Patient's question:
My baby is 51 days old today, and the symptoms include poor sleep and easily startled during sleep. After a hospital examination, it was diagnosed as active rickets. The report of the left wrist X-ray shows: decreased bone density at the distal end of the left ulna, thinning of the bone cortex, thinning and blurring of the primary calcification band, visible cup-shaped depressions and brush-like changes, with both sides becoming pointed. No carpal bones were observed. The doctor prescribed Incomac and Soluble Golden Calcium Granules. Could you please ask the expert if my baby will have any residual sequelae in the future? Thank you!Doctor's answer:
Hello! First of all, I wish your child a speedy recovery! I'd like to discuss the issue of "rickets" with you.Rickets, also known as "soft bone disease," is a common chronic nutritional deficiency disease in infants and young children. It is caused by insufficient vitamin D in the body, leading to abnormal calcium and phosphorus metabolism, preventing normal deposition of calcium and phosphorus in the growing parts of bones. In severe cases, it can result in skeletal deformities.
This disease rarely poses a threat to life, but it develops slowly and is often difficult to detect. Once symptoms become apparent, the child may have weakened immunity, making them prone to respiratory and digestive infections that could be life-threatening.
The main factors contributing to vitamin D deficiency are insufficient intake. Most children's diets contain very little vitamin D, and the amounts in breast milk, cow's milk, and other dairy products are not sufficient to meet the normal growth and development needs of infants. Vitamin D primarily comes from two sources: first, vitamin D naturally found in plants and animals, which promotes calcium and phosphorus absorption and retention, maintaining a certain concentration of calcium and phosphorus in body fluids. These substances are not only the main components of bones but also essential for the normal function of many important tissues in the body. The second source of vitamin D is ultraviolet rays in sunlight, which, when exposed to the skin, convert a substance called 7-dehydrocholesterol into vitamin D, compensating for the deficiency in dietary vitamin D.
Rickets often develops in infants 3–4 months after birth, initially manifesting as neurological symptoms such as restlessness, irritability, night sweats, and excessive sweating during feeding or crying, which can soak the pillow. Due to the irritation from sweat, children often shake their heads and rub their pillows, leading to hair loss in a ring around the back of the head. Later, skeletal changes appear, such as a square skull, an enlarged anterior fontanelle, delayed teething (e.g., no teeth by 10 months), chest deformities like costal beads, rib flaring, and pigeon chest. Prolonged sitting or standing can cause spinal curvature, while lower limbs may develop "O" or "X" shaped legs.
This is a common chronic nutritional deficiency disease in infancy, primarily caused by reduced vitamin D intake and insufficient sunlight exposure, leading to abnormal calcium and phosphorus metabolism. Its main clinical feature is impaired skeletal growth and development, while also affecting the function of nervous, muscular, hematopoietic, and immune tissues and organs, weakening the body's resistance. The disease develops slowly and is easily overlooked. Once it reaches the chronic stage, recovery becomes difficult, and it is commonly referred to as "pigeon chest" or "turtle back" in folk terms.
Rickets can be prevented. Regular outdoor activities for children, exposing them to sunlight so that ultraviolet rays directly reach their skin, can provide sufficient vitamin D. More than 2 hours of outdoor activity daily is recommended, but avoid excessive sun exposure in summer or sunbathing through glass, as this does not achieve the purpose of ultraviolet radiation. Additionally, it is important to add supplementary foods like egg yolks, pork liver, soy products, and vegetables to infants' diets to increase their vitamin D intake.
### 1) Treatment Notes
1. Early detection and treatment are crucial to prevent complications.
2. Maintain outdoor activities and combine with Chinese and Western medicine treatments.
3. Consume foods high in calcium, such as dried shrimp.
### 2) Over-the-Counter Medications
① Vitamin A and D pills—2 pills per dose, twice daily.
② Baitian Dazao pills—3–5 grams per dose, twice daily.
③ Gui Bai Mu Guo chongji—Half to one bag per dose, twice daily.
④ Long Mu Zhuang Gu chongji—One bag per dose, twice daily.
### 3) Home Remedies and Dietary Recipes
1. Take 500 grams of pig leg bones (with marrow), 50 grams of pork liver, 30 grams of Astragalus, and 3 grams of Schisandra. First, break the marrow and cook it with Schisandra and Astragalus in boiling water for 1 hour. Strain out the bones and herbs, add sliced liver to the broth, and cook until tender. Season with salt and a little MSG. Eat the liver and drink the soup. One dose can be taken in one meal and should be consumed regularly until recovery.
This remedy is suitable for children with rickets primarily caused by spleen and kidney deficiency.
2. Use 500 grams of fresh chicken, 250 grams of pork fat, 50 grams each of green peppers, scallions, ham, and garlic, and 20 grams of soy sauce. Remove the skin from the chicken, clean it, and cut it into large pieces. Heat pork fat in a wok until it reaches 50°C, then fry the chicken until golden and remove it. Keep 25 grams of oil in the wok, discard the rest, and stir-fry garlic slices, green peppers, ham, and scallions. Add the chicken, soy sauce, one spoonful of chicken broth, thicken with starch, and add MSG and a little sesame oil.
This recipe can prevent and treat rickets in children.
3. Take 100 grams of deer antler, 30 grams of Aconite, and 2 pig trotters. Slice the deer antler, clean the trotters, and cook all three together over low heat for several boils. Season and eat.
This remedy is suitable for children with poor development, soft bones, delayed walking, and closed fontanelles.
4. Use 500 grams of raw chestnuts and 250 grams of sugar. Boil the chestnuts in water for half an hour, let them cool, peel the skin, and place them in a bowl. Steam for 40 minutes, then mash the chestnuts into a paste while they are still warm. Mix in sugar, shape the paste into a flat cake, and serve.
This dish is effective for treating rickets in children when consumed regularly.
5. Take some tortoise plastron (the belly shell of a turtle). Soak the plastron in water for three days, changing the water daily. Scrape off any dirt, place it in a sand pot, add plenty of water, and simmer over low heat for 8–10 hours each day. Repeat for three days, then dry and grind into a fine powder. Take 1 gram per dose, twice or three times daily, and swallow with warm water.
This remedy can effectively prevent and treat rickets in children.
6. Use some eggshells. Clean and dry the eggshells, then grind them into a very fine powder. For children under 1 year old, take 0.5 grams per dose; for children aged 1–2, take 1 gram per dose, twice daily.
This remedy can prevent and treat rickets in children.
### 4) External Treatments
Grind 15 grams each of dried crab leg bones and Tetrastigma root, mix with milk, and apply to the affected bone joints. Repeat once daily.
### 5) Avoid Misdiagnosis
1. Avoid excessive or prolonged vitamin D supplementation, as it can lead to toxicity.
2. Avoid excessive sun exposure to prevent ultraviolet-induced dermatitis.
3. Limit sugar intake, as excessive sugar can hinder calcium absorption, leading to calcium deficiency in children.
4. Chronic diarrhea or other intestinal disorders can impair the absorption and utilization of vitamin D and other nutrients.
5. Do not neglect timely treatment.
6. If children exhibit symptoms such as excessive sweating, restlessness, or hair loss around the back of the head, these may indicate early rickets and should not be ignored.
If you find this answer helpful, please do not disappoint me by failing to select it as the "accepted answer."