Dr. Komarovsky about rickets

Many parents are concerned about rickets, particularly in relation to their children’s bone health. Renowned pediatrician Dr. Komarovsky frequently talks about this subject and offers helpful guidance to parents.

It’s critical to comprehend the signs and causes of rickets in order to detect it early. Dr. Komarovsky highlights that children’s deficiency in vitamin D is the primary cause of this condition, and he provides easy preventative measures.

Concerns about preventing their kids from contracting rickets are common among parents. Dr. Komarovsky provides lucid advice on eating a balanced diet, the importance of sunshine, and when taking supplements might be essential.

About the disease

A common illness in children is rickets. It is linked to aberrant skeletal bone formation and inadequate mineralization of the bones. This condition arises when the baby’s body pathologically lacks vitamin D while it is actively growing. Rickets can be linked to low levels of calcium and phosphorus in the blood, though it can also happen when these levels are perfectly normal. There are three stages of severity for the disease, including acute, subacute, and recurrent forms.

Rickets starts, picks up steam, and then goes away on its own, leaving doctors with nothing more to look at than the disease’s symptoms. Rarely, the illness recurs, mostly in the context of severe metabolic disorders, severe kidney disease, and children who have received long-term anticonvulsant therapy.

According to current theories, the prevalence of rickets is highest in children born in the winter or late fall, as well as in people who live in areas where the weather prevents them from seeing the sun frequently or in places with unfavorable environmental conditions (smoke, air pollution, few sunny days per year).

Babies who are fed formula have a higher risk of developing rickets than babies who are breastfed because the former only absorb 30% of the calcium while the latter can absorb up to 70%. Lack of vitamin D interferes with the absorption of calcium.

The sun’s rays that touch the baby’s skin are the primary source of this crucial vitamin.

Infant sleep disturbances, crying, poor appetite, timidity (flinching at loud noises), sweating, especially at night, and baldness of the back of the head—which the baby rubs against a diaper or pillow because of scalp itching—are all taken into consideration by medicine. The patient’s perspiration has a distinct, sour odor. These symptoms are all typical of the disease’s early stages, which can last up to one month.

During the active stage of the disease, the child may not develop as quickly mentally or physically and may have a variety of skeletal system disorders, softening of the bones, and deformation. Bracelets, strings of pearls, and rickety "rosaries" are typical indicators. Such elegant titles are used in medicine to describe less than idealized thickening of the cartilage-to-bone transition. "Strings of pearls" on the fingers, "rosary" on the ribs, and "bracelets" on the arms. Poetically speaking, another visual cue is also known as the "Olympic forehead." It shows up as a prominent forward protrusion of the frontal bone.

After that, the illness gradually worsens, leaving the child to live with the lifelong effects of rickets, including bad posture, chest deformity, and abnormalities in the leg bones. Since the narrowing of the pelvic bones, which may persist after rickets, can lead to future difficulties with natural childbirth, the disease is particularly dangerous for girls. It is advised that these women and girls have cesarean sections.

In order to lower the risk of rickets, which affects children’s bone development, Dr. Komarovsky stresses the significance of vitamin D, a balanced diet, and regular outdoor activity. According to him, basic preventive measures are essential to keeping kids healthy, and early detection and appropriate care can help children avoid the long-term effects of the disease.

Dr. Komarovsky on rickets

This diagnosis is highly favored by contemporary pediatricians. First of all, it absolves the doctor of any liability for potential developmental issues that may arise (anything can happen, but rickets!), and secondly, it is equally challenging to disprove as it is to prove. In this instance, the physician diagnoses a condition that does not exist, such as 0–1 degree rickets. Komarovsky denies the existence of any such illness. Additionally, nine out of ten young children have first-degree rickets, if that is what is desired. The symptoms of rickets will go away on their own in 99 percent of these kids.

You don’t need to worry if the doctor diagnosed the child with rickets and did not recommend any further testing.

In the extremely rare event that the physician has cause to suspect actual rickets, he will unquestionably refer the patient for an X-ray examination of the forearms and lower extremities and advise obtaining a blood test for calcium, phosphorus, and vitamin D.

Nowhere in the world is rickets identified by symptoms like loss of appetite, sweating, or deformity of the chest. Furthermore, according to Komarovsky, baldness on the back of the head is not at all associated with rickets; rather, it simply indicates that a newborn’s thin hair is automatically "wiped" on the diaper when he starts to turn his head, which happens between three and four months of age. No pathological explanation for this behavior needs to be sought out.

Ninety percent of the time, a baby’s sweating is related to the apartment’s incorrect temperature and the fact that his parents simply overwrap him because they don’t know how to dress him appropriately.

It only takes a close examination of your father, grandfather, or great-grandfather’ssternumto determine that a crooked chest is typically inherited. If there is no family history, there is also no need to be concerned because all of the deficiencies and curvature will go away on their own when bone growth slows down and the body’s calcium requirements decrease.

However, the majority of pediatricians obstinately refuse to acknowledge the current global guidelines for identifying this illness and persist in applying knowledge found in medical textbooks from half a century ago. As a result, nearly 70% of all newborns and infants in Russia are currently diagnosed with "rickets" based solely on the presence of sweaty feet and a bald head, while only 1% of children actually have a serious illness.

Treatment according to Komarovsky

When a child is diagnosed with rickets, doctors typically recommend shock dosages of vitamin D and pine-salt baths. Komarovsky claims that although these water procedures are very beneficial for children’s health, they are unrelated to the treatment of actual rickets. It is typically illegal to prescribe vitamin shock doses for medical purposes. A child should not consume more than 500 units per day or one drop of an aqueous solution of "Akvadetrim" at any one time. When a baby takes too much of an overdose, they may experience severe vomiting, diarrhea, problems with their urine, elevated blood pressure, and even the onset of cardiopathy and cardioneurosis.

In the summer, when walks outside replenish the deficiency of the substance in the body, do not rush to follow the recommendations to take the vitamin in lethal doses if you do not want to put your child at risk. More than reasonable treatment of the dosage is required.

For a child who has rickets or is suspected of having it, walks and fresh air are very beneficial. Cereals or vitamin-containing mixes should unquestionably be a part of the baby’s diet. It won’t hurt to have a consultation with a competent pediatric orthopedist, who can confirm or allay concerns based on X-rays of the forearm and shin. He will undoubtedly offer his recommendations in the second scenario.

Newborns are treated with cholecalciferol if laboratory tests confirm that rickets is linked to insufficient amounts of calcium, phosphorus, and vitamin D. The prescription for calcitriol may depend on the test results. For premature babies, this is insufficient, and potassium phosphate and calcium gluconate should be taken.

For the majority of kids who have actual rickets and not imaginary ones, the prognosis is quite good. However, parents must ensure that their children do not have a calcium deficiency, as this condition is more common in children than rickets, both in conjunction and alone. It is worthwhile to start giving the child calcium supplements in precisely calculated age-related dosages if blood tests reveal this deficiency.

Regarding childhood rickets, Dr. Komarovsky emphasizes the significance of early prevention and awareness. The prevention of this condition is largely dependent on timely medical check-ups, sunlight exposure, and a healthy diet.

In addition to making sure their kids get enough calcium and vitamin D from their diet, parents should make sure their kids spend time outside in the sun. It is essential to see a pediatrician if there are any symptoms or concerns so that early intervention can begin.

Families can prevent rickets and promote the healthy growth and development of their children by adhering to these easy guidelines.

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