Tuesday, August 5, 2008 11:11 PM CDT
Rickets on the rebound: Experts say bone disorder shouldn't stop new mothers from breastfeeding
By DAWN SCHABBING, Features Writer
dschabbing@jg-tc.com
Rickets, a bone disorder that is not common in the United States today, is getting some attention among the medical professionals in the region.
The discussion about rickets has come up at recent medical conferences, according to Mattoon pediatrician Dr. Onkar Sharma.
Sharma shared that rickets is characterized by softening and deformity of bones that in part is due to a concern that infants aren’t getting enough Vitamin D in their diets.
“The reappearance of rickets is an unintended consequence of an admirable health initiative — the promotion of human milk feeding,” he said.
Sharma said if mothers add a Vitamin D supplement to their babies’ diets, breast milk is still the best way to nourish the infant.
“I don’t want people to feel that breast milk isn’t that good,” Sharma said. “In spite of all that is being said, breast milk is still the best, as it has all the elements for growth and development that is easily bio-available.”
He also explained that rickets might be coming back due to an inadequate amount of sunlight exposure.
“Nutritional rickets manifests with symptoms of muscle and joint pains,” Sharma said.
The U.S. Department of Health and Human Services reported that the prevention of nutritional rickets comes from obtaining the proper amount of Vitamin D, beginning at least by the age of 2 months.
“Vitamin D is necessary for proper bone growth, but it is not found in many foods naturally. It is synthesized in the skin with exposure to sunlight, but many babies do not get much exposure to the sun for many reasons,” according to the national health department information.
According to emedicine.com, rickets is a disease of growing bone that is unique to children and adolescents.
Vitamin D-deficiency rickets occurs when the metabolites of Vitamin D are deficient, according to the Web site.
Pamela Hood, perinatal education coordinator and lactation consultant/nurse specialist at Sarah Bush Lincoln Health Center, said the American Academy of Pediatrics continues to document incidences of rickets throughout the United States.
She said, overall breastfeeding is the best route for nutrition and the infant.
“Breastfeeding is the best nutrition on the planet for your baby. Mother’s milk is designed specifically for her infant, with components only she can provide,” Hood said.
Breastfeeding also decreases the incidence of infectious diseases in infants, decreases the risk for Sudden Infant Death Syndrome or “crib death,” and decreases the incidence of Type 1 and 2 diabetes mellitus, lymphoma, leukemia, obesity and more, she said.
“While (rickets) is not that common, it is a concern. It is due to the lack of exposure to sunlight and inadequate intake of Vitamin D. Rickets means that a child has soft bones,” Hood said.
Vitamin D deficiency begins months before physical signs and symptoms of rickets appear.
Symptoms of rickets include skeletal deformities such as bowed legs, abnormal curvature of the spine; fragile bones; and impaired growth.
Hood suggests following the guidelines the physician suggests when it comes to the adequate amount of Vitamin D for the infant.
Sharma said it is recommended that all breastfed infants receive 200 IU of Vitamin D per day.
“These recommendations will ensure that the small number of children who do need Vitamin D to stay healthy, receive it,” Hood said.
Risk factors for babies who might be prone to rickets include the baby and mother having very little exposure to sunlight; or both mother and baby having darker skins, thus requiring more exposure to sunlight to generate the adequate amount of Vitamin D, Hood said.
Sharma said rickets may be on the increase due to several reasons: some parents are concerned about Vitamin D toxicity or overdose; the daily administration of vitamin drops is an interference with the breastfeeding routine; a decreased amount of sunshine due to concerns about harmful effects of ultraviolet rays to the skin; and increased breastfeeding among women with highly pigmented skin.
Hood added that making well-baby checks, staying updated on infant immunizations, following physician’s advice and discussing any concerns with the doctor regarding a baby’s health should help assure the baby’s good health.
Sharma said rickets is showing up in early stages in more populated areas, but it isn’t as common yet in rural areas.
“Rickets, if caught early, is curable, if treated properly,” Sharma said. “Adding Vitamin D or a multivitamin to breast milk makes breast milk best.”
Contact Dawn Schabbing at dschabbing@jg-tc.com or 238-6864.
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