickets, who were born in the expected duration and weight gain do not go beyond generally accepted norms, there is no need to appoint additional intake of vitamin D.

As for kids on artificial feeding, it is very important to choose the adapted dairy mixes. Their advantage is that in composition they are the most similar to breast milk, while enriched with various vitamins, including vitamin D.

Complete care for baby

Another way non-specific postnatal prevention is a bona fide child care, which includes:

  1. Therapeutic massage and physical exercisethat should take a daily baby at least an hour. A positive impact on the development and health of the baby have breathing exercises, rocking on a fitball, or on the hands. Also in progress daily is recommended to RUB the legs, arms, back, stomach and chest of the child.
  2. Daily bathing has a positive effect on kids suffering from irritability or low tone. Even ordinary water treatments have great impact on the health of the child, but for greater effect, you can use different solutions, decoctions or infusions. Depending on the kind of problem in the tub added some “healing” substances (e.g., pine extract, sea salt, chamomile, Bay leaf, series, lavender, etc.). Of course, the concept of action must be present in everything, including, if we are talking about bathing the baby in herbs. In addition, it is important to consider the individual characteristics of your child’s body and his reaction to certain ingredients.
  3. Daily long walks in the fresh air, and air baths taken in the summer in the shade of the trees. As you know, in the body of each person is producing their “own” provitamin D, which is exposed to direct ultraviolet rays to the skin aktiviziruyutsya. That is why one should pay particular attention to walking with small children. It should also be taken into account that is necessary for the synthesis of the provitamin ultraviolet rays cannot penetrate through the sunscreen, clothing or glass.

According to research conducted by British scientists, it was proved that the climatic conditions of the temperate zone in the cold season direct sunlight falling on the open face and hands kids, enough to start the process of synthesizing vitamin D.

For prevention of rickets was effective, the babies should be mandatory to take up, pay attention, do a daily gentle massage and exercise. That’s how nature that a body which is not used is prone to atrophy. If one baby is constantly in a lying or sitting position, start the process of active removal of calcium from bone for his “lack of demand”. That is why all the abandoned children are being diagnosed signs of rickets despite increased prevention of the disease conducted by the medical staff.

Vitamin D and its importance for child

The role of vitamin D in the human body is very difficult to exaggerate. With his participation formed bone tissue and maintained her healthy throughout a person’s life. At admission and synthesizing vitamin D insufficient fails calcium-phosphorus metabolism in the body.

In addition, many studies conducted in recent decades showed that deficiency of this vitamin significantly increases the risk of developing diseases such as:

  • diabetes;
  • malfunctions of the immune system;
  • diseases of an infectious nature;
  • problems in the cardiovascular system;
  • oncological diseases.

Interesting fact! Traditionally, vitamin D refers to a group of fat-soluble vitamins, although in reality it is not. Regardless of the source of the substance in the body (synthesis due to UV exposure or intake with food), its action is similar to the action of this hormone. Therefore, it would be absolutely logical to give him the title of D-hormone, not a vitamin. However, following the historical tradition, it is the active ingredient continue to be called vitamin D.

In General, in nature there are two forms of vitamin D:

  • ergocalciferol (D2);
  • cholecalciferol (D3).

Together, these substances do not differ neither in chemical structure nor in their behavior in the body.

Two ways of getting vitamin D by the body:

  1. Exogenous – with food and vitamin preparations.
  2. Endogenous – self-synthesis of vitamin in the skin when exposed to sunlight.

Regarding the food, with sufficient content of vitamin D3 forms in nature, not so much.

To date, the best sources of this vitamin are:

  • fatty fish (for example tuna, sardines, mackerel);
  • fish oil;
  • beef liver;
  • egg yolk.

Vitamin D2 can be found in such plant foods as mushrooms, yeasts and some plants.

In addition to the above sources on the market today, you can find other products which are artificially enriched with vitamin D. categories of these products include: adapted artificial mixtures for kids, milk and other dairy products, cereals, bread.

Do I need to give baby vitamin D to prevent rickets?

Before making a decision on this issue, parents should objectively assess the ability of available natural sources (foods and ultraviolet light) to fully meet the growing needs of children for vitamin D.

It is known that under normal conditions in human skin from exposure to ultraviolet light is an active synthesis of vitamin D – up to 15 ME/cm/h. This amount of vitamin is sufficient to meet the it needs of a child. However, it is understood that it is not always the sun’s rays can be a reliable source of vitamin D.

The factors influencing the process of self-production by the body of vitamin D:

  • the geographic situation of the country. The farther from the equator the country is, the fewer opportunities for the child’s body to produce sufficient number of its own vitamin D. for example, in Russia, the main dose of “vitamin” ultraviolet summer Sunny days;
  • the degree of pollution or the pollution of the atmosphere;
  • seasonality;
  • cloudy.

It should be noted that to synthesize a sufficient amount of vitamin D the baby who is one of only a diaper, needs to be under the influence of direct sunlight at least half an hour a week. As for the child, which are only open handle and face, the norm – about two hours. It should be noted that children under six months, experts generally do not recommend to walk under the open sun.

It is proved that necessary for the synthesis of vitamin D ultraviolet light does not pass through glass and other obstacles. That is, it is impossible to obtain the desired dose of the substance, walking in the shade of trees, under an umbrella or walking in traffic. In addition, when you use sunscreen cosmetics with a degree of protection SPF 8 and above on the skin forms a barrier that reduces the production of vitamin D is almost 95%.

As for food, the results food child can receive a total of up to 30% of the vitamin from the required standards. In this issue the problem will not be solved even by taking full diet.

The recommended daily allowance of vitamin D:

  • children under one year – 400ME;
  • children from one year to 18 years 600МЕ.

Artificial mixture for feeding infants are enriched in such a way that eating one liter of the prepared product child got your daily requirement of vitamin D is 400 IU. But in reality, young children are simply unable to eat per day this amount of food.

If we talk about breast milk, then, as practice shows, vitamin D, it is not enough to cover the daily needs of the baby.

It turns out that infants who could not so often see the sun, for objective reasons, are not able to get the right amount of vitamin D from natural sources. Therefore, additional supplementation of vitamin D to prevent rickets is assigned to all babies.

The used in our country, preparations of vitamin D include:

  1. Aquaderm (1 ml-15000МЕ). This aqueous solution is the most frequently prescribed by pediatricians because of the very fast and easy absorbability, good activity and rapid onset of effect (after a week).
  2. Fish oil (for example, Д3вит baby).
  3. The oily solutions: Vigantol (1 ml-20000) and Vitamin D3 BON (1 ml-200000МЕ).

If you want to learn, whether enough your baby gets vitamin D, it is possible to hand over blood for definition of level of a form of vitamin calzidiola. Analysis calcidiol can be done in most laboratories.

Indicators calzidiola in the blood:

  • Normal level is 30-100 ng/ml
  • Low – 21-30 ng/ml
  • Disadvantage – less than 20 ng/ml
  • The deficit is significant – less than 10 ng/ml
Overdose of vitamin D

Often, parents are unable to addressed in addition to give their children vitamin D for fear of an overdose. However, for such fears there is no scientific basis.

In particular, excess vitamin synthesized in the skin due to prolonged exposure to the sun is destroyed, so an overdose of vitamin own production is nonsense.

As for poisoning preparations of vitamin D, it happens very rarely and the main cause of this condition is an inborn error of metabolism of this active substance in a child. A similar problem can be identified by such features as: constant thirst, nausea and the urge to vomiting, dysfunction of the kidneys.

The research results showed that a single dose of vitamin dose 300000МЕ child does not threaten. But despite this scientific fact, vitamin D should be kept along with other medicines out of reach of children.

Use caution and doctor’s prescription, and then the topic of overdose will not affect you.

Every parent needs to take seriously the topic of prevention of rickets in children, because timely measures are not only to prevent the development of rickets in children, but also significantly reduce the risk of future development of many ailments of chronic nature, as well as to improve the durability of immunity to various viral infections.

Regular daily exercise, proper nutrition and supplementation vitamin D is a guarantee of good health of your baby.

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