VITAMIN D DEFICIENCY
DESCRIPTIONVitamin D deficiency is an insufficient intake or absorption of vitamin D, coupled with too little exposure to sunlight. This deficiency causes rickets in children and osteomalacia (softening of the bone) in adults. The total body is involved, but bones are more affected than other tissues. Vitamin D deficiency can affect both sexes, all ages, but is most common in infants and young children up to age 10.
Appropriate health care includes: self-care after diagnosis; physician's monitoring of general condition and medications.
SIGNS & SYMPTOMSRestlessness.
Poor sleep habits.
Delayed sitting, crawling, or walking.
Delayed closing of the fontanels ("soft spots" on the infant's head).
Poor muscular development, causing a pot belly.
Bowed legs, "knock knees," and "pigeon breast" after weight-bearing activities begin (standing and walking).
In older children and adults:
No symptoms until late stages (sometimes).
Shortening of the vertebral column and flattening of pelvic bones.
CAUSESInsufficient dietary intake of vitamin D.
Poor absorption of vitamin D, causing poor absorption of calcium and phosphorous necessary for healthy bone. Vitamin D absorption is affected by chronic diseases, such as pancreatitis, celiac disease, cystic fibrosis, colitis, bile-duct disorders, liver disorders, and kidney disease, or surgery on the stomach or small bowel.
Inadequate exposure to sunlight. This is especially likely if your child is confined to bed or home.
Poor function of the parathyroid glands (sometimes).
Genetic factors, such as black skin, which decrease the absorption of sunlight; use of anti-convulsant drugs; exposure to polluted air; (smog reduces sunlight penetration); improper diet as a result of poverty, food faddism, bulimia, or anorexia nervosa; pregnancy, in which the body needs additional vitamin D.
PREVENTING COMPLICATIONS OR RECURRENCE
Provide vitamin D supplements for yourself and your family--including breast-fed babies -- unless you are sure your diet supplies a satisfactory amount; encourage your child to exercise outdoors in sunlight; urge your child not to follow fad diets, which may be deficient in many nutrients, including vitamin D.
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; laboratory blood studies of calcium, phosphorous, and alkaline levels.
Spontaneous fractures in your child's softened bones.
Difficult or impossible vaginal childbirth in females with flattened pelvic bones. Delivery by Cesarean section is usually necessary.
Usually curable with an adequate diet, vitamin D supplements, and treatment for any underlying disease. Bone malformation cannot be reversed.
HOME CAREYour child should sleep on a firm mattress.
MEDICATIONYour doctor may prescribe vitamin D tablets or injections.
See Medications section for information regarding medicines your doctor may prescribe.
ACTIVITYExercise whenever possible, especially in sunlight. Weight-bearing exercise, such as walking or running, is especially beneficial.
Avoid excessive bed rest.
Stoop--don't bend--to lift heavy objects.
Instructions for your child:
DIET & FLUIDS
Increase your family's intake of foods rich in vitamin D -- even if they take vitamin D supplements. Dietary sources include fortified milk, liver, eggs, margarine, green vegetables, cauliflower, tomatoes, and cheese.
OK TO GO TO SCHOOL?Yes.
CALL YOUR DOCTOR IF
Your child has symptoms of vitamin D deficiency.
Your child's symptoms don't improve in a month, despite treatment.
Pain or suspected fracture occurs following an injury--even minor injury.