Signs and treatment of rickets in children over one year old. What is rickets and how to treat it in children? Bone rickets in children treatment

For correct formation For the growth of a healthy child's body, a sufficient amount of various vitamins and microelements is necessary. Their shortage can lead to serious illnesses that require immediate assistance from qualified specialists. One of these diseases is rickets.

Rickets is endocrine disease children early age, most often observed in infants up to one year old, resulting from a lack of vitamin D in the body, which leads to damage internal organs, nervous and endocrine systems, musculoskeletal system.

IN infancy The baby receives the bulk of the necessary vitamins and microelements either through mother’s milk or from an adapted milk formula.

However, it is not always possible to replenish the body with all the vitamins necessary for growth and proper development, especially vitamin D.

Causes of rickets in children under one year of age

Since vitamin D is called the sun vitamin, the incidence of rickets in children under one year of age is much higher in those countries where there is a lack of sunlight. On average, the incidence of this disease is about 40 percent of children under one year of age.

The risk group includes children whose mothers did not pay due attention to their health during pregnancy.

Eg, future mom was on a diet, limiting her body in foods rich in animal proteins, or in the last trimester of pregnancy she suffered from severe toxicosis, which, as a result, again led to a limitation in the consumption of necessary food.

A short interval between pregnancies also gives reason to assume that the baby may develop rickets, because the mother’s body didn't have time to recover after a previous pregnancy and childbirth, replenish the reserves of vitamins and microelements, and now it is necessary to give everything back to the future baby.

This also includes children born much older ahead of schedule or those born in the cold season, children who are bottle-fed or living in areas with unfavorable weather conditions.

Children who are on breastfeeding, may also be at risk, especially if their mothers, for fear of gaining excess weight, exclude healthy, nutritious foods from their diet, limiting the use milk, meat and fish, and giving preference to low-calorie foods.

Children at risk should be prevented with the help of medications - fortified fish oil. You can start taking it from the age of one month over a long period, gradually increasing the dosage.

To make it easier to remember when it is necessary to take drug prophylaxis, there is a rule of the letter “r”. Vitamin D is taken only in those months that have the letter “r” in their names. In addition, the following causes of rickets in infants can be identified:

• rare walks in the fresh air;
• tight swaddling and, as a result, restriction of the child’s mobility;
• artificial feeding or feeding the baby with unadapted milk formula;
• congenital disorders and pathologies gastrointestinal tract, such as dysbiosis, lactase deficiency;
• the child is often sick;
• rapid weight gain, which provokes a sharp increase in the body’s need for calcium.

Signs of rickets

The first signs of rickets in children under 1 year of age can be detected already from the first month of the baby’s life. These include the following symptoms:

A few weeks after the first signs of rickets appear, the following signs of the disease appear in children under 1 year of age:

• Low muscle tone.
• The baby lies down more and does not try to roll over, raise his head, walk or crawl.
• In children with rickets, teething and fontanel closure occur much later.
• The shape of the head may become deformed, become elongated, and the back of the head may become flattened.
• Abdominal bloating is common and changes occur chest, the legs become crooked and the pelvic bones narrow.

In order not to start this disease, parents must be carefully monitored for the slightest changes in the physical condition of your baby. After all, an advanced form of rickets in infants will leave an indelible mark not only on the baby’s physical condition; some of the sick children are unable to walk or sit independently, but also mentally (a noticeable developmental delay).

As a result of skeletal deformation, scoliosis, flat feet, changes in pelvic bones. At an older age - myopia, anemia, weak immunity and pain.

Classification of rickets in children

There are two degrees of rickets. The first degree is characterized by disturbances in the functioning of the nervous system, weakening of muscle tone, baldness and flattening of the back of the head. This degree of rickets is highly treatable and almost never leaves visible physical changes;

The second degree is already visible at first glance, they become obvious physical changes, such as deformation of the skull, curvature of the limbs, changes in the shape of the chest and posture.

With regard to internal changes, the internal organs increase and as a result begin to function incorrectly. After treatment, there is a chance that with age, obvious physical changes will become less noticeable or disappear altogether.

Treatment of rickets

As you know, any disease is easier to treat in the early stages, so if you suspect rickets in an infant, you should contact your doctor as soon as possible. And only after confirming the diagnosis, based not only on external signs, but also confirmed laboratory research and tests, treatment should be started as quickly as possible.

You should know that even with an advanced form of rickets, the patient is not hospitalized, but treatment is carried out at home. Most often, procedures are prescribed to make up for the lack of the “sunshine” vitamin and to restore to the maximum the changes that have already occurred to the body.

That is, basically the treatment will consist of a set of procedures aimed to change and improve diet mothers and babies, increasing the number of walks and correcting the daily routine. And also do not forget about such procedures as massage and physiotherapy exercises, which include a variety of exercises.

The massage should consist of stroking the baby's arms, legs, and back. Of the exercises - breathing exercises, turning the baby from the stomach to the back and back, light swaying on the fitball and strengthening already formed reflexes (walking, sitting, crawling, etc.).

If a child is excited, often cries and is irritable, then to improve his mental state he first of all needs peace, calm and quiet environment. It is worth remembering about bathing with the addition of either pine needle extract (soothing effect) or sea ​​salt(raising muscle tone). To obtain a positive effect, you must undergo at least 10 procedures.

The most effective medicine in the treatment and prevention of rickets is considered vitamin D solution. It can be oil-based (Devisol, Videin, etc.) and water-based (Aquadetrim). A doctor should prescribe a particular drug, its dosage and duration of use.

To avoid an overdose it is necessary regularly take urine tests, since a large amount of vitamin D in the body can lead to vomiting, constipation, decreased appetite, urinary retention and even cramps.

Prevention of rickets

It should be noted that even if the baby was diagnosed with rickets, this is not a death sentence. Timely treatment will allow you to completely get rid of unpleasant symptoms illness and the child’s well-being will be fully restored.

And, most importantly, to avoid a disease such as rickets, you should stick to simple rules:

• spend more time outdoors;
• avoid stress;
• eat right and be sure to include fish, meat, cottage cheese and vegetables in your diet;
• fulfill physical exercise and don’t forget about hardening the body.

​

A general ailment of the body that occurs when there is a disorder associated with insufficient vitamin D, mineral metabolism of Ca (calcium) and P (phosphorus).

This disease is characterized primarily by changes in the nervous, and to a greater extent, skeletal systems, as well as impaired absorption and metabolism of the minerals calcium and phosphorus.

The significance of rickets, according to scientists, is determined by the fact that in severe cases it slows down growth and further growth and can lead to irreversible modification of bones.

With this disease, the percentage of diseases associated with long-term upper respiratory tract infections increases.

Causes of rickets in children?

The causes of rickets in children have been known for a long time; it is a disease of

emaciated organism. Often found in areas where there is not enough sunlight, in large cities, less often in villages and villages.

The disease is seasonal and occurs more often when there is little ultraviolet rays, and this is in winter and spring, which indicates a lack of sunlight as a causative factor.

More often rickets occurs in children on artificial feeding, also with a monotonous and unbalanced diet, for example, they are fed with cow's milk alone. Vitamin D is produced only under the influence of ultraviolet rays, so the lack of ultraviolet rays can lead to rickets. Found in foods: milk, eggs, butter, vitamin D, together with the influence of sunlight, covers the needs of an adult in this vitamin, however, in children with rapid growth the body's need for this is increased.

Rickets usually affects babies (3-24 months), but it may develop earlier. With very poor care, as well as with a special state of metabolism, this ailment can be observed in older children.

Symptoms and degrees of rickets in children.

Characteristic changes in a blood test taken from a vein are always: a very small amount of phosphorus, slightly reduced calcium levels and high activity of alkaline phosphatase.

With 1st degree of rickets in children.

• At the age of about the parents notice that there are changes in the behavior of the baby, he becomes more restless and irritable, or vice versa, sluggish, there is profuse sweating, itching appears, so he rubs the back of his head against the pillow and a bald spot forms, then the bones of the skull become thin and soft, and so thus the skull becomes flat.
• Due to the increase and growth of bone tissue, the frontal sections of the skull increase, the parietal bones become in the form of tubercles, and the skull takes on a square shape.
• With rickets, there is a delay in the eruption of teeth, as well as their random appearance in the future.

With 2nd degree rickets in children.

• In the second degree, swelling begins to appear in the area of ​​the ribs, which is visible upon examination, and “rachitic rosaries” are also visible.
• Changes occur, the chest is deformed and becomes like a chicken breast, which is fraught with serious consequences, as it negatively affects breathing.
• The spinal column also changes: if the child begins to sit down very early, the formation of kyphosis (stoop) and scoliosis (curvature to the right or left) may begin; the pressure of the spine on the pelvis leads to the formation of a narrow pelvis, associated with rickets, which in girls will later be a serious problem during childbirth.
• Quite early on, bone growths that look like bracelets form in the wrist and ankle area.
• Later, when the child is a child, a whole chain of changes occurs in lower limbs, that is, the legs take an X- and O-shape, which is why fractures can occur.

With grade 3 rickets in children.

• The most severe degree. Serious deformation of the shape of the bones occurs. One cannot but agree that such a child, pale and with a large “frog” belly formed as a result of weak abdominal muscles, evokes a feeling of pity and pain not only among the medical staff, but also among those around him.
• However, rickets is not a disease of the skeletal system only, but also weakening of muscles, ligaments and joints, constipation often appears, hemoglobin in the blood decreases, the liver and spleen enlarge, such children are predisposed to frequent relapses of protracted upper respiratory tract infections.
• In advanced cases, severe curvature of the bones can cause disability in children in the future.

How to treat rickets.

To treat the causes of rickets in children, vitamin D3 is prescribed - an aqueous solution of "Aquadetrim" in drops, the dosage is selected by the doctor, the approximate therapeutic dose is 6-10 drops, the course can last up to two months, then the dosage is reduced to preventive, this is 1 - 2 drops daily until summer, bright sun. The dosage must be strictly followed as prescribed by the doctor; severe violations can occur with an overdose of vitamin D or even when prescribed in normal doses, due to an individual increase in sensitivity.

If, after prescribing and taking vitamin D, the child begins to eat poorly or refuses to eat at all, vomiting appears, combined with constipation, growth arrest, it is necessary to inform the doctor about this in order to undergo an examination.

The leading biochemical shift in this case is hypercalcemia; when making a diagnosis, it is important to establish the presence of increased calcium in and the presence of calcium in the urine using the Sulkovich test. The most important thing in treatment is to immediately limit calcium intake.

Prevention of rickets.

Prevention of rickets with vitamin D in a full-term baby begins at 3-4 weeks, in a premature baby - 2 weeks, regardless of the time of year, the child should be given vitamin D. In the summer, when the child spends a lot of time in the sun, prophylaxis is not carried out in full-term babies vitamin D. In preventing the causes of rickets in children, good care of the baby, proper balanced nutrition, and complementary feeding introduced on time play an important role. Walks in the open air,

Rickets is a typical childhood disease; it occurs only during a period of very active growth, up to two years. At older ages, rickets does not occur. This disease occurs as a result of a lack of vitamin D in the diet, due to which the bones become stronger and the skeleton actively grows.

Rickets especially often occurs in the first year of life, when the body is actively growing and requires a lot of nutrients and vitamins. Vitamin D will be especially important, which helps calcium to actively penetrate and be deposited in the bones. Due to this, the bones of the skeleton actively grow, the metabolism is normalized, and the child feels good.

For the most part, rickets occurs in children born in the autumn-spring period, when there is little sunlight and insufficient vitamin D is formed in the skin. Also, children born prematurely, twins, or if there is little vitamin D in the diet (in infants or children fed unadapted formulas) more often suffer from rickets. The initial stage of rickets in infants can appear as early as two or three months, but often the first symptoms of rickets are mistaken for other diseases or a normal variant. Gradually, due to vitamin D deficiency, metabolism is disrupted and calcium levels in the bones change. This leads to more pronounced changes - the skeleton suffers, the shape of the head and chest changes, the functioning of the nervous system and digestion suffer.

Based on the severity of symptoms and course, rickets in infants can be divided into three degrees of severity. With rickets of the 1st degree, the infant exhibits minor disturbances in the nervous system, muscle tone changes, but there are no pronounced changes in the skeleton, which may subsequently remain for life. If you look at a photo of a baby with stage 1 rickets, there will be no serious changes in appearance. The back of the head flattens slightly and the hairs on it may roll up, forming bald patches, and the muscles will be somewhat weakened.

With grade 2 rickets, a baby may exhibit quite noticeable changes in the skull, which will smooth out as the child grows. The chest and limbs may also become deformed, and quite noticeable changes occur in the growth of the skeleton, the functioning of the muscular system and hematopoiesis. The nervous system and digestion suffer, internal organs do not work properly, the liver and spleen may become enlarged.

With rickets of the 3rd degree, all changes are strongly expressed, pronounced changes in the skeleton occur, which remain for later life, and internal organs suffer greatly. The shape of the head is sharply changed, the chest can be deformed so that the breathing process is disrupted. The legs are severely curved, which interferes with normal walking. Fortunately, such rickets practically does not occur today.

Sometimes even a photo can show what rickets looks like in infants. Such children are excitable, cry a lot, are frightened by sharp sounds and shudder violently. They are irritable and have trouble sleeping. The skin of such babies may have a “marbled” appearance with red spots easily remaining at the slightest pressure. Such children sweat a lot with the slightest effort - sucking, screaming, and especially at night, while sleeping. At the same time, sweat is sticky with a sour taste and a special smell; it can cause the skin to itch and irritate. Due to sweating and itching, a bald patch forms on the back of the child’s head due to friction between the back of the head and the pillow. The back of the head itself may become flat due to deformation of the less dense bones of the skull. If you look at a photo of the head with rickets in infants, you can note an increase in the pubic and parietal bones, which can cause the head to become “square”. In this case, the forehead protrudes strongly, the hairline rises to the back of the head.

As rickets progresses, the entire skeleton may suffer. In the photo of infants with rickets, changes in the chest can be revealed. It seems to bulge out in the sternum area, and becomes narrower on the sides (chicken breast). With severe rickets, the baby’s legs may take on the shape of the letter “o” or “x”.

But what else is dangerous about rickets in infants? In addition to the fact that the skeleton changes, the growth of teeth suffers, they erupt much later than usual. The functioning of the heart or lungs is impaired, and there may be constipation. Because of all this, children lag behind in development, both physical and mental, immunity suffers - children can often get sick for a long time.

It is important to notice the first signs of rickets and begin its treatment in order to avoid complications and visible changes in the skeleton and organ function.

Rickets - general disease 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.

In the early stages of the disease, the child becomes irritable and capricious. Sweating appears, especially during feeding and sleep. Sweat sticky, 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.

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

WARNING: 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 - a reduced content of 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 formula: although the composition of infant formula is as close as possible to breastfeeding and they are richer in vitamin D (therefore, “artificial formula”, as a rule, does not need to take it prophylactically), calcium and phosphorus from such food are absorbed approximately 2 times worse than from breast 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;

receiving some medications. Well anticonvulsant therapy in the first week of life, in particular, diphenine and phenobarbital (it is also prescribed for jaundice of newborns) reduces the activity of cytochrome P-450 reductase, an enzyme involved in the formation of the active form of vitamin D in the liver. With its deficiency, the level of calcium in the blood drops, from - 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. 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!" - the motto of 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. Ultrasonography detects low bone mineralization.

Cause of rickets- vitamin D deficiency. So far, little of it comes from food, and the need for it during intensive growth is very high: 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 a child in a spoonful of breast milk or a mixture 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.

Bathing is useful to replace the 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 of sea or table salt are dissolved 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.

Decoction baths are recommended for children with manifestations of exudative diathesis. medicinal herbs. 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. Bath your baby in a healing decoction every day for 5-10 minutes until his skin is cleansed.

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 pregnancy occurred during the cold season, the doctor may prescribe a preventative course of vitamin D or irradiation with a 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 for at least 3-4 months, and preferably 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. Prepare warm water in the bath, mix it with the broth and bathe the child.

Be outdoors as much as possible.

Sunbathing.

Give your child every day for 1 month fish fat. After a 15-day break, repeat the course. In the diet of a child with rickets, there should be 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, we started.

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. Complicate the previous exercise. 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. Put the baby with its legs towards 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 get a toy, thereby you stimulate crawling.

5. Move the baby 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). So 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 the ball or your hand with his legs.

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 roller made 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.

Rickets in children is a disease of the endocrine system that occurs with the active growth of the child's body against the background of an insufficient amount of vitamin D, as a result of which all types of metabolism, especially phosphorus-calcium, are disturbed. Children are exposed to this pathology up to 3 years of age.

The causes of rickets in a child cause us to associate with poor living conditions. In practice, it has been proven that one in ten children can develop rickets.

The main factor in the manifestation of pathology is the lack of vitamin D, calcium and phosphorus in the child's body, which are the main building material of bone tissue.

The process occurs due to the intensive growth of young children. For example, in a baby up to a year old, growth is multiplied by 1.5 times, and weight - by 3, which gives a significant burden on the body with immature vital systems.

There are other causes of the disease, which are conditionally divided into 2 groups: congenital and acquired.

Assuming the development of pathology (congenital rickets) on the part of the mother during pregnancy and breastfeeding:

• age category of the pregnant woman (under 17 or over 35 years);
• toxicosis;
• poor nutrition;
• not a rationally designed daily routine;
• pregnancy was accompanied by serious illnesses;
• difficult childbirth;
• prematurity of the child.

On the baby's side (acquired rickets):

• Wrong diet. If the mother is no longer breastfeeding, but prefers artificial feeding, the mixture should be carefully selected. Nutrition should be rich in vitamins, minerals and proteins;
• Weak mobility (for example, with tight swaddling or with irregular gymnastic classes);
• The presence of pathologies of the skin, liver or kidneys;
• Lack of exposure to fresh air.

Classification

According to the criterion according to the severity of symptoms and the nature of the course, the disease is divided into rickets:

• 1st degree – assigned to the baby at initial stage development of pathology;
• 2 degrees - diagnosed if the system of internal organs and bones has undergone modification;
• 3 degrees - when the pathology is accompanied by psychomotor and physical retardation, destruction of the functioning of internal organs, the nervous system and bones.

According to the nature of the disease, it can be:

• acute rickets;
• subacute;
• recurrent.

Rickets is classified according to periods as follows:

• initial period;
• the height of pathology;
• recovery;
• period of residual effects.

Symptoms

The clinic of rickets has its own characteristics and character of expression depending on the severity and period of the pathology in the baby.

The first symptoms of rickets in children under one year of age:

• restlessness and irritability;
• sweating appears, primarily in the back of the head, with a characteristic unpleasant odor;
• as a result of sweating, bald patches appear;
• the child may be afraid of bright lighting and loud sounds, to which he reacts by flinching;
• There is a decrease in muscle tone instead of the typical hypertonicity for young children.

During the height of the disease, the symptoms become more obvious, and their rapid progression occurs. At this stage, rickets is characterized by a baby’s lagging behind in psychomotor development.

Parents may also notice associated symptoms:

• Head deformation. In babies under one year of age suffering from pathology, the process of closing the fontanelle slows down, as a result of which the back of the head can become flattened or flattened on the side where the child most often sleeps.
• Teeth erupt late or inconsistently;
• Scoliosis curvature;
• The baby's chest becomes sunken, compression of the chest occurs on the sides;
• “Rachitic rosaries” appear - thickenings on the ribs (they are especially noticeable on the 5th and 6th ribs).

A severe form of rickets in a child causes complications, manifested by a delay in physical and mental development. In children, the structure of the chest is disrupted, and deformation of the bones of the skull and limbs occurs.

The clinic of a particularly advanced case of rickets is characterized by disorders of cardio-vascular system, sick children are diagnosed with tachycardia, difficulty breathing and an increase in liver size.

Diagnostics

It is possible to determine the diagnosis of rickets by examining the child by an endocrinologist. If there is insufficient data, auxiliary analyzes are resorted to. Sometimes, to confirm the diagnosis, it is prescribed biochemical research blood composition. The essence of the analysis is to study the level of alkaline phosphatase and phosphorus.

With rapidly progressive or non-treatable forms of the disease, the patient is referred for radiographic examination of skeletal bones.

Treatment

Treatment of rickets in children is carried out under the strict supervision of an endocrinologist. It is necessary to treat the disease from the moment the parents discovered the first signs of rickets and observe therapeutic indications until complete recovery.

Exist general rules recommended for compliance when caring for a child outside of hospitalization. The doctor must prescribe a comprehensive treatment, the main goal of which is to eliminate all factors that provoke disruption of the metabolic process of calcium and phosphorus by the endocrine system.

Parents need to ensure that their child’s daily routine is correct. Sick children, depending on age and personal indications, should spend more time outside while avoiding bright light and noise.

Vitamin therapy

When rickets is diagnosed in a child, the doctor will definitely prescribe therapy with vitamin D, as well as drugs containing calcium and phosphorus.

Pharmacy chains offer many drugs rich in vitamin D. The doctor recommends taking a monovitamin medicine, the basis of which consists only of vitamin D. The advantage of these drugs is that their use allows you to strictly control the dosage of the drug.

Many experts argue about what dosage form vitamin D is preferred. Your doctor will advise you to use a water-based medicine (for example,) since the medicine is safe and easy to use. One drop medicine contains the dose required for a child's body (500 IU).

Parents should spoon-feed the drug to their baby to prevent overdose. Very young children (especially under one year old) can spit out a tasteless liquid, so it is recommended to dilute the drug with a few drops of milk or boiled water.

Vitamins must be taken strictly according to the doctor’s instructions so that the child does not become intoxicated. The duration of vitamin therapy is from 30 to 45 days, depending on the severity of rickets. Afterwards, a prophylactic dose of the drug is prescribed, which must be taken daily for 2 years, and in the third year of treatment - only in winter.

Massage

Therapeutic massage helps to activate metabolism in the skin, as well as stimulate the production of vitamin D by the child's body. General massage is recommended for children of all ages. age categories during various courses of the disease. And the methods massage treatments must be followed as prescribed by the doctor.

When a child has rickets, the bones soften, which is why it is necessary to treat this disease during its peak period with the help of therapeutic exercises in a gentle manner. Keep in mind that massage causes instant fatigue for the child; therefore, the repetition of all exercises can be reduced by 2-3 times.

The massage consists of stroking, which should be accompanied by breathing exercises.

A set of physical education classes for a one-month-old baby:

1. breathing exercises (2-3 times);
2. hand massage;
3. foot massage;
4. foot massage;
5. transferring to the tummy;
6. back massage;
7. chest massage;
8. swinging on a ball;
9. breathing exercises again.

When rickets worsens, massage techniques should focus only on stroking to soothe nervous system and improve breathing.

To avoid modification of the shape of the bones, parents need to frequently shift the baby and ensure that the sick child does not remain in the same position for a long time. If a child is diagnosed with a distorted chest, place him on his tummy.

Therapeutic gymnastics for children under one year of age and older with acute rickets:

1. breathing exercises (3–4 times);
2. stroking arms, legs and back;
3. reflex exercises and foot massage;
4. rolls onto the stomach with the baby's support;
5. baby crawling or crawling stimulation;
6. breast massage;
7. spreading your arms in different directions, then crossing your arms at chest level;
8. stroking the legs;
9. bending legs in order.

During the recovery period of the disease, it is recommended to increase the duration of therapeutic exercises and increase their intensity. Classes should be carried out in a horizontal position. Exercises for strengthening the muscles of the abdomen, legs and back are noted to be effective. During the recovery period, the child is recommended swimming and water gymnastics. At this stage, stroking should be accompanied by rubbing and kneading.

During the period of residual effects, rickets should be treated with the help of gymnastic exercises in various starting positions. Difficulty level physical activity systematically increases and approaches the norm for healthy children.

Nutrition

The best food for a baby suffering from rickets is mother's milk, which promotes complete absorption of vitamins. The nutrition of a nursing mother must be correct. Preference should be given to dishes made from fish, dairy products, as well as cereals, fruits and vegetables.

When complementary feeding, the nutrition of a sick baby must be strictly balanced. suffering from rickets, it is recommended to administer it 1 month earlier than the standard. Meals must include purees and decoctions of vegetables.

The healthiest vegetables for making puree: carrots, cabbage, pumpkin, zucchini. Once a day, give your child porridge with vegetable broth, which should be alternated with other types of porridge throughout the week. At 3 months You can give your baby grated egg yolk, and at 4–5 months - cottage cheese. At 5–6 months, the child can be prepared with liver soufflé, and a month later, a little white meat and poultry can be given.

Prevention

Prevention of rickets in children is carried out at the stage of intrauterine development. A pregnant woman should consume about 400 IU of vitamin D every day. Children are prescribed vitamin prophylaxis from the 4th week of life.

To avoid illness, parents should not forget about therapeutic exercises with children and massage. The child must be picked up so that calcium is not “washed out” from the bones due to constant stay in one position.

Prevention of rickets in children is as follows:

• proper care of the baby, including physical activity;
• walks in the open air;
• timely introduction of complementary foods;
• vitamin intake.