Clinical signs of rickets. Mindfulness is the key to future health. Etiology of rickets in children and vitamin D

This condition is called rickets and is often very frightening for parents.

Characteristics of rickets in children

Rickets is a curvature of the bones due to a disorder of phosphorus-calcium metabolism caused by a deficiency of vitamin D. In children under the age of 2 years, nutritional, or infantile, rickets of food origin occurs. In older children, the cause of rickets is hypophosphatemia caused by renal failure. The incidence of infantile rickets in the first 2 years of life ranges from 5 to 20%. Rickets is more often observed in children with low weight. During infantile rickets, the initial stage, the height stage and the recovery stage are distinguished.

The initial stage, which appears at the age of 3 months and reaches a maximum at 4-5 months, is characterized by vegetative and neurological manifestations in the form of convulsions, tetany, stridor. In the first half of the year there is a delay in crawling. No bone changes are observed.

The peak stage begins at 6-8 months of age. Characterized by curvature of bones. There is deformation of the bones of the skull, thickening of the frontal and parietal tubercles, thinning of the occipital and parietal bones. There is a delay in calcification of the physis of long bones, which leads to their thickening. The thickness of the epiphyses of the bones of the forearm and phalanges of the fingers is increased. From the second half of the year after mastering sitting, kyphotic deformity of the spine begins. Thickening of the ribs occurs at the osteochondral junction. The chest acquires a convex or concave deformation with protrusion of the lower edge of the costal arch. In the 2nd year of life, with the transition to standing and walking, the progression of the curvature begins lower limbs. There is a limitation in the growth of bones in length, thickening of the bones and their deformation in the shape of an arc. Curvature of the bones of the lower extremities occurs in the frontal and sagittal planes. In the frontal plane, varus deformity of the femur and tibia develops more often than valgus.

Varus is accompanied by hypertonicity of the flexor muscles and sprain of the lateral collateral ligament knee joint. Valgus is more associated with muscle hypotonia and sprain of the medial collateral ligament of the knee joint. Curvature in the frontal plane is often symmetrical and less often asymmetrical, when varus on one leg is combined with valgus on the other. In the sagittal plane, deformation of the lower leg bones occurs forward and outward. The tibia has a smooth surface, its crest has a sharp edge. The leg bones are painful on deep palpation. There is thickening of the knee joints. There is increased elasticity of the ligaments, which leads to hypermobility in the joints. When the ligaments of the knee joints are weak, their recurvation develops. Joint space ankle joint beveled with an outward angle. There is a flattening of the pelvis.

The radiograph shows the following changes: varus or valgus deformation of the femur and tibia in the form of a gentle arch, anterior curvature of the tibia, osteoporosis, which is most pronounced in the ribs, thinning of the cortical layer, curvature of the epiphyses of the femur and tibia, growth of the growth plate to the sides, a wide zone between the metaphysis and the epiphysis, expansion of the metaphyses. On the medial side of the proximal part of the femur, Loeser zones are found in the form of transverse stripes of non-mineralized osteoid, surrounded by a zone of sclerosis, which are qualified as pseudofractures due to osteomalacia. Meet pathological fractures, which lead to angular secondary bone deformations.

The child has a delay in the development of motor skills and a delay in the start of independent walking, which is caused by hypermobility of the joints, low muscle tone and curvature of the legs. Deformation of the lower extremities and weakness of the gluteal muscles lead to unstable walking with significant deviation of the torso in the frontal plane. Valgus of the legs and thickening of the knee joints lead to their impact while walking. Leg varus causes a narrowing of the stride width. With deformation of the lower extremities, secondary plano-valgus deformity stop with a forced increase in pronation during the roll. The child gets tired quickly and complains of pain in the legs after physical activity.

Recovery stage. Occurs spontaneously in the 3rd year of life. As recovery progresses, statics and dynamics normalize. Deformities of the spine and limb bones are corrected. The pain in the legs stops. Leg deformity at the age of 4-5 years in a child with short stature and delayed motor development are considered as prolonged rickets.

Causes of rickets in children

Rickets occurs due to a deficiency of vitamin D in the child’s body, and this is not only a disease of the bones, but general disease, expressed in the softening and expansion of bones closer to their ends, which leads to deformation of the chest, curvature of the legs and a delay in the start of walking.

The prevention of rickets has long been a daily intake of vitamin D, as well as supplementing the baby’s diet with foods rich in this vitamin.

It is believed that one of the causes of rickets is an insufficient amount of sunlight, but it is known that in many countries where there is enough sun and not everything is in order with nutrition, rickets is still very common.

Pronation (dislocation of an arm or leg)

When playing with a baby who is not yet a year old, parents often grab his hand too tightly, and as a result, a dislocation or subluxation occurs. elbow joint or heads radius. The child begins to cry, his hand either hangs powerlessly or freezes in an awkward position: the forearm is bent, the palm is turned down. That's when the diagnosis is made - pronation. And every doctor knows how painful it is for the baby. But any doctor also knows how to correct the situation: one movement is enough (but made by a specialist!) to return the joint to its place and stop excruciating pain. The child immediately calms down and begins to move his hand exactly as he did before the injury.

Pronation has nothing to do with bone cracks or fractures. In general, this is a painful but not terrible thing, so x-rays are unlikely to be needed here. But we must remember: the cartilage in the joints of the bones of a small child is very delicate and fragile, and therefore, when playing with the baby or leading him by the hand when he begins to walk, you should avoid sudden movements, and in no case pull or pull his limbs (pronation can also occur in the leg).

In fact, rickets is not a disease, but a condition, although it can aggravate the course of the disease.

Symptoms and signs of rickets in children

The first symptoms are minor and may not even be noticed by your pediatrician. The child develops increased anxiety, sweating, a sour smell of sweat, and as a result - constant irritation on the skin (prickly heat). The child rubs his head on the pillow, and as a result, baldness of the back of the head appears. The baby begins to flinch at loud noises. Further, muscle strength and tone are impaired; children later master motor skills. Due to a lack of calcium, changes develop in the skeletal system: bones become softer and are easily deformed (flattening of the occiput, pliability of the edges of the large fontanelle, deformation of the chest, curvature of the spine and legs).

In the future, growths may develop bone tissue, characteristic of long-term untreated hypovitaminosis D: occipital protuberances, “rachitic rosary” (thickenings at the junction of the bony part of the ribs into the cartilaginous part), thickenings in the wrist area (“bracelets”). With age, limb deformities can be eliminated (with proper treatment), but curvature of the spine and other bone changes can remain for life and indicate rickets suffered in childhood. Girls who have suffered from rickets sometimes experience deformation of the pelvic bones, which in the future can create certain difficulties during childbirth. In some children, vitamin D deficiency may slow down the eruption of teeth, which will later suffer from tooth decay. Anemia is a frequent accompaniment of rickets.

A natural question arises: why is almost all infants suffer rickets if the cause of this condition has long been known? Give all of them at the age of 1-1.5 months the required amount of vitamin D, and no rickets!

This approach does not solve the problem and does not reduce the prevalence of rickets. With our lifestyle, the effect of ultraviolet radiation on the skin is minimal and cannot provide the necessary amount of vitamin. Moreover, being in the open sun (“roasting”) is contraindicated not only for infants, but also for adults. Children under one year of age, as a rule, do not receive fish products, but fish fat, which is back on the market, is much less effective than a vitamin D supplement.

With a severe deficiency of vitamin D, calcium levels can decrease not only in the bones, but also in the blood, which will lead to an attack of seizures. This condition is called spasmophilia and develops more often in the spring.

Vitamin D in conditions of rapid growth of a child in the first months of life is necessary for the growing body in large quantities. How better baby gains weight, the more he lacks vitamin D. The need for vitamin also depends on the individual characteristics of the body, its growth rate, time, date of birth (for children born in the autumn-winter period, it is higher) and dietary habits - untimely administration vegetable puree, cottage cheese, meat (lack of calcium and phosphorus in foods).

Why don't doctors prescribe vitamin D?

For some reason, many doctors stubbornly do not notice the symptoms of developing rickets or, seeing them, do not prescribe vitamin D, citing the following reasons:

• Vitamin D is produced in the human body from provitamin under the influence of ultraviolet rays. Let the child walk in the sun, and there will be no rickets;
• the child is fed with formula milk, which is fortified with vitamin D;
• the child is breastfed, and the mother drinks a vitamin complex that contains vitamin D;
• the use of calcium-rich cottage cheese or a few drops of fish oil (previously this was the only way to treat rickets - some types of fish actively synthesize vitamin D) is enough to get rid of rickets.

If your baby receives porridge more than once a day, his vitamin D deficiency may worsen.

A temporary deficiency of this vitamin appears even in adolescents: during their intensive growth, a condition occurs accompanied by a decrease in calcium in the bones and their increased fragility. On radiographs of the bones, changes similar to those in children with manifestations of rickets are observed.

Naturally, the minimum (one might say microscopic) amount of vitamin D a child receives from breast milk, formula and even fish oil are clearly unable to compensate for the deficiency. Moreover, rickets can develop successfully against the background of a so-called prophylactic dose of vitamin D prescribed by a doctor (1-2 drops of an oil or even an aqueous solution per day or every other day).

It turns out to be a paradox: the child receives vitamin D and has a clinical picture of active rickets. What's the matter?

But the point is in the timing of the start of the prevention of rickets, in the doses the child receives for the course of treatment, and in the duration of the course. While the baby is still very small, he has a small supply of the vitamin given to him by his mother. But when he turns one month old, it’s time to give him a prophylactic dose.

Exist various schemes taking vitamin D. There are supporters of constantly taking a drop of the vitamin every day or every other day. As practice shows, in this case the effectiveness of vitamin D is low, and rickets is sure to develop to one degree or another.

A preventive course (!) dose of vitamin D for a child who does not yet have signs of rickets is 200,000 - 400,000 IU. The number of drops and the duration of their administration depend on the concentration of the vitamin in the drug you purchased, as well as what kind of vitamin it is - D 2 or D 3.

When prescribing vitamin D, it must be remembered that it is dosed not in drops or milliliters, but in thousands of international units (IU).

Vitamin D 2 (ergocal diferol) dissolves in oil and alcohol and accumulates in the liver, so it can be prescribed after 1-1.5 months of life in intermittent courses (8000-12,000 IU per day for 20-25 days).

In a number of European countries, a prophylactic dose of vitamin D 2 is given quarterly in several doses or even in one dose (200,000 IU). In our country, such a scheme for the prevention of rickets has not been adopted.

2-3 months after completion of the preventive course of vitamin D (the child does not receive vitamin D at this time), his condition is assessed to decide whether to continue the prevention or treatment of rickets. If the baby does not have signs of rickets, he is repeated a preventive course of vitamin D, and this is done again in the 2nd half of life.

Currently, all children after reaching one month old You should start giving 4 drops (2000 IU) of an aqueous solution of vitamin D3 (colecalciferol) once a day continuously until they are one year old. But monitoring over time is necessary (this dose is not enough for all children).

Considering the fact that an oil solution of vitamin D2 is less absorbed, and an alcohol solution is not currently available, scientists have developed an aqueous solution of vitamin D3 (colecalciferol), which is eliminated from the body much faster and requires constant use. Vitamin D3 is produced under the commercial name "Aquadetrim". One drop of this drug contains 500 IU of this vitamin.

If a child has certain signs of rickets, he needs a treatment course of vitamin D. The total dose for the entire treatment course depends on the severity of rickets and can range from 400,000 to 1,000,000 IU. Naturally, the pediatrician should determine how much vitamin D should be given per course. The general rule is the following: the course of treatment should not be very long - the child should receive the entire required dose in 2-4 weeks. Moreover, the more severe the rickets, the sooner the child should receive the course dose (accordingly, the higher daily dose). Why? As practice has shown, vitamin D accumulates in the body and begins to act most actively only after the child has received the entire course of vitamin D.

After 2-3 months, the child must be examined to assess the effectiveness of antirachitic treatment. If the result is good (disappearance or significant reduction in the signs of current rickets), the child is prescribed a prophylactic course of vitamin D again after some time (at the age of 8-9 months) (especially if this age falls in the autumn-winter period). If the effect is insufficient, a therapeutic course of vitamin D is re-prescribed. Children with certain individual characteristics (premature, receiving anticonvulsant therapy, with pathology gastrointestinal tract) may need more high doses vitamin D and repeat courses treatment. The decision about this, of course, must be made by the doctor.

We remind you that if the need for prophylactic administration of vitamin D is ignored and rickets develops, the child may subsequently develop deformities of the legs, chest, curvature of the spine and other postural disorders, and caries can easily develop. If you notice the first signs of vitamin D deficiency, bring it to your doctor's attention immediately.

I would especially like to warn you about the inappropriateness of using a complex preparation - an aqueous solution of vitamins D and A imported. It contains extremely little active ingredient (up to 10 bottles are needed for a course of treatment).

In the old days, rickets was called the “English disease.” Perhaps this happened because it was on the shores of Foggy Albion, where there was a severe lack of sunlight, that it manifested itself especially often in children and English pediatric doctors paid attention to this disease? However, today there is nothing “foreign” about this disease; domestic children are no less susceptible to rickets.

It should be said that rickets can manifest itself in a child in varying degrees. A mild form of rickets is almost close to normal, while a severe form entails severe developmental delays and weakening of the body for many years. A mild form of rickets is not even considered a disease; it is easily corrected with vitamin D, sufficient sun exposure and proper nutrition, while severe forms are treated in special rehabilitation centers.

Rickets or hypovitaminosis D - enough frequent violation in children under three years of age. In children under one year of age, rickets is most pronounced. Children born in the autumn-winter period, as well as “artificial” children, are especially susceptible to it. Premature babies and twin babies are also very vulnerable to this disease.

City children are susceptible to rickets to a much greater extent than village children.

Almost every modern child (according to some data, more than 60% of domestic children suffer from rickets) has some signs of rickets. Manifestations of rickets are varied - the child sweats frequently and profusely (especially during eating and sleeping), the back of his head becomes bald, and his appetite decreases. The urine and sweat of a child with rickets may acquire an ammonia odor.

It is more difficult to cure rickets in a child in whom it is caused by digestive disorders (vitamin D is not absorbed). This usually happens with intestinal dysbiosis, when absorption of many vitamins does not occur. After the dysbacteriosis is cured, rickets quickly disappears.

Severe cases of rickets are very rare these days. Typically, severe rickets accompanies a general painful state of the body (digestion, neurology). At severe cases Rickets causes deformation of the bones and the fontanel may not heal for a long time (up to 3 years). Children with rickets sleep poorly, become whiny and nervous. Physical and mental development child. A child with a severe form of rickets begins to sit after one year, and walks only by two years. In the future, rickets may come back to haunt you with scoliosis, caries, and even stunting. Already in the elementary grades, children who suffered from a severe form of rickets may develop myopia.

Children with severe rickets are usually registered at a dispensary and treated in special centers, take ultraviolet and salt baths, massotherapy.

But that's enough light form rickets can lead to curvature of the bones (hence the so common occurrence in adults with crooked legs, protruding ribs, “chicken” breasts, and protruding shoulder blades).

Treatment of rickets in children

To treat rickets, general drug therapy and orthopedic measures. Assign Spa treatment, insolation, massage and baths. Vitamin D and calcium supplements are used as medicines. Rest and load limitation are prescribed. In the advanced stage, if there is a risk of bone fracture, immobilization is used with splints and orthoses. At the age of 1.5-2 years, for varus, splints are used on the thigh and lower leg with a retraining pad in the area of ​​the knee joint. Redressing is used up to 3 years of age. If there is a risk of fracture, a Thomas apparatus is prescribed to unload the hip and tibia. Full load is limited until 5 years of age. Gradual loading of the legs is allowed when, against the background of general and drug treatment Bone calcification appears.

For rickets, massage the muscles of the legs and back. A massage session takes 20-25 minutes. The course of treatment consists of 20 sessions. The massage is repeated after 4-5 weeks. If the gluteal muscles are weak, a stimulating massage of the buttocks and thighs is done by rubbing and kneading them. In case of varus curvature of the knee joint, manual correction of the joint is performed by pressing on the lateral condyle of the femur. A relaxing massage is performed on the inner surface of the leg in the form of stretching, stroking, shaking and a toning muscle massage. outer surface thighs and legs. In case of valgus curvature of the knee joint, manual correction of the joint is performed by compression on the inner condyle of the femur, relaxing massage on the outer surface of the leg and strengthening massage on the inner surface of the thigh and lower leg. For planovalgus feet, a relaxing massage is given on the outer surface of the foot and a strengthening massage on its inner surface. Varus curvature can be corrected more easily than valgus, which is difficult to correct after 3 years. The prognosis of treatment depends on the time of its start. Treatment results for it early start turn out to be relatively better.

The operation is performed both before the end of growth and after ossification of the skeleton. The operation on a growing child is performed with the aim of affecting the bone growth zone and correcting the axis of the limb, which facilitates growth conditions in all joints and segments of the leg and reduces the possibility of secondary deformities. Unilateral epiphysiodesis with fixation with staples or a plate is used. Surgery after growth is complete is performed in case of significant deformation of the femur and tibia. The most common procedure is supracondylar osteotomy of the femur.

In case of infantile rickets, the child is shown preventive shoes, which give him confidence in walking and help improve motor activity. Most often these are sandals for home wear with an instep support, which prevents the development of planovalgus feet. During internal rotation of the leg, the shoe insole is made with the pronator fasciculus. The child wears shoes until recovery.

Prevention of rickets in children

The best way to prevent rickets is to keep your baby in the sun (under the influence of ultraviolet rays, vitamin D is produced in the skin). In this case, the child must directly absorb the sun's rays (expose at least his face and bare arms to the sun, but be sure to cover his head with a hat or scarf). The most beneficial sunshine occurs from early morning until 11 o'clock (and on hot days - until 10 o'clock). After 11 am and before 5 pm it is better not to walk in the open sun - it is too radioactive. But in the cold season, the baby’s exposure to the sun is limited (from approximately October to March, the number of sunny days is very small), so the prevention of rickets is carried out using an oil solution of vitamin D (ergocalciferol).

The mother, after consulting with the doctor, should begin preventing rickets even before the baby is born (especially if it is expected to appear between mid-autumn and the end of winter). Mom needs to walk in the sun (in the morning, but not “roast” in the sun). The diet of the expectant mother should be rich in proteins and vitamins. You should take special vitamin complexes for pregnant women, which include vitamin D3.

Breastfeeding also plays an important role in the prevention of rickets. It is breast milk that contains calcium, vitamin D and phosphorus in the proportions necessary for the baby, this ensures their complete absorption.

Artificially-bred children are prescribed to take vitamin D at 1 drop per week (besides, vitamin D is contained in infant formula), and if the child drinks mother’s milk, then the mother should take vitamins (1 drop of vitamin D every three days). After the introduction of complementary foods in a volume of more than one third of all food, the infant is given vitamin D 2 drops per week.

Before giving the baby vitamin D, drop it with a pipette into the a large number of(spoon) breast milk or formula. Then the diluted vitamin is given to the child to drink.

A healthy diet is also very important for the prevention of rickets. If at the age of up to six months this is done with mother's milk or an adapted formula, then after six months the child is given foods rich in vitamin D: egg yolk, butter, fish (especially fish oil!). However, fish oil should only be given to a child on the recommendation of a doctor. The most useful varieties of fish for rickets are cod, hake, and pike perch. Vegetables and fruits and various juices are good for the child. Since rickets destroys bones and prevents them from strengthening, calcium is useful. Cottage cheese is an invaluable source of calcium, available to a child after 4-5 months. We can also recommend special dairy products(cottage cheese, yoghurts), enriched with calcium, for older children. Eggshells are a source of easily digestible calcium. eggshells prepared in the same way as for the treatment of diathesis (see chapter on diathesis). Juices from apricots, apples, plums, and blackberries contain large amounts of calcium. For better absorption of calcium, it is advisable to mix cereal and flour dishes with fruits or vegetables and wash them down with juice.

Every child should receive everything from birth necessary substances for proper growth and development. A deficiency or excess of any nutrient can lead to disruption of the body's functioning. This is especially dangerous in the first year of life, when all organs and systems are being formed. For example, a lack of vitamin D leads to serious metabolic disorders, including rickets.

What is rickets?

Rickets is a general disease of the body, accompanied by metabolic disorders (mainly mineral). Characterized by a significant disorder of bone formation and disruption of the functioning of a number of organs and systems. Most often, the disease occurs in children 2–12 months old.

Rickets develops due to a lack of vitamin D in the body. This happens due to nutritional disorders or lack of sunlight, or rather ultraviolet radiation, under the influence of which this substance is produced.

A lack of vitamin D causes dysfunction of the hypothalamus, as well as the kidneys, parathyroid glands, and intestines. This disrupts normal phosphorus-calcium metabolism in the body and causes a decrease in the level of inorganic phosphorus in the blood. Then acid-base balance in the body changes towards acidosis, which prevents the deposition of calcium and phosphorus dissolved in the blood in the bones. The processes of bone formation and cartilage tissue are violated.

With rickets, the bones of a child's skull may soften

Reasons for the development of the disease

Most often, rickets is observed in children living in areas with a lack of sunlight. This is not surprising, because ultraviolet irradiation triggers the body’s mechanism for producing vitamin D. Typically, rickets develops in those children who suffered from vitamin deficiency before birth. If the expectant mother was malnourished or suffered from late toxicosis, rarely spent time in the sun or refused animal proteins, this makes the baby prone to developing this disease.

The main reasons for the development of rickets in the postnatal period are similar:

• Poor nutrition;
• Lack of sunlight.

This happens if the mother does not pay due attention to the baby and does not walk with him. Feeding a child leads to rickets cow's milk or other products that are not suitable for his age. Breastfed babies are also at risk. If a mother is malnourished due to a desire to lose weight, religious views or any other reasons, this may interfere with the composition of her milk.

In addition, rickets is caused by:

• Swaddling and other methods of limiting the baby's physical activity;
• Disturbances in the functioning of the gastrointestinal tract and congenital pathologies, for example, lactase deficiency, celiac disease, etc.;
• Frequent illnesses;
• Treatment with anticonvulsants;
• Gaining weight too quickly.

Signs and symptoms in children under one year of age

The first signs of incipient rickets in a child may appear as early as 2 or 3 months of life. The mother may notice changes in the child’s behavior; he becomes easily excitable, fearful and restless. May appear this way various diseases, so mom should not ignore these symptoms.

Restlessness and frequent crying may be symptoms of rickets

After behavioral disturbances, other signs appear. One of them is heavy sweating during sleep or when feeding. Another obvious symptom is hypotension or decreased muscle tone, which is usually high in healthy children.

If treatment measures are not taken in time, the disease may progress and in two to three weeks it will reach its peak. It manifests itself in the form of even more pronounced muscle disorders, which gradually cause the baby to lag in development. He rarely and reluctantly turns around, even if he used to do it with pleasure, does not try to sit down and makes much less noise. Sometimes you can even notice the first signs of softening of the skull bones if you carefully examine the head.

If the parents still have not suspected anything and have not started treatment, then by the end of the first six months the baby will develop a flattening of the back of the head, the configuration of the chest will change, and the legs will become bent. More often observed O-shaped deformation lower extremities, but it can also be X-shaped. At the same time, in children, the circumference of the head may increase, bumps form on the frontal and parietal parts, and thickenings appear on the wrists and ribs, which are called “bracelets” and “rosaries.”

Degrees of severity and nature of the course

Depending on the severity of rickets, there are three stages of its development:

• Mild (I degree) – characterized by minor disorders of muscle and nervous tissue.
• Moderate (II degree) – there are obvious disorders not only in bone, muscle and nervous tissues, but also at work hematopoietic system. A change in activity is already taking place internal organs, anemia is observed. The child's liver and spleen are enlarged.
• Severe (III degree) – manifested by pronounced disorders of the central nervous system, as well as bone and muscle tissue and internal organs.

There is also a classification depending on the nature of the disease:

• Acute type. It develops quickly, the phenomena of osteomalacia predominate.
• Subacute type. It develops slowly, most often showing signs of osteoid hyperplasia.
• Recurrent type. Against the background of a sluggish course of the disease, exacerbations periodically occur. They are associated with diseases, for example, ARVI.

In the second stage, rickets can be noticed with the naked eye.

Diagnostics

The most famous sign of rickets is considered to be a bald spot on the back of the head of an infant. Indeed, with increased sweating, the baby can twist his head to scratch it, and the hairs on the back of his head are wiped off. But the presence of this sign does not allow the mother to make a diagnosis on her own. Moreover, none of the symptoms in itself is a basis for prescribing treatment. Rickets must be confirmed in the laboratory.

To make a diagnosis it is necessary to study Clinical signs and confirm suspicions with analyzes and data x-ray examination. To clarify the degree of disturbance of mineral metabolism, carry out biochemical research blood and urine.

You can suspect rickets if the data laboratory research showed:

• hypocalcemia and gopophosphatemia;
• increase in alkaline phosphatase activity;
• decreased levels of calcidiol, calcitriol and citric acid.

When examining the acid-base state of the blood, acidosis is detected. Urine tests show hyperphosphaturation, hypocalciuria, hyperaminoaciduria. Also, with rickets, the Sulkovich test is negative.

X-rays of tubular bones show characteristic changes: an unclear boundary between the epiphysis and metaphysis, goblet-shaped expansion of the metaphyses, thinning of the cortical layer of the diaphyses. Ossification nuclei are not clearly visualized in the image. To assess the condition of bone tissue, ECG of long bones and densitometry are usually used. X-rays of the skull, spine and ribs, as a rule, are not performed - this is inappropriate due to the specificity and severity of clinical changes in them.

Characteristic changes in bone structure are visible on x-rays

If rickets is suspected, it is necessary to carry out differential diagnosis with diseases that give similar symptoms. These include rickets-like diseases - vitamin D-dependent rickets, resistant rickets, renal tubular acidosis, de Toni-Debreu-Fanconi disease, etc., as well as chondrodystrophy, hydrocephalus, congenital dislocation hips, cerebral palsy, osteogenesis imperfecta.

Treatment

Nowadays, there are practically no cases of advanced rickets due to competent and timely prevention. If it is not possible to prevent the disease, it is necessary to take measures to treat it. The methods used differ slightly depending on the stage of the disease.

Since vitamin D is soluble in fat, you need to monitor the amount of it in your food. If the child is already eating complementary foods, add a little vegetable or butter. But the optimal nutrition for a baby with rickets is breast milk or an adapted milk formula.

On initial stage it is enough to optimize the child’s lifestyle, walk a lot fresh air and take vitamin D in the form of aqueous or oil solutions. Such children are also recommended to bathe in pine and salt baths. They help calm nerves and improve the baby's immunity.

When treating rickets at more advanced stages, a whole range of measures is used. Ultraviolet irradiation is usually used, which can increase the production of vitamin D in the baby's body. Massage and special gymnastics for infants are also recommended. Electrophoresis is sometimes recommended for children, but its effectiveness is questionable.

Massage is part of a set of measures for the treatment and prevention of rickets

But you need to understand that in situations where the bone tissue is already seriously deformed, it is unrealistic to return it to its normal state; the consequences will last a lifetime.

Medicines for rickets

The main medicine used in the treatment of rickets is vitamin D. Today it is produced in two forms - an aqueous and an oil solution. Modern doctors prefer an aqueous solution, for example, the drug Aquadetrim, since it is well absorbed and does not accumulate in the body and is excreted through the kidneys. Children born in the fall, or those who spend little time outdoors, are recommended to take 2–4 drops prophylactically from the age of 4 weeks. Treatment doses are selected individually by the doctor.

Several decades ago, children were given fish oil to prevent rickets. This product is indeed rich in vitamin D, but it negatively affects the functioning of the pancreas and is less effective than modern products.

Oil preparations, for example, Vigantol, Videin or Devisol, are used less frequently. One of their advantages is low allergenicity, but they are less digestible and are not suitable for children with dysbacteriosis. And it’s also quite difficult to pick them out correct dosage.
You should not prescribe these drugs to your child yourself. In our country, the negative consequences of an overdose of vitamin D are much more common than rickets.

Consequences

If treatment is not started at the very beginning of the disease, the child will develop muscle weakness. He grows slower, turns over later, learns to sit, stand up and walk. The baby's belly increases in volume, and he develops diarrhea or constipation. Then the formation of his skeletal system changes. When a child begins to walk, it becomes difficult not to notice changes; his limbs and spine become bent. Such children suffer from flat feet and impaired development of the pelvic bones.

If you start treatment at early stage, then it will pass without any consequences. In the absence of timely treatment, the problem can remain for life. Such people, as adults, often suffer from scoliosis, deformation of the chest and legs, and caries. It is more difficult for a woman who has pelvic development disorders due to rickets suffered in childhood to bear and give birth to a child.

Advanced rickets cannot be treated

Prevention

The basics of preventing rickets are normal nutrition (breast milk or an adapted formula), proper sleep patterns, and sufficient exposure to fresh air. If necessary, the doctor recommends prophylactic intake of vitamin D. A dose of about 500 IU is considered safe. It is better to give D3 - it is more effective than D2, and at the same time stimulates the production of your own vitamin.

It is very important not to limit the baby’s physical activity. Gone are the days of tight swaddling. Modern pediatricians recommend dressing the child in pants and blouses from birth and giving him the opportunity to move freely.

The vitamin is given to the child in the first half of the day during meals. You cannot exceed the norms and prescribe something yourself.

Video “Doctor Komarovsky about rickets”

Rickets - dangerous disease, which, if not treated in a timely manner, cannot be cured and can leave the child permanently disabled. Therefore, it is better to prevent it. Proper nutrition, sufficient exposure to fresh air and taking vitamin D will help avoid rickets.

Rickets is a disease caused by metabolic disorders in the body. The disease occurs due to a lack of vitamin D (calciferol). The disease affects the musculoskeletal system, internal organs, and systems, namely the nervous and endocrine systems.

Today, rickets in young children is less common than half a century ago. This is due to the fact that the quality of nutrition for pregnant and nursing mothers and artificial infant formula has become an order of magnitude higher. However, the disease also affects modern children. Most often, children living in northern regions and large cities with poor ecology are susceptible to the disease.

The development of rickets manifests itself in the first 2-3 months after the birth of a child. Without adequate treatment, by 5-6 months, signs of bone tissue damage become obvious.

Causes

What is associated with the development of bone rickets in children? First of all, with a deficiency of calciferol or vitamin D. This in turn causes a disturbance in phosphorus-calcium metabolism. In other words, the body does not absorb calcium. As a result, changes in bone tissue occur (thinning and softening), the functions of internal organs are disrupted, and the functioning of the nervous system deteriorates. Rickets of the chest in children is a change in the bone frame of the chest, which interferes with the normal growth and development of internal organs.

Vitamin D deficiency can develop for several reasons, including:

• lack of balanced nutrition in pregnant and nursing mothers,
• feeding a formula-fed baby with low-quality formula,
• gastrointestinal diseases (dysbacteriosis, lactase deficiency), congenital pathologies,
• lack of walks in the fresh air during daylight hours,
• taking anticonvulsants,
• rapidly growing body weight of the child,
• living in northern regions and megacities with heavy air pollution.

Symptoms

Currently, the diagnosis of rickets is made less and less often. One child out of 200 thousand is diagnosed with this disease. This is due to the fact that the quality of life has improved significantly; the diet of pregnant and nursing mothers has become more varied. Also preference breastfeeding gives positive results. In mixtures for artificial feeding now you have the vitamins and minerals you need to harmonious development child.

However, the first signs of the development of rickets should be known to every mother. Symptoms of the disease include the following:

• softening and thinning of the skull bones,
• an increase in the size of the frontal and parietal tubercles of the skull,
• decreased muscle tone,
• late eruption of baby teeth,
• darkening of tooth enamel,
• development of caries,
• seals on the ribs (“rachitic rosary”),
• child's growth slowdown,
• Fractures are possible during the “first steps”.

There are also a number of conditions that are considered symptoms of rickets. Among them:

• increased sweating,
• bald patch on the back of the head,
• loss of appetite,
• child's moodiness and restlessness
• twisted arms and legs.

You need to understand that sweating and decreased appetite, like other signs, cannot be indicators of rickets. Increased sweating can be caused by heat exchange processes in the body, and almost all babies who spend most of their time lying down have a receding hairline. All these symptoms in children may occur not due to rickets, but due to other reasons not related to impaired metabolic functions of the body.

Diagnosis of rickets in a child

None of the above symptoms, nor a number of signs, can be evidence of the development of the disease. Accurate diagnosis can only be diagnosed after an X-ray examination. You can also diagnose the disease by doing tests for vitamin D, calcium, phosphorus and certain hormones.

Complications

Why is rickets dangerous? Rickets does not pose a threat to the child's life, but can seriously affect his further development.

If the disease is not cured in time, the following disorders may occur:

• X-shaped or O-shaped curvature of the legs,
• caries of milk and permanent teeth,
• developmental delay,
• deformation of the pelvic bones,
• curvature of the spine, flat feet.

School-age children have the following diseases:

• myopia,
• anemia,
• decreased immunity,
• susceptibility to viral and bacterial infections.

The development of rickets can be prevented even at the stage of bearing a child. Balanced diet in accordance with the stage of pregnancy will help reduce to zero the risk of the baby developing the disease after birth.

Treatment

What can you do?

The best treatment for rickets is sunbathing. But extreme caution should be taken here to avoid overheating and burns.

It is also necessary to adjust the child’s diet. It must contain the necessary amount of protein, minerals and vitamins for the harmonious development and proper growth of the child’s body.

What does a doctor do?

Treatment of vitamin D deficiency is carried out by taking aqueous or oil solutions of vitamin D2 or D3. The dosage is determined by the doctor strictly according to individually. When treating rickets in children, clinical recommendations must be followed.

Please note that an overdose of the drug can cause disruptions in the cardiovascular system, liver, kidneys and gastrointestinal tract. It should also be taken into account that there are children whose bodies are hypersensitive to vitamin D. Therefore, before starting treatment, an individual tolerance test is carried out. For rickets, hospitalization is not required.

When treating rickets, you should strictly follow your doctor's recommendations for taking a drug with vitamin D3. The duration of therapy and dosage are determined only by the doctor in each individual clinical case.

Prevention

Preparations containing vitamin D3 are also prescribed in for preventive purposes. They must be taken during the cold season. Most often, the drug is prescribed to children living in the northern regions and big cities with a bad environment.

In other cases, the following will help as prevention:

• breast-feeding,
• balanced diet for nursing mother and child,
• walks in the fresh air daytime days,
• hardening and physical education.

For a fair-skinned child, it is enough to stay under 10-15 minutes. sun rays to get the dose of vitamin D his body needs. The darker the skin, the longer sunbathing should be. When performing a massage for rickets in children, stroking movements should be light, smooth and directed from the periphery to the center.

Since there are practically no sick children, parents have to deal with various pathologies. One of the dangerous conditions for infants is rickets, and mothers and fathers do not fully understand what it is. The disease is often associated with an emaciated child whose tummy is bulging and whose arms and legs are thin and weakened. Indeed, such signs indicate the development of rickets, but clinical picture pathology may be more extensive.

The concept of rickets in children

Rickets is not a disease of a specific organ or system. Doctors view it as a complex of metabolic disorders caused by a deficiency useful substances. Signs of abnormalities appear in the background vitamin d deficiency– the main participant in phosphorus-calcium metabolism. The correct formation of the musculoskeletal system of children depends on its quantity.

Why do babies under one year old experience metabolic failures? There are several reasons for the anomaly:

1. Poor nutrition of a woman carrying a child. Food depleted in calcium and vitamin D is useless for the pregnant woman and the fetus.
2. Premature birth. The baby receives a significant dose of calcium at last weeks intrauterine development. Early birth does not allow him to receive the right substance fully.
3. Birth in the cold season or in northern regions. Lack of natural ultraviolet radiation causes rickets in infants. Small residents of warm countries suffer from pathology less often.
4. Improper feeding. Early transfer to mixtures, excessive or insufficient food consumption cause a distortion of metabolism and deplete the body of vitamins.
5. Bad ecology. Living of infants in megacities and areas with high concentrations of pollution, as well as prolonged stay in harsh climate zones, is fraught with a deficiency of the “sunlight vitamin”.
6. Congenital metabolic disorder. Incorrect course of processes responsible for the absorption of vitamins and minerals provokes the development certain diseases and affects the balance of nutrients.

How is vitamin deficiency expressed?

During the newborn period, signs of rickets are usually absent. Parents can notice its first manifestation at 3–4 months of the baby’s life, when the process of bone formation in the body is activated. “English disease” in children under one year of age occurs in several stages.

At the 1st stage, parents notice changes in the baby’s behavior. He worries and gets irritated for no reason or, on the contrary, becomes lethargic and indifferent. The baby sweats profusely and suffers from itching. In an attempt to get rid of discomfort, he may twist his head and rub it on the pillow, which leads to abrasion of the hair on the back of his head.

But these symptoms are not yet direct evidence of the development of the disease. They often involve children being exposed to dry, hot conditions, causing them to sweat and become restless. Baldness appears due to the fact that an overly active child turns his head with pleasure. However, parents should not relax. The baby needs to be shown to a pediatrician and tested.

If there is a careless attitude towards the child’s health, the signs of vitamin deficiency worsen closer to 8 months. Rickets takes shape moderate severity and shows characteristic symptoms:

• the fontanel does not contract or expand;
• the head becomes disproportionately enlarged and sweats;
• the forehead and tummy become convex;
• the baby cannot sit and crawl due to muscle weakness;
• rapid growth of the lower ribs and hardening of the bones on the wrists (doctors call this condition “rosary beads”).

At stage II, treatment of children should begin as soon as possible. But if parents continue to ignore the symptoms of rickets, up to 1 year the disease takes a protracted turn and develops into stage III. Now the signs of vitamin deficiency will be observed even more clearly and additional anomalies will join them:

1. chest deformities;
2. curvature of the legs (O-shaped or X-shaped);
3. disproportion of the head and torso;
4. mental inhibition and weakness of motor skills.

In premature babies, all of the listed symptoms appear due to unfavorable intrauterine development. Their body weight is already low, but due to poor conditions in the mother’s womb and poor bone mineralization, weight loss cannot be corrected from birth until the end of the first year of life.

The danger of rickets for children's health

Late control of the state of rickets or its incorrect treatment dangerous for babies with pathological changes. Thus, soft bone tissue distorts significant parts of the skeleton - the spine, cranium, thighs, legs and ribs. In adulthood, the consequences of rickets are fully felt by girls who experience difficulties during childbirth. They are explained by deformation of the pelvic bones and concomitant underdevelopment of the reproductive organs.

Untimely treatment of rickets is fraught for female patients with infertility or difficult childbirth if conception does occur. Physical development children, whether girls or boys, are noticeably lagging behind. Mental abilities suffer slightly, but in the later stages, rickets does not allow children to attend educational organizations.

Correction of rachitic condition

The pediatrician prescribes treatment based on the results of the examination. Help to diagnose deviations:

• urine analysis according to Sulkowski, which reveals the degree of calcium loss;
• biochemical blood test that determines the content of phosphorus and calcium.

If the tests confirm external symptoms rickets, parents should not panic - adequate therapy can completely improve the baby’s health. To correct the figure, treatment is carried out optimal doses vitamin D, more specifically ergocalciferol (D2). It is given to children in the form of oil and aqueous solutions(Vigantol, Aquadetrim). The second type of medicine is considered more effective, since the substance is less absorbed in oil. Difficult processing causes disruptions in the gastrointestinal tract.

Cholecalciferol (D3) is produced by the body independently with sufficient exposure to the sun. It can be obtained through prevention in the form of air baths. The substance improves the absorption of phosphorus and calcium and contributes to the normal construction of the skeleton. Its deficiency is compensated by food of animal origin, herbal products They do not contain D3.

Calcium preparations are quickly absorbed by the digestive system even of those children who suffer from allergies or have gastrointestinal problems. Precise dosage of medications allows the child to receive about 500 IU of the substance with each drop.

For patients under one year of age, therapy begins with 4 drops with a gradual increase to 10 per day. High dosages are needed for a rickety baby when symptoms show pronounced bone changes.

The average course of therapy lasts 30–45 days, after which prophylaxis begins (1–2 drops of medication per day).

The intake of drops is supported by the use of phosphorus and citric acid preparations - it is needed for better absorption of calcium by the intestines. Symptoms of vitamin deficiency are eliminated by irradiation with a UV lamp and natural sunbathing. While therapy is being carried out, hardening procedures, walks, exercises will be useful physical therapy, massages and salt baths.

Rickets is a general disease of the whole body with metabolic disorders, mainly calcium and phosphorus metabolism. Mostly children in the first 2-3 years of life suffer from rickets, but it can also occur at a later age, especially during periods of increased child growth. The main cause of rickets is a lack of vitamin D. Even mild forms of rickets reduce the child’s body’s resistance and lead to frequent colds. Pneumonia in children with rickets has a protracted course. Rickets is often accompanied by dystrophy and anemia.

Symptoms of rickets.

On early stages illness, the child becomes irritable and capricious. Sweating appears, especially during feeding and sleep. Sweat is sticky, with unpleasant smell. The child rubs his head on the pillow, and the hair on the back of his head falls out. As the disease progresses, the bones of the skull soften and the head takes on a square shape; teething slows down, bite is disturbed; The bones of the chest become soft, the chest becomes deformed. In severe cases, a hump may appear.

Traditional methods of treating rickets.

Prescribe vitamin D, ultraviolet irradiation, therapeutic massage, therapeutic exercises. Much attention is paid to the child’s nutrition and daily routine.

ATTENTION: Rickets!

Be on your guard - rickets often begins in the third month of a child’s life. The first signs of rickets: the child becomes restless, fearful, flinches when there is a sharp knock, especially when falling asleep. He begins to sweat, beads of sweat appear on his face during feeding, and at night his head sweats so much that by morning there is a damp spot on the pillow. He keeps rubbing his head against the pillow, causing the hairs on the back of his head to fall out. You may also notice that the urine has acquired an unusually pungent odor - the amount of ammonia in it has increased.

The likelihood of developing rickets is higher in children:

born ahead of schedule, full-term with low weight (less than 3 kg), signs of immaturity, indicating trouble at the end of intrauterine life. And that's why. The main “supply” of building materials - calcium and phosphorus - from mother to fetus and their “laying” in bone tissue under the guidance of vitamin D occurs in the last months of pregnancy. A child born before the 30th week is born with osteopenia - reduced content minerals in the bones. In fact, this is already a symptom of rickets. The same can happen with a full-term baby if at the end of pregnancy the mother had toxicosis or other health problems, or out of fear of “overweight” she went on a diet without consulting a doctor;

artificial: although the composition of milk formulas is as close as possible to breastfeeding and they are richer in vitamin D (therefore, “artificial” ones, as a rule, do not need to take it prophylactically); calcium and phosphorus from such food are absorbed about 2 times worse than from mother’s milk. And a deficiency of mineral “building blocks” for building bones leads to rickets;

suffering from atonic diathesis, food allergies, exudative enteropathy, diseases of the liver and biliary tract - all these conditions complicate the absorption of calcium, phosphorus and vitamin D in the gastrointestinal tract;

received some medications. A course of anticonvulsant therapy in the first week of life, in particular, diphenin and phenobarbital (it is also prescribed for neonatal jaundice), reduces the activity of cytochrome P-450 reductase, an enzyme involved in the formation of active form vitamin D. With its deficiency, the level of calcium in the blood drops, which is why convulsions and even fractures are possible, and by the end of the month, if the child continues to take the drug, the first symptoms of “medicinal” rickets appear. Its mechanism can be triggered by vitamin D antagonists - glucocorticosteroid hormones, heparin (in children it is more often used in the treatment of kidney diseases), furosemide, aluminum-containing antacids (drugs that reduce the acidity of gastric juice), sodium bicarbonate, replacement blood transfusion;

deprived of the ability to actively move, for example, due to immobilization due to dysplasia hip joints. “Movement is life!” - motto infancy. With muscle activity, the blood supply to the bones increases, which means that the “building” of the skeleton is better maintained, which rickets tends to disrupt.

If the baby is at risk, parents need to be very attentive to his condition so as not to miss the slightest manifestations of rickets, and at the very first visit to the pediatrician, find out how to more reliably protect the child from this growth disease.

Signs of congenital rickets

1. The dimensions of a large fontanel exceed 2.8 x 3 cm.

2. The small and lateral fontanelles are open.

3. The seams between the bones of the skull diverge (gape).

4. The level of calcium and phosphorus in the blood serum is reduced.

5. Ultrasound examination reveals low bone mineralization.

Cause of rickets- deficiency of vitamin D. Little of it is still supplied with food, and the need for it is intensive growth very great: after all, this vitamin is involved in the formation of the skeletal system and bone mineralization. True, nature has prudently provided the body with its own laboratory for the production of vitamin D - it is formed in the skin under the influence of ultraviolet solar radiation.

But our environmental troubles have affected us here too: through the veil of industrial emissions that hangs over the cities, rays with an antirachitic effect are difficult to penetrate. How many of them will a city child get, especially one born in autumn or winter, when only his face remains exposed during a walk?

Rickets develops quickly, and within a couple of weeks after the first signs appear, it enters a stage called the full stage, or blooming rickets. At this time, the doctor can already feel softening along the edges of the fontanelles and cranial sutures, thickening on the ribs (“rachitic rosary”), and detect other disorders of the skeletal system.

Rickets “reshapes” the skull in its own way, increasing the frontal and occipital protuberances, which is why the head becomes square or, as experts say, “buttock-shaped.” Years later, as in infancy, the diagnosis will be “written on the forehead”, excessively steep and high - it is called “Olympic”. A “notch” in the form of a saddle will remain on the nose, the bite will be disrupted, and the teeth will erupt later and not in the sequence determined by nature, moreover, they will turn out to be an easy target for caries.

By 5-6 months, the child will lag behind in psychomotor development, and the disease will make changes - alas, irreversible - to the structure of the skeleton, not for the better.

Have you ever met a child with “wheel” legs, curved in the shape of the letter “O”? This is the result of untreated rickets. A rickety child is often also characterized by anemia, reduced general body resistance, and a tendency to infections. I believe you won’t allow any of this! Moreover, the treatment of rickets is relatively simple and quite affordable - just don’t be late!

If you notice the first signs of rickets, immediately contact your local pediatrician. He may have already prescribed you prophylactic doses of vitamin D, but since they did not work, now, apparently, they will have to be increased. An important warning regarding infants receiving formula milk: most formulas are fortified with vitamin D, and this will need to be taken into account as An overdose of vitamin D is dangerous.

Vitamin D is given to the baby in a spoonful of breast milk or a formula containing it. You cannot drip into a spoon directly over the edge of the bottle; be sure to use a pipette, and hold it strictly vertically - if it is tilted, a drop that is too large will form, which may contain extra units of vitamin.

It is useful to replace bathing with a therapeutic bath.

Conifers will help excitable children relax. For 10 liters of warm (36°) water, take a teaspoon of natural liquid pine extract or a standard strip of briquette. For the first time, 5 minutes is enough, and then gradually increase the procedure time to 10 minutes. The course of treatment is 12-15 baths, daily or every other day.

Toning baths are useful for those who are sluggish, “loose” and sedentary. 2 tablespoons sea or table salt dissolve in 10 liters of water (35-36°). The first bath is 3 minutes, then no longer than 5 minutes. Limit yourself to 8-10 procedures every other day.

For children with manifestations of exudative diathesis, baths from decoctions of medicinal herbs are recommended. Plantain leaves, calamus root, oak bark, string grass and chamomile should be mixed in equal quantities and brewed at the rate of a tablespoon of the mixture per liter of water. Bathe your baby in healing decoction every day for 5-10 minutes until its skin is cleared.

You should worry about preventing rickets even before the baby is born, by planning your pregnancy, firstly, during a favorable period for the family and, secondly, with the expectation that the child will be born in the spring or summer. Then he will have time to “intercept” his “portion” of ultraviolet radiation before the onset of cold weather, under the influence of which a supply of vitamin D is formed in the skin.

From the first days of pregnancy, drink 2 glasses of milk daily (if you tolerate it well) or yogurt, kefir, eat a few slices of cheese and 100-150 g of cottage cheese. In this way, you will create a “reserve” of calcium in your body - those irreplaceable 30 g that the baby will certainly “demand” in the last 3 months before birth.

Make it a rule to spend several hours every day in the fresh air, in the summer - not under the scorching rays, but in the through shade of trees. The diet includes fish, eggs, butter and vegetable oil. All this will help to some extent compensate for the need for vitamin D, which has increased 10 times since you decided to become a mother.

If the pregnancy occurred during the cold season, the doctor may prescribe a preventive course of vitamin D or radiation quartz lamp. But on your own initiative, do not do anything and do not sunbathe at home under a source of ultraviolet light: otherwise, hypervitaminosis is possible, which upsets metabolic processes in the same way as a lack of vitamin D.

After your baby is born, do everything in your power to breastfeed him accordingly. at least 3-4 months, or better yet, up to 1-1.5 years.

Take the baby for a walk three times a day, at least for 1.5-2 hours. In hot weather, the stroller should be in the shade - diffused light is enough for vitamin D to form in the baby's body.

Forget about tight swaddling! From the first days, equip the baby in onesies so that he can freely move his arms and legs when he is awake - this way the bones will get stronger faster and will not succumb to rickets. Do not neglect daily massage and gymnastics for your baby. And if there is an opportunity to teach him to swim in the pool at the clinic, take advantage of it!

In each specific case, the doctor will prescribe you a massage, restorative, general developmental and breathing exercises for the prevention and treatment of rickets.

Folk remedies for treating rickets

Herbs and herbs for rickets

Pour 2 tablespoons of string herb with 2 cups of boiling water, leave for 30 minutes, strain. Give the child 0.5 cups for rickets 2-3 times a day.

Pour 1 tablespoon of burdock root with 2 cups of boiling water, leave for 2 hours, strain. Take the infusion for rickets hot, up to 0.3 cups 3-4 times a day.

Pour 15 g of peppermint herb into 100 ml of alcohol, leave, strain. Take as folk remedy for rickets, 15-20 drops 3 times a day.

Therapeutic baths for rickets

Mix 200 g of elecampane root and burdock root and pour 10 liters of boiling water over the mixture. Place on low heat and heat for 15 minutes, leave for 1.5 hours, strain. Pour the broth into the bath and bathe the child.

Mix 150 g of calamus root and nettle root, pour 10 liters of boiling water over the mixture, heat over low heat for 10 minutes, leave for 50 minutes, strain and use for baths.

Take 400 g of tripartite herb and 100 g of common yarrow flowers, brew the mixture with 10 liters of boiling water. Place on low heat and heat for 5 minutes. Leave for 50 minutes, strain. Cook in the bath warm water, mix it with the broth and bathe the child.

Be outdoors as much as possible.

Sunbathing.

Give your child fish oil every day for 1 month. After a 15-day break, repeat the course. The diet of a child with rickets should include milk, egg yolks, pureed liver, fish (especially tuna, salmon).

An approximate set of exercises for the prevention of rickets.

With rickets, a child often has trouble holding his head up. Therefore, at first the exercises are carried out in horizontal position, and they should be given 10-15 minutes several times a day. It is very important to train the muscles of the back, abdomen and chest. You should start and end classes with a light, short (1-3 minutes) massage of the body, arms and legs - stroking and rubbing. Do a massage between exercises, repeat each of them 2-4 times, depending on the child’s well-being and mood. So, let's start.

On the back

1. Hold the baby’s shins and encourage him to get the toy that lies first on one side and then on the other side of him: “Take the rattle.”

2. Make the previous exercise more difficult. Holding the child by the shins, encourage him to take a toy that lies further away - 40-50 cm or located above him. You can simultaneously support him from behind by the shoulders and head, helping to lift it and strain the anterior muscle groups of the neck, shoulder girdle, and abdomen.

3. Place your baby with his legs facing you. Holding them with one hand and holding his hand with the other, help him turn on his side and stomach (the same in the opposite direction, holding the baby by the other hand).

On the stomach

4. With one hand, support the child under the chest, showing the toy lying in front, and with the palm of the other hand touch his soles - the baby will push off from it. Encourage him to reach for the toy, thereby encouraging him to crawl.

5. Move the baby's legs towards you. Hold him by the shins with one hand, and with the other show the toy to the left, then to the right, then in front of him (it must be in his field of vision at all times). This is how the baby learns to raise his head and turn it.

6. The child lies first on his back, then on his stomach and pushes off with his legs from the ball or your hand.

Gradually, as the baby’s condition improves, you can put him on his feet and “practice” stepping, and then walking. Walking helps strengthen and develop the muscles of the legs (this prevents their curvature). Only in one case - with a significant decrease in muscle tone - should a doctor give the go-ahead for exercises related to walking.

It is very useful to place the baby on a hard mattress or board 8-10 times a day (before meals or 40 minutes after). In this position, the natural curves of the spine are formed and strengthened, some deformities of the chest and spine are prevented and corrected, and the corresponding muscles are strengthened. Children who do not raise their head and shoulders when lying on their stomach are considered weakened. A flannelette diaper placed under the chest, folded several times, or a roll of baby oilcloth, half filled with sand and covered with a diaper, will help. In this position, it is easier for the child to raise his head and shoulders.