Cases of rickets are on the rise in England, with hospital admissions for both rickets and vitamin D deficiency increasing by a third in the space of a year. Many of those admitted with rickets were young children.
The illness occurs as a result of a deficiency in either vitamin D or calcium, and affects bone development in children, causing pain, poor growth and soft, weak bones.
It’s more common in children with darker skin as they need more sunlight to get enough vitamin D, according to NHS Choices. Children who are born prematurely or take medicine which interferes with their vitamin D levels are also at risk.
The issue can affect both adults and children, says Dr Kenny Livingstone, a registered GP and chief medical officer of ZoomDoc, although it is more common and picked up more frequently in young children.
Spotting The Symptoms In Children
With malnutrition levels on the rise in the UK and the difficulty of keeping vitamin D levels up, particularly during the winter months, it’s worth being aware of the signs of rickets in little ones.
Children might experience sore and painful bones, making them reluctant to walk or run, or prone to getting tired easily. Their walking might look different – for example, they might start waddling.
Rickets can cause skeletal deformities where the bones in the ankles, wrists and knees thicken or widen, the legs become bowed and, in rare cases, the spine bends. A child with rickets might not grow properly, so can be shorter than their peers. In some cases they might also be more prone to bone fractures and breakage.
As the condition impacts bone growth, it can also result in dental issues like weak tooth enamel, delays in both baby and adult teeth coming through and an increased risk of cavities.
:: In 2017/18 there were 101,136 hospital admissions with a main or secondary diagnosis of vitamin D deficiency – 34% more than the 75,708 in 2016/17.
:: There were an additional 474 admissions in 2017/18 where the main or secondary reason was rickets, up from 445 the year before.
:: Almost all these cases were young children, with 332 admissions for rickets in children aged nine and under, up from 324 the year before.
:: A further 80 admissions for rickets were among those aged 10 to 19 years old, up from 67 the year before.
When To Get Help
If your child has any signs or symptoms of rickets, such as bone pain, delayed growth or muscle weakness, they should see a GP for a check-up.
Treatment for the condition will usually involve increasing intake of vitamin D and/or calcium by eating more foods rich in vitamin D, taking supplements or having an annual vitamin D injection.
Prevention
Dr Kenny Livingstone says parents should try to ensure their children have a balanced healthy diet, but acknowledges that child food poverty and economic inequalities have contributed to growing issues of malnutrition in the UK, so it’s not always easy.
“Dietary sources of vitamin D include oily fish, red meat, liver and egg yolks and in fortified food like breakfast cereals and spreads,” he tells HuffPost UK. Some families might also be eligible for free nutritional supplements, he adds.
“Children should also be encouraged to spend some time outside in the sun,” says Dr Livingstone.
In spring and summer, most people can get enough vitamin D from being out in the sun for short periods of time with their forearms, hands or lower legs uncovered. But while we’ve all been taught the importance of wearing sunscreen to reduce skin cancer risk, it has been suggested that wearing cream also lowers absorption of vitamin D.
Dr Kim Pfotenhauer, from the College of Osteopathic Medicine at Touro University California, conducted research into vitamin D exposure and sunscreen and suggested people should avoid sunscreen use when exposed to midday sun for up to 30 minutes twice a week to increase and maintain normal vitamin D levels.
But Dr Livingstone disagrees and believes people should wear sunscreen when they’re outside, full stop.
“There is a narrow window between protecting oneself from the harmful effects of UV radiation from sun overexposure and the importance of getting outside as much as possible for the known beneficial effects,” he says. “It is always advised to wear sunscreen when you’re outdoors in the summer months.”
- Update: This article originally advised people to wear sunscreen however this has been found to lower levels of vitamin D so we have updated the advice to acknowledge this.