How to recognize the symptoms and the first signs of rickets in infants, how to carry out treatment of the disease. Treatment of Rakhita in children up to the year and preventive measures Treatment of rickets in children

How to recognize the symptoms and the first signs of rickets in infants, how to carry out treatment of the disease. Treatment of Rakhita in children up to the year and preventive measures Treatment of rickets in children

22.10.2020 Information

If our parents followed the advice of doctors almost unquestioned, then modern mothers often put the recommendations of pediatricres in doubt. And this is understandable: the abundance and inconsistency of the information are able to confuse anyone. On the forums on the Internet, the disputes on the need for appointments of Vitamin D influx are increasingly flared up. His overdose leads to serious consequences, and our kids eat well, walk a lot from where rickets come from? So arguing moms. It seems that everything is true. But sometimes Vitamin D plays a vital importance for the baby and saves it not only from the lack of calcium, but also from health problems in the future.

Insidious disease

Rahit is a disease caused by a lack of calcium and phosphates in the child's body, expressed in violation of bone mineralization, growth delay, bone deformations, vegetative dysfunction. To understand why the lack of calcium and phosphorus leads to the development of such a difficult disease, it is necessary to determine the role of these minerals in the human body. First of all, they are composite components of bone tissue, bricks needed to build our skeleton.

Calcium is responsible for the reduction of muscles, helps the operation of nerve cells, regulates the tone of the autonomic nervous system, is part of protein molecules, hormones and enzymes. Phosphorus is no less valuable. It provides energy processes, participates in the exchange of glucose. And then the question arises: if these minerals are so important for the body, then why only little children get rickets?

The fact is that the infant lays a colossal load: its growth in the first year of life increases on average at 1.5-2, and weight - 3 times! And this is with the relative immaturity of various systems, and respectively, compensation mechanisms. Therefore, even a small shortage of certain substances affects the health of the baby. Especially subject to the development of rakhita premature babes. Adults, long ago came out of the period of intensive growth, so calcium deficiency for them can remain unnoticed and not cause discomfort.

Why are they sick?

The prerequisites for the occurrence of Rakhita often develop even before the birth of the baby.

The risk of developing Rakhita in the first year of life increases several times, if the future mother suffered from gestosis or during pregnancy, a vegetarian diet was observed.
Rahit is often developing in artificial feeding children if the principles of rational nutrition are not respected, as well as with prolonged natural feeding, when the mother refuses the timely administration of dust.
The lack of calcium and phosphates can be observed in the baby in the syndrome of impaired intestinal suction (Malabsorption), which develops by virtue of various reasons: lactase insufficiency, celiac disease, intestinal infections. Rakhit can provoke hereditary diseases, convulsive syndromes (with a debt of luminal's use), kidney disease and liver.

Drink or not?

Rahita prevention begins during pregnancy. The future mother should be more in the fresh air, to eat well (in the diet, the presence of dairy, meat products, eggs, vegetables and fruits). In the middle band, healthy children of the first year of life, pediatricians are usually prescribed a preventive dose of vitamin D, to receive from October to May. In the period from May to September, prophylactically vitamin D cannot be taken, since at this time its sufficient amount is produced under the influence of solar radiation.

If the child has Rachita, the doctor prescribes vitamin D at a dose of greater than preventive. Rahit treatment must be not only drug, be sure to include in the therapy walks in the fresh air, swimming, hardening, massage if your baby suffers from rickets, do not hurry to put it on the legs. Due to the lack of calcium and phosphorus, the kids are soft and easily deformed, acquiring an ugly o- or x-shaped form.

Rachet got sick girl? Try not to plant her longer: there is a danger of strain pelvis. In this case, the baby in the future may have problems with confusion. Remember that with non-compliance with the dosage it is possible to develop acute or chronic poisoning with vitamin D. Clinically acute intoxication is manifested by the general heavy condition Child, thirst, vomiting, sharp decline in body weight, convulsions. You must immediately stop the reception of vitamin D and call "ambulance".

Chronic vitamin D poisoning manifests itself in the form of a poor appetite, weakness, irritability, sleep impairment, early closure of large spring, raising arterial pressure, the formation of stones in the kidneys. It is necessary to stop receiving vitamin D and immediately consult a doctor. If you have noticed the kid signs of Rahita, be sure to consult a pediatrician, since the independent assignment of vitamin D can cause severe consequences.

The main signs of Rakhita

The clinical picture of the disease depends on the degree of failure of calcium and phosphorus and, accordingly, wears an increasing nature.

For light shape Rakhita is characteristic:

increased neuropsychic excitability, manifested in the form of frequent irritable crying, anxiety, poor sleep;
a small height delay;
fuel and soreness of the bones of the skull;
slow closure of large springs;
flooding the nape;
the dim color and hair fragility, the formation of bald on the back of the head. Such a baby cries a lot, easily awakens. Due to the increased sweating of the child, Mama has to often change his clothes, he slowly grows, the teeth do not break for a long time, the pace of psychomotor development slows down (later begins to hold the head, turn over, lifted on the handles).

With the moderate form of rickets All of the above features become more pronounced, moreover, attention is drawn to:

an unusual shape of the head: Flavored headlings, expressed frontal and dark bugs - the so-called begodice skull;
chest deformation: the baby's chest looks splashing or, on the contrary, takes the kind of keel;
noticeable intercreic gaps, Harrison's groove attracts itself - the border between the chest and the belly takes the type of groove;
the belly becomes like a frog due to severe muscular hypotension;
there is an increased fatigue, the baby prefers to stay in the crib for a long time, refuses the games;
violations of the nervous system can manifest itself in the form of a chin trembling, handles;
if by this time the baby learned to get up, becomes a noticeable deformation of the legs: they look like the letters "x" or "oh".

The heavy form of Rahita manifests itself:

pronounced lag in physical and mental development;
rude deformities of the skull, chest, limbs;
such kids are usually not capable not only to get out of the crib, but even sit without support;
in addition, kids may have difficulty breathing (sidewash), an increased heart rate, an increase in liver dimensions;
at this stage of the disease, the bone of the child becomes so fragile that they easily break even from small external influences.

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Rahit is the total disease of the whole organism with a metabolic disorder, mainly exchange of calcium and phosphorus. Rickets are predominantly the children of the first 2-3 years of life, but it can meet at a later age, especially in periods of reinforced child growth. The main cause of Rahita is the lack of vitamin D.. Even light shapes of rickets reduce the resistance of the child's body, lead to frequent cold illness. Pneumonia in children, patients with rickets, have a protracted flow. Rahit is often accompanied by dystrophy, anemia.

Symptoms of Rakhita.

In the early stages of the disease, the child becomes irritable, capricious. Sweat appears, especially during feeding and sleep. Sweat sticky, with unpleasant odor. The child rubs his head about the pillow, and the hair on the back falls out. With the development of the disease, the bones of the skull softened, the head acquires a square shape; Slow teething slows down, bite disrul; Chest bones become soft, the chest is deformed. In severe cases, humps may appear.

Traditional methods of treating Rakhita.

Prescribed vitamin D, ultraviolet irradiation, therapeutic massage, medical gymnastics. Much attention is paid to the nutrition and the child's day regime.

ATTENTION: RAHIT!

Be relatives - on the third month of the child's life, Rahit is often starting. The first signs of Rakhita: the child becomes restless, frightened, shudders with a sharp knock, especially when falling asleep. He appears sweating, during feeding on the face there are droplets of sweat, at night the head sweats so much that a wet spot remains by morning on the pillow. He then also rubs his head about the pillow, because of this, the housing on the head falls out. It can also be noted that the urine has acquired an unusual sharp smell - it has increased the number of ammonia.

The probability of rickets is higher in children:

born ahead of the deadline, suffered with small (not reaching up to 3 kg) weighing, signs of immaturity, testifying to disadvantaged at the end of the intrauterine life. And that's why. The main "delivery" of building materials - calcium and phosphorus - from the mother to the fruit and their "laying" in bone tissue under the guidance of vitamin D occur in recent months of pregnancy. The child, which appeared to the light until the 30th week, is born with osteope, a reduced content of minerals in the bones. In fact, it is already a symptom of Rakhita. The same can happen with a dead little baby, if at the end of pregnancy the mother had toxicosis or other health problems, or from the concern to "go through" the weight she sat on a diet, without consulting a doctor;

of artificials: Although the composition of the dairy mixtures is as close as possible to infantry and they are richer with vitamin D (therefore, "artificials", as a rule, do not need its preventive admission), from such food calcium and phosphorus are absorbed by about 2 times worse than maternal milk . And the deficiency of mineral "bricks" for the construction of bones leads to rickets;

suffering from atonic diathesis, food allergies, exudative enteropathy, diseases of the liver and biliary tract - all these states make it difficult to absorb calcium, phosphorus and vitamin D in the gastrointestinal tract;

received some drugs. The course of anticonvulsant therapy in the first week of life, in particular, diphenin and phenobarbital (it is also prescribed with yellow newborn) reduces the activity of the cytochrome of the R-450 reductase - the enzyme involved in the formation of the active forms of vitamin D. With its deficit, calcium levels in Blood, which is why convulsions and even fractures are possible, and by the end of the month, if the child continues to take the drug, -Forty symptoms of the "medicinal" Rakhita. Bringing its mechanism is capable of vitamin D antagonists - glucopor-ticosteroid hormones, heparin (in children it is often used in the treatment of kidney disease), furosemide containing aluminum antacids (means that reduces the acidity of gastric juice), sodium bicarbonate, replacement blood transfusion;

the ability to actively move, for example, due to immobilization in displays of hip joints. "Movement - Life!" - The motto of infant age. With muscular activity, the blood supply to bones is enhanced, and, it means that the "construction" of the skeleton is better arranged, routing striking.

If the baby is included in the risk group, parents need to be very attentive to his state, so as not to miss the slightest manifestations of Rahita, and in the first visit to the pediatrician to learn how reliably protect the child from this growth disease.

Signs of congenital Rakhita

1. The size of a large springs exceed 2.8 x 3 cm.

2. The small and lateral springs are open.

3. Dissolve (gap) seams between the bones of the skull.

4. In the serum, the level of calcium and phosphorus is reduced.

5. Ultrasound examination reveals low bone mineralization.

Reach Rakhita - Vitamin D deficiency. With food, it is still not enough, and the need for it in intensive growth is very large: because this vitamin is involved in education bone system and mineralization of bones. True, nature 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 irradiation.

But our environmental misfortunes have affected here: through a veil of industrial emissions, which hangs over cities, rays that have an anti-radiation effect make their way with difficulty. Are there many of them to go to the city child, and even born in the fall or in winter, when only a face remains on a walk?

Rahit develops quickly, and after a couple of weeks after the emergence of the first signs, it turns into a stage, which is called the stage of phargs, or a blooming rickets. At this time, the doctor can already try to softening along the edges of the spring and cranial seams, thickening on the edges ("Rachitical rosary"), detects other disorders of the bone system.

Rahit "Reflecting" skull on his own way, increasing the frontal and occipital bumps, which is why the head is made square or, as experts say, "Berodico-different". Years later, as in infancy, the diagnosis will be "written on the forehead", overly steep and high, - it is called "Olympic". "Cub" in the form of a saddle will remain on the nose, the bite will break, and the teeth will shift later and not in the sequence that is defined by nature, besides, they will be easy "eagle" for caries.

By 5-6 months, the child will defend in psychomotor development, and the disease will make changes - alas, irreversible - in the structure of the skeleton is not for the better.

Have you ever found a child with the legs "wheel", curved in the form of the letter "O"? This is the result of untreated rickets. Anemia is often characteristic of the rickets, and the reduced overall resistance of the body, and the tendency to infections. Nothing it, believe, you do not allow! Especially since the treatment of rickets is relatively simple and is quite accessible - just would not be late!

Noticing the first signs of Rakhita, immediately contact your precinct pediatrician. Perhaps he has already prescribed you preventive doses of vitamin D, but since they did not work soon, now, apparently, they will have to increase them. An important warning relating to children receiving dairy mixes: Most mixtures are enriched with vitamin D, and it will be necessary to take into account because overdose vitamin D is dangerous.

Vitamin D give a child in a spoon of breast milk or a mixture containing it. You can not drip in a spoon right through the edge of the bottles, be sure to use the pipette, and keep it strictly vertically - with an inclined position, a too big drop is formed, which may also contain unnecessary units of vitamin.

Bathing is useful to replace the healing bath.

Configured children will help excitable children. On 10 liters of warm (36 °) water take a teaspoon of natural liquid coniferous extract or standard briquette strip. For the first time, it is enough for 5 minutes, and then gradually increase the time of procedure up to 10 minutes. Course treatment - 12-15 baths, daily or every other day.

Slug, "loose" and low-propelled tonic baths. 2 tablespoons of sea or table salt are dissolved in 10 liters of water (35-36 °). The first bathing is 3 minutes, then - no longer than 5 minutes. Limit 8-10 procedures every other day.

Children with manifestations of exudative diathesis recommended bubber baths medical herbs. The leaves of the plantain, the root of Aira, the bark of oak, the grass turns and daisies need to be mixed in equal amounts and brew a mixture on a liter of water at the calculation. Bat the baby in a healing brave every day for 5-10 minutes, until his skin cleans.

The prevention of rickets should be worried even before the birth of the baby, planning the pregnancy, firstly, in a family favorable period and, secondly, with the calculation so that the child is born in spring or summer. Then he will have time to "intercept" before the coldness of his "portion" of ultraviolet, under the influence of which vitamin D is formed in the skin.

From the first days of pregnancy, drink 2 cups of milk daily (if you carry it well) or prokobawashi, kefir, eat some slices of cheese and 100-150 g of cottage cheese. Thus, you will create calcium in your "reserve" in the body - those essential 30 g, which the baby will certainly "demand" in the last 3 months before birth.

Take the rule every day to spend a few hours in the fresh air, in the summer - not under the scorching rays, but in the end-to-end trees. Fish, eggs, creamy and vegetable oil are required in the diet. All this will help to some extent to compensate for the need for vitamin D, 10 times the increased since you are going to become a mother.

If pregnancy occurred during the cold season, the doctor may assign a preventive course of vitamin D or irradiation with a quartz lamp. But in your own coherent, do not take anything and do not sunbathe at home under the source of ultraviolet: otherwise hypervitam-nose, which upsets metabolic processes as well as the lack of vitamin D.

After the birth of the baby, do everything from you depends to feed it with breasts at least 3-4 months, but better and up to 1-1.5 years.

Three times a day, at least 1.5-2 hours, remove the baby for a walk. In the hottime, the stroller should stand in the shade - the scattered light is quite enough so that Vitamin D is formed in the body of the kid in the body.

Forget about Tug Pelasania! From the first days, an equipper baby in the slider so that he could move freely with the handles and legs, when it is awake, - so the bones will faster and do not fall rickets. Do not neglect the daily massage and gymnastics for the baby. And if you have the opportunity to teach him to swim in the pool at the clinic - take advantage of it!

In each particular case, the doctor will appoint you a massage, constructing, generalizing and breathing exercises for the prevention and treatment of Rahita.

Folk Treatments of Rakhit

Herbs and fees from Rachita

Pour 2 tablespoons of the grass of 2 glasses of boiling water, insist for 30 minutes, strain. Giving a child from Rahita at 0.5 cup 2-3 times a day.

Pour 1 tablespoon of burdock root 2 glasses of boiling water, insist 2 hours, strain. Infusion from Rakhita take hot to 0.3 cup 3-4 times a day.

Pour 15 g of mint grass with a 100 ml of alcohol, insist, strain. Take folk remedy From Rahita 15-20 drops 3 times a day.

Therapeutic baths when rickets

Mix 200 g of the root of nine and the root of the burdock and pour the mixture of 10l boiling water. Put on a weak fire and warm for 15 minutes, insist 1.5 hours, strain. A decoction pour into the bath and bathe a child.

Mix 150 g of the root of AIRA Bolotnaya and nettle root, pour a mixture of 10 l cool boiling water, warm on a slow heat for 10 minutes, insist 50 minutes, strain and use for baths.

Take 400 g of grass a series of three-part and 100 g of yarrow flowers of an ordinary, brew a mixture of 10l boiling water. Put on a slow fire and warm for 5 minutes. Insist 50 minutes, strain. Cooking warm water in the bath, mix it with a decoction and bathe a child.

As much as possible to be in the fresh air.

Sunbathing.

Daily within 1 month to give a child fish fat. After a 15-day break, repeat the course. In the diet of the child, a sick rickets, there must be milk, egg yolks, a crushed liver, fish (especially tuna, salmon).

Exemplary set of exercises for the prevention of rickets.

With rickets, the child often does not hold his head. Therefore, at first the exercises are carried out in horizontal positionAnd they should be allocated for 10-15 minutes several times a day. It is very important to train your back muscles, abdomen and chest. It is necessary to start and finish occupation. We need easy short-term (1-3 minutes) massage of the body, hands and feet - strokes and rubbing. Make massage and between exercises, each of which repeat 2-4 times, depending on the well-being and mood of the child. So, started.

On the back

1. Hold the baby's tibia and promptly get a toy lying first from one, and then on the other hand from him: "Take a rattle."

2. Complicate the previous exercise. Holding the child for the legs, encourage him to take a toy, lying away - at 40-50 cm or on it. You can simultaneously maintain him behind the shoulders and head, helping to lift it and strain the front muscles of the neck, shoulder belt, belly.

3. Put the kid with legs to yourself. Holding them with one hand, and the other holding his brush, help turn on the side and on the stomach (the same in the opposite side, taking the baby for another brush).

On stomach

4. Support the baby under the chest with one hand, showing the toy lying ahead, and with the palm of the other hand touch his sole - the baby will be repelled from her. Make him to get a toy, thereby stimulate crawl.

5. Put the kid with legs to yourself. Hold it with one hand for the legs, and the other show the toy then to the left, then on the right, then in front of him (she must always be in the field of his view). So the baby learns to raise his head and turn her.

6. The child is at first on his back, then on the stomach and repels the legs from the ball or your hand.

Gradually, as the child's condition improves, it is possible to put it on legs and "train" in overpanding, and then in walking. Walking helps to strengthen and develop the muscles of the legs (it warns their curvature). Only in one case - with a significant decrease in the tone of the muscles - "good" on the exercises associated with walking, should give a doctor.

Very useful 8-10 times a day (before meals or 40 minutes after) lay out a child with a tummy on a hard mattress or shield. In this position, the natural bends of the spine are formed and strengthened and warned, and some deformations of the chest and the spine are corrected, the corresponding muscles are strengthened. Children who in the position lying on the stomach do not raise their heads and shoulders, are considered weakened. A biked diaper-legged under the chest, rolled by several times, or a roller from a children's oilcloth filled with half sand and covered with a diaper. In this position, the child is easier to raise his head and shoulders.

Usually, such a diagnosis is voiced by a pediatrician, on the next of the techniques or preparations are prescribed to prevent Rakhit, especially in the conditions of the northern territories. Although modern medicine stepped far ahead in terms of diagnosis and treatment of diseases, Rahit, everything also remains a relevant issue today. Sometimes in the clinical picture it is difficult to understand even a doctor, and ordinary parents are not at all under power.

The disease is unpleasant to what can be masked for other, and manifestations can already be in running cases. As a result or untreated rickets, or self-treatment where Rahita is not, which leads to the overdose of drugs.

What is called Rakhit?

Rahit is considered to be one disease, although in fact this is a whole group of exchange diseases or disorders that combine one general basis characterized as a decrease in calcium level in bone tissue - osteopenia. Such a state can cause not only vitamin D deficiency, it may be the effect of external or internal factors, therefore, at the first signs of Rakhita, it is not necessary to immediately treat it with vitamin D, it is necessary to clarify the reasons. Sometimes vitamin D can even be contraindicated.

Rahitov is actually quite a lot, but in order to be easier to understand, classic rickets stand out, as the most common and rakhito-like diseases. Their manifestations are quite similar, but the causes of the occurrence and methods of treatment are returned. Rachito-like includes several exchange diseases, but they are not distinguishable to parents, and even the doctor is not always easy to determine. However, there are fundamental differences in treatment. Therefore, with the first signs of Rakhita, it is necessary to contact the doctor.

A bit of history

Rahit is also called an active growth disease, as it arises exclusively in the kids in early ageWhen the skeleton is active and there is a temporary discrepancy between the amount of flow calcium and vitamin D, and the consumption of these substances by the body. Rahit was the diet of the kids in antiquity, he was known in Greece, and his name went precisely from the Greek word "Rakhis", which denoted the ridge or vertebral pole, since the deformations in the form of a hump appear during severely form.

In the 17th century, Rakhit began to call " English disease"Due to the fact that it became extremely often to meet in the environment of children of workers who lived near the factories in the area of \u200b\u200bpermanent smog, and which because of this did not receive the sun and ultraviolet. The scientist who studied the disease described the full clinic of Rachita on the results of the inspection and openings already then guessed the reasons, but I could not install them. But given a name to several symptoms. In the twentieth century, the reason was revealed, first of all it was established that the use of fish oil was saved from Rakhita, and then it was installed and some of the components of fish oil helps to treat Rahit. Thus, Vitamin D was opened and then the era of the treatment of Rakhita came, and now there is almost no heavy episodes of Rakhit.

But the first years of Rakhita vitamin D treatment were also serious, since the first doses that were used were very large, severe complications appeared - hypervitaminosis D, until it was found out, what is the role of vitamin and what its properties, which doses are therapeutic And what kind of prevention. However, still work on rickets remain relevant and much still studies.

Who is rakhita?

Rahit may occur in any country and on any continent, even in Africa, but still the frequency of occurrence in zones with a small amount of the sun is naturally normal. Usually Rahit occurs in children who are born from October to March-April, but summer children can also be subject to rickets. We have rickets most of all in Siberia and in the Polar region, although the average strip also has about 15% of children with the manifestations of Rahita.
The city children suffer from Rakhita, as they are less than the sun, especially in cities with smalleriness, poor ecological situation, with an abundance of transport. Usually rickets occurs in children with nutritional impairment and unfavorable conditions for growth and development.

There are certain risk groups that are more likely to suffer from Rahita. You can split all categories on subgroups. Usually Rahit occurs in children whose mothers had problems with pregnancy, very young, or vice versa, their age exceeds 35-40 years, if they were not enough in the sun, they have chronic pathology, poorly feed.

One of the risk factors for the development of Rakhit is the subsequent pregnancy, especially at a small time interval between them, since the mother has the reserves of vitamins and mineral substances, if it is a multiple pregnancy or the presence of a kid.

One of the essential factors in the development of Rahita is the nutrition of the baby, and earlier there was an opinion that Rahitis is more likely to have breasts, which are not allowed to vitamin D, because it is little in breast milk. But it is actually incorrect, today it has been proven that breast milk has a characteristic feature - the front portions of milk contain calcium, and the rear portions have a sufficient amount of vitamin D, which actively helps in calcium utilization. With proper nutrition, women and full-fledged breastfeeding, without regimes and restrictions, it is almost excluded with rickets.

Most often, Rachyt occurs in kids receiving mixed or artificial nutrition, especially if it is non-adapted mixtures (cow or goat milk), or cheap mixtures. Children suffer from rakhita, hypotrophy, obesity, nutrition disorders.

One of the risk factors of Rakhit - Diseases of children, which lead to disorders in metabolism, including calcium and vitamin D, is allergic, dermatosis, disorders of food suction in the intestine. Usually are more susceptible to Rakhita boys, dark-skinned and with the second blood group, but much more depends on the living conditions and care.

What role is the minerals play?

For active growth and development of the child, a robust and healthy bone basis is needed so that the bones of the skeleton are durable, mineral substances are needed - magnesium, phosphorus, calcium and vitamin D for their assimilation and deposit in bone tissue. Bone contains up to 90% of all these minerals, and their concentration in blood according to the principle of feedback regulates the additional flow of these substances with nutrition or water.

Calcium is necessary for the growth of the child with a mineral, because of it, the bones become durable, but should continuously enter the body with breast milk or food. In the small intestine, it absorbs and falls into the blood, where, under the influence of hormones, he goes into the bone or in need of it organs. Bones are formed from calcium compounds by type of chalk, they are durable, they give the ability to withstand loads.

Calcium also participates in coagulation processes, helps the work of the nervous system, regulates blood pressure. A sharp decline in calcium levels in children to cramps to prevent this, the body begins to actively remove calcium from bone tissue under the action of hormones of the thyroid and parachitoid glands. The role of magnesium and phosphorus - to give the bones of elasticity and strength, without them bones will be fragile.

For the stable and full work of the body, it is necessary to maintain a stable level of minerals in the blood and bones. The calcium level is especially important, and in its two forms - general and active or ionized. The calcium level usually fluctuates in strict limits from 2.2 to 2.7 mmol \\ l, with an active form in it should be at least 1.22 to 1.37 mmol \\ l, that is, about half of this amount. Calcium is constantly lost with urine, and therefore its regular arrival is necessary. The removal of calcium with urine is one of the diagnostic tests with rickets and when determining the overdose of vitamin D. The calcium level in the urine is the diagnostic base of the sample on Sulkovich - it is determined by the loss of calcium with urine.

The stable amount of blood phosphorus is important, but it is not so dramatic for the body - its norm is from 1.25 to 2.2 mmol \\ l, and after three years, the level changes to 0.95-1.95 mmol \\ l.

Why does the vitamin deficit arise?

In fact, the reasons for changing the level of calcium and phosphorus is sufficient. In the first place is the presence of varying degrees, as calcium accumulates in the last weeks of pregnancy, especially actively on the ninth month. Therefore, in case of prematurity, calcium will naturally be less, and the body will suffer.

Another reason is the lack of calcium in the nutrition of the future mother, especially if it observes diet, is a vegetarian or fasten. The impact is also important. different diets The child himself, for example, in the nutrition of its kefir, cow's milk or semolina.

The problem of mineral exchange is acutely standing in disruption of intestinal suction or transport of minerals in the bone. Such a phenomenon is possible in violation of the work of enzymes in the intestines, immaturity of digestion, kidney diseases, or violation of hormone metabolism. And an important influence has an entry into the body due to poor ecology of such substances as chromium, zinc or lead, which replace calcium, and violate its deposition in bone tissue.

Rahit is closely interrelated with endocrine diseases - the work of the thyroid or parachitoid gland affects rickets, as they are responsible for the exchange of phosphorus and calcium. Calcium is much lost in diseases, then vitamin D deficiency will complement the clinic.

The role of vitamin D.

The main function of vitamin D is the maintenance of a constant concentration in the blood level of calcium, enhancing its absorption in the intestine, returning it from the kidneys and primary urine, calcium deposition in bone tissue, improving the work of the immune system. With nutrition, the child receives up to 20% vitamin, the large part of it is formed in the skin under the influence of ultraviolet.

In the skin cover under the influence of ultraviolet waves of a special length, vitamin D precursors turn into an active form. Summer of the Sun is more than enough, so basically Rahit becomes relevant from October to April, when it is still cold and children spend a little time on the street and in the sun. Also interfere with the absorption of ultraviolet waves of clouds, fog or the presence of smoke and smog, do not help the rays of the sun on the balcony through glass or reflected waves.

In the first year of life, the most full-fledged source of minerals and vitamins will be breast milk, since in it all substances are in a screaming of the optimal form, so they are almost not lost and everyone goes to the construction of the body. The most expensive and most adapted mixtures are still not approaching the degree of suction to breast milk, and the animal milk is even further from the composition of the breast milk according to calcium and phosphorus, at best, up to 40% of calcium from it can be understood.

The most valuable of food products for calcium and vitamin D are animals - milk and dairy dishes, cottage cheese, fish, eggs, and here in calcium plants are very few. Plus, most of the vitamin D hits with skin.

Vitamin D is a fat soluble substance, in the body there are several forms - D2 of food and D3 of the skin, and in the liver they pass the episode of transformation, moving to a soluble form, and getting into the kidneys, go to active forms of vitamin D, which work in organism.

The most active metabolite is calcitriol, it is reinforced by reducing the level of calcium in the blood. If the calcium level is normal or even increased, another metabolite of vitamin E begins to work, it sends calcium, magnesium and phosphoric salts to bone tissue. And even the level of vitamin E affects the work of the parathyroid glands, activates the intestinal wall for suction of calcium from food and supports immunity.

Diagnostics Rakhita

We disassemble the main reasons and conditions for the development of Rahita, and reached the discussion of the reasons leading to violation of the work of vitamin D in the body. These will include the following points. The problems of Rakhita include lack of vitamin d or its active forms, it occurs with a lack of vitamin in nutrition, a rare stay on the street, impaired its absorption in the intestine. Problems lead kidney and liver diseases, which interferes with the transformation of inactive vitamin D to active. An important influence has a shortage of trace elements and vitamins involved in the exchange of vitamin D, and the reception of drugs that destroy Vitamin D in the liver.

As classified

Usually, pediatricians are rickets to three degrees in gravity, and today it is generally a rickets of an easy degree, in which the symptoms are not sharp, usually these are light neurological disorders or disruption of the oil-muscular system.

With the average severity of disorders, there are already quite pronounced, bright and occur in the work of the nervous system, problems with bones, and they are joined by the problems of muscles, blood and violations of the respiratory organs. Suffering digestion, vessels and heart. With severe form, persistent and heavy disorders arise, resulting in disability.

In addition to severity, Rachitis is divided into acute, which manifests dramatically and quickly, passing with adequate therapy, subacute - manifestations gradually arise and it flows sluggish and recurrent, the episodes of exacerbations go with the episodes of remission.

In addition, in the cards often noted the stage of Rahita - initial manifestations, the height of the disease, reconvaluescence or recovery and residual phenomena.

Rates for suspicions

The manifestations of Rahita are even more diverse than the reasons, leading to it, and most of these manifestations are not specific for Rakhit, such manifestations may well be in most children's diseases. That is why the detected symptoms of Rakhita themselves will not allow any more diagnosis and begin active treatment. A whole range of surveys and confidence in the legitimacy of the diagnosis is necessary.

Rahit never arises in the first three months of the child's life, mostly Rakhit arises from half a year before a year, after the year Rahit appears rather as an exception from the rules. The main manifestations with rickets arise due to the lack of calcium and phosphorus in the blood, which is washed out of the bones as a result of the activation of hormones, the same hormones affect the kidneys, without allowing calcium to get lost with urine.

One of the manifestations of Rahita is signs of a concern of the baby, the bugs of his more ordinary, he shudders from bright light or sharp sounds. There is a strengthening of sweating, especially in the head zone, sweat of specific acid odor, with a pronounced itch. The head sweats especially strongly, he rubs the head of the pillow, because of which the hair on the back of the head is getting out - it turns out bald.

The muscles of usually reduced tone, as a result of which the kids later begin to crawl, sit, get up and then walk, and from the side of the muscles of the front abdominal wall hypotension is manifested by the symptoms of the splashing abdomen, a froggy nest. In this case, an umbilical hernia can be formed, the deformation of the ribs.

The softening of the briefs of the spring occurs, this is due to the washing out of calcium and the edges become soft and puffy, it is possible to distinct the seams on the skull clearly, and if the changes are pronounced - the seams can diverge. Due to the softness of the bones at the beginning of the active movement with legs, they become curves - the letter O or H. due to the pressure on the head of the backbone during lying it can be bleached, the chest is deformed, it places or repents like a keel or chicken breast.

Naturally, in the body of a child, all these changes are not undergoing unnoticed, the body is trying to conduct compensation work, correct the situation. Thus, the mechanism of strengthening bone tissue is launched due to its expanding. However, calcium with rickets still lacks, and then, the result on the head is formed by the frontal and dark bugs - Socratic forehead with baldness. The growing in the bone zones will be visible on radiographs in the form of typical zones - rachitic nodules on wrists, bracelets, rickettic rosary on ribs, pearl threads on the bones of fingers. In addition, an additional symptom of Rakhita is the later timing of the closure of the spring, although it may be a family or constitutional feature, and the timing can vary greatly.

In case of rickets, one of the symptoms may be later teething, but the teeth can have individual dates of the teething, along with the spring and the teething is influenced by many factors such as external genus and internal.

The work of the nervous system may also suffer, convulsive readiness is developed with convulsions as a result of minor influences, the digestion system does not work very actively, children are poorly added in weight, the minimum increases or at the lower limits of weight. Frequently occurring, violation of the chair with constipation or diarrhea, develops iron deficiency with anemia. Children having Rahit often sick colds with complications that are passing into pneumonia, otitis or bronchitis, as there are defects of immunity.

The doctor finds in the blood tests shifting of biochemistry indicators - the level of calcium - general and ionized, they decrease or are on the lower boundary of the norm. The level of phosphorus in the blood is low, but the level of alkaline phosphatase, the special enzyme of the body, begins to rise, and quite sharply.

The initial stage of Rakhita lasts from one to three months, and if it is not started to treat it, Rahit goes into the stage of the gap, then all the symptoms will manifest much more sharp. With the correct and timely diagnosis, recovery can be achieved in about three or four weeks of the disease. Then they go to the supporting therapy of Rakhita. As health treatment is treated, nervous disorders and digestion disorders pass. Children quickly catch up with peers in development and in skills, the muscle tone and changes in the bones pass longer.

Diagnosis Rakhita

The main in the diagnosis is inspection and examination of the doctor, and not consultation and treatment in absentia, by phone or the Internet. A thorough and phased inspection of a doctor is needed, a story about all disturbing symptoms, especially concerning stool violations, excitability and bone changes. But, without laboratory research and other triggers, it is impossible to put some triot, as there are several diseases on rickets.
One of the easiest, but not exact diagnostic methods is urine analysis, Sulkovich's test. This test allows you to estimate calcium loss with urine, as well as to control the treatment. The precision digit method does not give, it is semi-quantitative, it is determined by the degree of turbidity of urine on a special scale, if mixed with a special reagent.

The sample rate is positive on one or two plus, either given in units from 0 to 4. If the reaction is negative or dubious, in combination with the inspection data, it is almost certain possible to make a diagnosis of rickets. The same test is applicable to control the treatment of vitamin D - if it is very positive for 3-4 plus or units, the abolition of Vitamin D. is necessary

It is also important to donate blood and urine on biochemical indicators - determine the level of calcium, phosphorus and alkaline phosphatase. They will confirm the diagnosis of finally. The edge of the bones also used to identify typical bone changes, but today it does not apply.

How is Rakhit treat?

Treatment Rakhita - This is the main task of the doctor, because it affects the entire metabolism, the growth of the body and the immune system. However, not only the drops of vitamin D, but also a whole range of events are used to treat Rakhita, but also a whole range of events - regime, walks, massages and the latest place of medicines.

It is important to start with the organization of the right day mode so that it be sure to go to the air, it is necessary to walk at least 2-3 hours, you can cut walks in winter, and in the summer it is increased. In the nursery, it is necessary to regularly venture, clean and open the curtains.

It is important to power the child with the enrichment of nutrition with vitamins and minerals, timely supplies, but without a rush. It is impossible to overload the intestines of crumbs, as allergic and digestive disorders disrupt the suction of calcium and vitamin D. daily hygienic, hardening procedures, gymnastics for muscle tone and massage. These measures maintain muscle tone, strengthen the body.

Medical treatment, as well as doses of drugs, only the doctor chooses. It is impossible to give vitamin D independently as prevention, an overdose and negative consequences for the body can occur.

Vitamin D is prescribed based on the severity of the state, the stage of the disease and the identified abnormalities in health. The dose is selected individually to each child, it depends on the age, heredity and genetics, the nature of nutrition, and other features. In addition, doses at different times of the year will be much varied. Usually, vitamin D is dosed by international units contained in a drop of solution. It is important to carefully read the label and dose. Previously practiced recommendations on the impact doses of vitamin D in the treatment of rickets were not justified, they often led to signs of overdose.

Today small doses and a long course of treatment are prescribed, with a gradual transition to supporting therapy. Many doctors are generally prescribed a whole complex of polyvitamins, since with rickets in one way or another suffers all the metabolism in general.

Today, the main drugs for the treatment of rickets are oil or water forms of vitamin D, these are vigantol and aqualeber. They are well absorbed and digested in the digestive system, even if there are problems of digestion and allergies. Especially indicated by such children the drug aquadery. They are precisely dosed, in one drop of the drug about 500 months, and it is convenient to calculate the dose of drops.

On average, it is prescribed from 4 to 10 drops of solution per day, begin with minimal doses and gradually increase them to therapeutic, until the effect is achieved. On average, high doses are needed only with pronounced bone changes. On average, the course lasts from 30 to 45 days, after which the dose is left prophylactic at 500-1000m, that is, one or two drops. This dose is primed from October to April for the first two years of life.
The effectiveness of treatment is evaluated by Sulkovich's sample, conducting control every 2-4 weeks.

In addition, in parallel with the preparation of vitamin D, calcium preparations are prescribed, since one reception of vitamin D can reduce the level of calcium in the blood. To prevent such disorders, gluconate or calcium lactate is used in the first two weeks of taking vitamin D, but calcium is prescribed not to all children, especially in infants, since they have a sufficient calcium level in milk. Especially indicated by calcium, premature children and ill.

Prevention Rakhita

Rachita prevention measures begin during pregnancy - in the form of walks and balanced nutritional nutrition. In addition, it is important to feed the baby with breasts, then it will get calcium and vitamin D is quite enough. It is useful to take polyvitamins and calcium.

After birth with about 2-3 months, it is necessary during the cold season with the aim of the prevention of rickets to use vitamin D daily, under the control of the pediatrician.

It is important to introduce conformity in time, often to be on the street, especially in sunny weather. For tone of muscles and assimilation of calcium, massages and gymnastics are needed, conducting hardware and intake events. And of course, permanent doctor control is necessary.

Of course, the problem of Rahita is relevant to this day, but today there are many ways to combat this problem, and it is only important to begin prevention in time, then the baby will be healthy.

Diseases associated with scarce states are found in children quite often. It may not only be sick, but also the kids older. Today we will talk about rickets from kids older than one year.

What it is?

Rahit is a children's pathology associated with a pronounced violation of calcium-phosphoric exchange. To this pathological condition, various causes causing lack of vitamin D. or calciferol in the body. Normally, this biologically active substance participates in the internal exchange of calcium and phosphorus, which ensures normal concentrations of these substances.

Usually, early adverse signs of Rahita appear in the child in the first months and within 1 year after birth. However, the disease is also registered in children and at an older age.

According to statistics, this disease is more susceptible to kids living in the Nordic countries.

The boys sick Rickets as often as the girls. The pronounced shortage of vitamin D in the children's body leads to a violation of the exchange between calcium and phosphorus. Both of these substances provide bone strength. With a disturbed calcium-phosphoric exchange, a child appears various adverse symptoms associated with a pronounced deficit of biologically active substances.

Usually the first signs of Rahita are detected by a children's doctor during regular kid surveys. Diagnosis of the disease does not cause significant difficulties from medical professionals.

The reasons

The development of the disease in kids leads various reasons that contribute to a decrease in the level of calciferol. In some cases, the impact of causes can be combined. It is very important to deal with what caused factors caused factors. Only elimination of the cause of the disease will lead to a complete recovery of the child.

The peak of the incidence of rickets falls on his chest age.Usually the first manifestation of Rakhita is found during the first three months from the moment of the birth of the child. In some cases, with a slight course of the disease, clinical signs are not visible, which makes it difficult to diagnose. In such a situation, the diagnosis is usually set only to age for 2-3 years.

To the most frequent reasonsleading to a deficit in the children's body of calciferol include:

Insufficient vitamin D arrival along with food. Todders up to the year, it leads to a quick cancellation of breastfeeding. In earlier children, the cause of exogenous deficit of calciferol is unbalanced and defective nutrition. The absence of animal products and vegetarian food can cause a child of the manifestation of Rakhita.
Accommodation in the northern regions. The lack of solar insolation leads to the fact that an insufficient amount of endogenous (internal) vitamin D is synthesized in the children's body. Impact on the skin of the rays of the ultraviolet spectrum causes a cascade of biological reactions in the baby, which are launched by the synthesis of calciferol.

The kids who live in countries with long winter and short lighting day, according to statistics, have a higher chance of getting rickets than their peers living in the south.

Chronic diseases organs digestive system. The leading role is assigned to intestinal pathologies. Chronic enteritis, accompanied by a strong impairment of suction of various substances from food, often leads to the formation of various deficit states in kids. Without the treatment of the main disease in this case, with unfavorable symptoms of Rakhita can not cope.
Prematurity and congenital pathologies. The birth of the baby earlier than the scheduled period is often a launch reason for the development of Rahita. This can be explained by the fact that the premature child has not completed the formation of many internal organs. Violations of intrauterine development often become the cause of various health problems in the future.

Symptoms

The development of the disease undergoes several consecutive stages. The initial period of the disease is accompanied mainly by the emergence of vegetative violations. This is manifested by violations in the behavior and the mood of the baby. The child becomes nervous, easily annoyed on trifles. The kids are losing interest in their favorite games, try to limit active movements. Usually the initial stage lasts about a month.

This period of the disease is also characterized by the appearance characteristic symptom - The child is intensified by sweating. Also changes its smell. Sweat becomes caustic, sour. His abundant allocation on the skin contributes to the development of irritation and the train. Kids are often combing affected skin. The change in the smell of sweat is due to the change in its chemical composition and the electrolytes included in it due to the impaired metabolism.

After the lapse of initial stageThe disease passes during the period of the rank. This is more unpleasant time characterized by the emergence of numerous symptoms. The baby appears the first deformations of bone tissue. Basically, all tubular and flat bones that are actively growing are involved in the process. Diagnosis of the disease at this time is not complicated and does not represent problems for the doctor.

The severity of clinical symptoms can be different.

The difficult course of the disease in the kids older than the year is rare enough.

The child has the characteristic curvature of the spine - scoliosis. Changes the density and thickness of the clavicle. They come forward somewhat. The architecture of the thoracic structure is also violated.

Ribs are somewhat flattered, intercostal intervals change. Some children appear characteristic signs of Rakhit: the pressure or empty of the lower third of the sternum. Since ancient times, characteristic names are used for these states - "Chest of shoemakers" and "Chicken breast". Appearance The child changes greatly. Usually these signs appear in kids, which are diagnosed too late.

The child changes the shape of the lower extremities. They become orally or x-shaped. Usually this sign appears in kids with a pronounced course of Rahita by five years. In order to reveal this symptom, you should look at the kid from different angles of view. Usually the curvature of the lower extremities is well viewed on the side.

Also during the midst of the disease muscle hypotonus appears and various neuromuscular pathological conditions are joined.In a horizontal position in patients, kids are well traced "Frog abdomen". In case of inspection, the tummy of the child becomes molten and hesitate to the lateral surfaces of the body. This symptom is due to the presence of a pronounced muscle hypotonus constituting the front abdominal wall.

The bone deformations of the skeleton also lead to violations in the work of the internal organs. Pathology of the chest helps to reduce the ventilation capacity of the lungs, which leads to the development of emphysema and other pathological conditions. Breathing disorder is reflected in hemodynamics and vascular tone. Such combined states lead to the fact that the kid has problems in the work of the heart muscle and vessels.

The hypotonus of the muscles of the abdominal wall and the pronounced curvature of the spine contribute to the compression of the internal organs. In some cases, this leads to violations of the liver and spleen. Bone pathology contribute to the development of numerous orthopedic diseases in the kid, which require the appointment of appropriate treatment. On average, the period of gap lasts for several months.

On time, the appointed treatment contributes to the normalization of the state of the child and improving its appearance.

The reconnaissance period or recovery can be from 2 to 4 months.In some cases, it lasts until six months. If the child suffered rickets in severe, then the residual symptoms of the disease can be maintained during a couple of years since reconvaluedness. Usually they fully pass after the course of rehabilitation activities.

Diagnostics

To identify signs of rickets in kids should be as early as possible. Timely diagnosis It will avoid the development of the child of remote complications and will help return the baby to active life. To identify the very first signs of the disease and suspect Rakhit Doctor may when conducting regular inspections. After the clinical examination of the child, the doctor appoints additional analyzes to clarify the severity of violations and confirm the established diagnosis.

The following studies are applied to identify the disease:

Measuring in the blood of calcium and phosphorus. Normally, the calcium level should be - 2.5-2.7 mmol / l, and phosphorus - 1.3-2.3 mmol / l. The reduction of these indicators in the child below the age norm indicates the presence of signs of the violation of calcium-phosphorus exchange.
Definition of alkaline phosphatase. This enzyme is actively involved in the exchange between calcium and phosphorus. Normally, it is up to 200 units. An increase in this indicator indicates the presence of exchange violations In calcium-phosphoric exchange.
Radiography.Allows you to clarify the presence of bone deformations and a violation of the skeleton architecture caused by the disease. With the help of radiography of bones, it is possible to identify specific features characteristic of Rakhita: "Rachitical bracelets", pathological curvature of the spinal column, "Rachitical rosary", peppercase pathologies, bone seals in tubular bones. This method It can be used only by strict indications.
CT scan. It is carried out according to the same indications as the radiography of bone tissue. This method has a higher resolution and allows you to get the most accurate result. The use of computed tomography allows doctors to estimate the level of damage and the degree of functional disorders.

Effects

The forecast of the disease in kids is very influenced by the diagnosis and purpose of treatment. If rickets in the child was revealed in the earliest stages, then negative complications of the disease, as a rule, does not occur. In case of late diagnosis, the kid may have various distant consequences of the disease that require compulsory rehabilitation activities. The frequent consequences of Rahita, transferred in childhood, include: a moderate reduction in muscle tone, small curvature of the lower extremities, incorrect bite and others.

Treatment

Several therapeutic methods are prescribed to eliminate adverse symptoms of the disease. Control over the effectiveness of designated therapy is carried out with the obligatory determination of the content of calcium in the blood. During the treatment, the clinical condition of the child is also evaluated. When appointing therapy, the baby should feel better and become more active.

For the treatment of rickets, the following principles of treatment are applied in kids:

Regular outdoor walks. Insolation with sunlight is needed for a baby suffering from rickets. Ultraviolet rays have a pronounced therapeutic effect on the children's body, increasing the inner synthesis of calciferol. Make a walk in the fresh air Kid must daily. Only regularity and systematics will allow you to achieve a good and resistant result.
Purpose medicinal preparations, vitamin D containing in its composition. Many doctors prefer water-soluble forms. The dosage of the drug should conduct the attending physician individually for each kid.

Independent selection of a healing dose is unacceptable! Such self-treatment can contribute to the appearance of a very dangerous state in the kid - vitamin D.

Full nutrition.In the daily diet, the kid must be present to the products rich in Calciferol. These include: Meat, Chicken, Fish, Eggs, Milk and dairy products, cottage cheese, cheese. The kid must necessarily eat a variety of dishes that contain vitamin D. If the child receives drugs with calciferol, the diet is necessarily discussed with the attending physician to avoid overdose of the receipt of this vitamin to the children's body.
In children from 1 year

Diseases associated with scarce states are found in children quite often. It may not only be sick, but also the kids older. Today we will talk about rickets from kids older than one year.

What it is?

Usually, early adverse signs of Rahita appear in the child in the first months and within 1 year after birth. However, the disease is also registered in children and at an older age.

According to statistics, this disease is more susceptible to kids living in the Nordic countries.

Usually the first signs of Rahita are detected by a children's doctor during regular kid surveys. Diagnosis of the disease does not cause significant difficulties from medical professionals.

To the most frequent reasons leading to a deficit in the children's body of calciferol include:

Insufficient vitamin D arrival along with food. Todders up to the year, it leads to a quick cancellation of breastfeeding. In earlier children, the cause of exogenous deficit of calciferol is unbalanced and defective nutrition. The absence of animal products and vegetarian food can cause a child of the manifestation of Rakhita.
Accommodation in the northern regions. The lack of solar insolation leads to the fact that an insufficient amount of endogenous (internal) vitamin D is synthesized in the children's body. Impact on the skin of the rays of the ultraviolet spectrum causes a cascade of biological reactions in the baby, which are launched by the synthesis of calciferol.

The kids who live in countries with long winter and short lighting day, according to statistics, have a higher chance of getting rickets than their peers living in the south.

Chronic diseases of the organs of the digestive system. The leading role is assigned to intestinal pathologies. Chronic enteritis, accompanied by a strong impairment of suction of various substances from food, often leads to the formation of various deficit states in kids. Without the treatment of the main disease in this case, with unfavorable symptoms of Rakhita can not cope.
Prematurity and congenital pathologies. The birth of the baby earlier than the scheduled period is often a launch reason for the development of Rahita. This can be explained by the fact that the premature child has not completed the formation of many internal organs. Violations of intrauterine development often become the cause of various health problems in the future.

Symptoms

This period of the disease is also characterized by the appearance of a characteristic symptom - the child intensifies sweating. Also changes its smell. Sweat becomes caustic, sour. His abundant allocation on the skin contributes to the development of irritation and the train. Kids are often combing affected skin. The change in the smell of sweat is due to the change in its chemical composition and the electrolytes included in it due to the impaired metabolism.

After the initial stage, the disease passes during the rank. This is more unpleasant time characterized by the emergence of numerous symptoms. The baby appears the first deformations of bone tissue. Basically, all tubular and flat bones that are actively growing are involved in the process. Diagnosis of the disease at this time is not complicated and does not represent problems for the doctor.

The severity of clinical symptoms can be different.

The difficult course of the disease in the kids older than the year is rare enough.

Ribs are somewhat flattered, intercostal intervals change. Some children appear characteristic signs of Rakhit: the pressure or empty of the lower third of the sternum. Since ancient times, characteristic names are used for these states - "Chest of shoemakers" and "Chicken breast". The appearance of the child changes greatly. Usually these signs appear in kids, which are diagnosed too late.

On time, the appointed treatment contributes to the normalization of the state of the child and improving its appearance.

Diagnostics

To identify signs of rickets in kids should be as early as possible. Timely diagnosis will avoid the development of remote complications in a child and will help return the baby to active life. To identify the very first signs of the disease and suspect Rakhit Doctor may when conducting regular inspections. After the clinical examination of the child, the doctor appoints additional analyzes to clarify the severity of violations and confirm the established diagnosis.

The following studies are applied to identify the disease:

Measuring in the blood of calcium and phosphorus. Normally, the calcium level should be - 2.5-2.7 mmol / l, and phosphorus - 1.3-2.3 mmol / l. The reduction of these indicators in the child below the age norm indicates the presence of signs of the violation of calcium-phosphorus exchange.
Definition of alkaline phosphatase. This enzyme is actively involved in the exchange between calcium and phosphorus. Normally, it is up to 200 units. The increase in this indicator indicates the presence of exchange disorders in calcium-phosphoric exchange.
Radiography.Allows you to clarify the presence of bone deformations and a violation of the skeleton architecture caused by the disease. With the help of radiography of bones, it is possible to identify specific features characteristic of Rakhita: "Rachitical bracelets", pathological curvature of the spinal column, "Rachitical rosary", peppercase pathologies, bone seals in tubular bones. This method can be applied only by strict indications.
CT scan. It is carried out according to the same indications as the radiography of bone tissue. This method has a higher resolution and allows you to get the most accurate result. The use of computed tomography allows doctors to estimate the level of damage and the degree of functional disorders.

Effects

For the treatment of rickets, the following principles of treatment are applied in kids:

Regular outdoor walks. Insolation with sunlight is needed for a baby suffering from rickets. Ultraviolet rays have a pronounced therapeutic effect on the children's body, increasing the inner synthesis of calciferol. Make a walk in the fresh air Kid must daily. Only regularity and systematics will allow you to achieve a good and resistant result.
Appointment of drugs,vitamin D containing in its composition. Many doctors prefer water-soluble forms. The dosage of the drug should conduct the attending physician individually for each kid.

Independent selection of a healing dose is unacceptable! Such self-treatment can contribute to the appearance of a very dangerous state in the kid - vitamin D.

Full nutrition.In the daily diet, the kid must be present to the products rich in Calciferol. These include: meat, chicken, fish, eggs, milk and dairy products, cottage cheese, cheese. The kid must necessarily eat a variety of dishes that contain vitamin D. If the child receives drugs with calciferol, the diet is necessarily discussed with the attending physician to avoid overdose of the receipt of this vitamin to the children's body.
Conduct physiotherapy. The UFO course (ultraviolet irradiation) helps the kids suffering from rickets, improve overall well-being and increases the density of bone tissue. It usually consists of 12-15 procedures. The duration of them can be different: from 2 to 10 minutes. Physiotherapy has a number of contraindications and is appointed by the attending physician.

About what rickets are in children and how to treat it, look in the next video.

Quite often, with another visit to the pediatrician with a 3-4 month old child, parents can hear the diagnosis of Rakhit. Many parents have the concept of this disease very foggy and superficial, they do not know the basic symptoms of the ailment and do not constitute possible treatment. So what is rickets and what is dangerous when detecting in children?

Rahit is a violation of the sharing of phosphorus and calcium in the body resulting from the lack of vitamins of the group D. First of all, the absorption of calcium ions from the intestine deteriorates, and as a result of its lack, demineralization and bone curvature occurs.

Why do you need vitamin D?

Vitamin D is produced in the skin under the influence of sunlight and only a small part falls into the body with food.

Promotes calcium transportation through the intestinal wall.
Enhances the holding of calcium and phosphorne ions in the renal tubules, which prevents their excessive losses in the body.
Promotes accelerated impregnation of bone tissue minerals, that is, strengthens the bone.
It is an immunomodulator (regulates the state of the immune system).
It has a positive effect on the exchange of tricarboxylic acids, as a result of which a lot of energy is released in the body necessary for the synthesis of various substances.

Vitamin D (90%) is produced in the skin under the influence of ultraviolet rays, and only 10% enters the body with food. Thanks to him, the intestine is absorbed by calcium, the necessary organism for the normal formation of bone tissue, the full work of the nervous system and other organs.

With a long lack of vitamin D in children begin to demineralizing bone tissue. Then osteomalacia (softening of tubular bones) and osteoporosis (bone resolution), which lead to gradual curvature of bones.

Most often, rickets are sick between the ages of 2-3 months to 2-3 years old, but kids are most vulnerable to 1 year.

Causes of the disease

If the cause of the disease is rickets one - a shortage of a vitamin D child's body, and as a result, a decrease in calcium levels, then factors provoking a disease, a lot. Conditionally, they can be divided into several groups:

Insolation as a result of an infrequent duration of the baby in the fresh air, and the associated decrease in the formation of vitamin D in the skin.

Error in nutrition:

artificial feeding with mixtures, in the composition of which there is no vitamin D, or the calcium-phosphoric ratio is broken into them, which makes it difficult to absorb these elements;
later and improper administration of lures;
alien breast milk often causes poor calcium absorption;
predominance in the diet of monotonous protein or fatty food;
defective nutrition of a pregnant woman and mother, nursing baby breast milk;
introduction of predominantly vegetarian supplies (porridge, vegetables) without a sufficient number in the diet of the kid of the protein of animal origin (yolk eggs, cottage cheese, fish, meat), as well as fats (vegetable and animal oils);
the state of polyhypovitaminosis, especially taking a lack of vitamins of the group B, and some of the trace elements.

Prematurity and large fruit:

the presence is one of the leading reasons for the appearance of Rakhita at the kid, since phosphorus and calcium begin to intensively enter the fetus only after 30 weeks (for 8 and 9 months of pregnancy), so premature children are born with a lack of bone tissue;
it should also be considered that because of the relatively rapid growth premature babies in relation to the kids who appeared on time, they need food rich in calcium and phosphorus;
large kids need much more vitamin D than their peers.

Endogenous reasons:

malabsorption syndromes (impaired nutritional suction in the intestines), accompanying a number of diseases, for example, celiac disease;
dysbacteriosis due to which suction and metabolic processes are violated, including vitamin D;
the weak activity of the enzyme lactase responsible for the splitting of the milk sugar contained in dairy products.

Inheritance factors and predisposition to the disease:

anomalies of phosphorous calcium exchange and synthesis of active forms of vitamin D;
hereditary interomalies for metabolism in the body (tyrosinemia, cystinuria).

Other reasons:

mother's disease during pregnancy;
environmental factor: environmental pollution - soil, and then water and food - salts of heavy metals (strontium, lead, etc.) leads to the fact that calcium in bone tissue begins to replace them;
walled diseases contribute to an increase in vitamin needs, including groups D, but at the same time deteriorate their suction; Also during the disease, the number and duration of walking with the baby is reduced, which leads to insolation;
hydgodina (reduction of motor activity), which can be caused by both a violation of the nervous system and the absence of physical education in the family (charging, massage, gymnastics).

Changes in the body with vitamin D deficiency

The deficiency in the organism of vitamin D leads to changes from many organs and systems.

The formation of a specific protein is reduced, which binds calcium ions and contributes to their passability through the intestinal wall.
Due to the reduced level of calcium in the blood, the nearby-shaped glands begin to actively produce the parathgamon, which is necessary to ensure the constant level of calcium in the blood. As a result of this process, calcium can be washed from bone tissue, and the inverse absorption of phosphorus ions in the renal tubules is reduced.
Failures begin in oxidative processes, the bone demineralization continues, they become soft and begin to be gradually curved.
In the zone of active growth of bones, an infallible bone tissue is formed.
Acidosis develops (shear of the acid-alkali equilibrium of the organism in the acidic side), and then functional failures in the central nervous system and many internal organs occur.
Immunity is reduced, the child begins to painfully root, and the course of the disease is longer and severe.

Groups of children, most susceptible to RAHIT

Baby with the second blood group, mainly boys.
Children with overweight, large babies.
Premature babies.
Children living in large industrial cities, as well as the northern climatic zone and high-mountainous areas where fogs and rains and little clear sunny days are.
There is a genetic predisposition due to the characteristics of the enzymatic system at the Nero-shaped race.
Often and long-friendly children.
Babies born in autumn or winter.
Children on artificial feeding.

Rachita classification

Currently, several classifications of the disease are adopted.

Distinguish primary and secondary forms of the disease. The primary form is based on the lack of vitamin intake with food or the synthesis of its active forms. The secondary form of Rakhita develops as a result of a variety of pathological processes:

calcium suction disorder - Malabsorption syndromes;
fermentopathy;
long-term reception by a child of drugs, in particular anticonvulsant, diuretic and glucocorticoids;
parenteral nutrition.

Depending on the type of exchange violations, allocate:

rahit with calcium deficiency (calciumpenical);
rahit with phosphorus deficiency (phosphopopenic);
without changes in the level of calcium and phosphorus in the body.

By the nature of the course of the disease:

the acute form at which bone tissue is softened (osteomalacia) and the symptoms of the nervous system of the nervous system are expressed;
the shape for which the predominance of bone expanding processes are characterized by its vacuum;
recurrent (wave-like) Rahit, in which frequent relapses are observed after the acute form transferred.

By severity:

1 degree (light), its signs are characteristic of the initial period of the disease;
2 degree (moderate severity) - changes from the internal organs and the bone system are expressed moderately;
3 degree (severe current) - severe violations by domestic organs, nervous and bone systems, a pronounced lag of a child in psychomotor development, frequent appearance of complications.

In relation to vitamin D, Rakhit is divided into two types:

vitamin D dependent (happens I and II type);
vitamin D resistant (stable) - phosphate-diabetes, de Tony syndrome - Debre - Fanconi, hypophosphate, kidney tubular acidosis.

Symptoms of the disease

Rickets are clinically divided into several flow periods for which certain symptoms are characterized.

Initial period.

It occurs at the age of 2-3 months and lasts from 1.5 weeks to the month. At this time, parents begin to celebrate the appearance of the first symptoms:

changes in the usual behavior of the child: anxiety, bugs, shuddering with sharp and unexpected sounds, increased excitability;
decline in appetite;
the appearance of frequent joins and vomiting;
the child sleeps restlessly, often waking up;
face I. maspress part Heads often sweat, especially this is noticeable during feeding and sleep; Pot with an unpleasant sour smell, constantly annoying the skin, thereby causing itching and the peel;
because of the constant itching, the baby rubs his head about the pillow, hair rolling appears and the characteristic baldness of the head and temples appears;
there is a decrease in the muscle tone and the weakening of the ligament;
intestinal spasms, constipation or diarrhea;
anemia develops;
a seizures caused by a disadvantage of calcium in the body are possible;
stridor - noisy, whistling breathing;
pediatrician when ticking the seams and the edges of Big Rodnick notes their softness and compliance;
thickening appears on the ribs, reminiscent of rosary.

There are no pathology from the internal organs and systems of pathology.

Period of fusion of the disease

Usually accounts for 6-7 months of the child's life. The disease continues to step immediately in several directions. At the same time, a number of new symptoms appear.

Bone deformation:

the process of softening the bones is pronounced, it is especially noticeable if you try the seams and large spring;
there is a beveled, flat back (Craniotabes);
dolikhetiaphalia - the elongation of the bones of the skull;
asymmetric head shape that can resemble a square;
saddle nose;
changing the shape of the chest - "Chicken breast" or "Cilent" (forward), or "boobs of a shoemaker" (Pressure in the field of a sword-shaped process);
there is a curvature of the collar, the compaction of the chest with the simultaneous expansion of the book;
foot curvature - O-shaped or X-shaped (occurs less frequent) Bone deformation;
appears flatfoot;
pelvic bones are applied, the pelvis becomes narrow, "flat-core";
putting dumping and frontal bumps ("Olympic" forehead) can appear on the head ("Olympic" forehead), which are developing due to excessive growth of non-compliant bone tissue, but over time they disappear;
"Rachitical rosary" on the edges, thickening in the wrist offices ("Rachitic bracelets"), thickening the phalanx of the fingers ("Night pearls") is all the growing of bone tissue where it goes into cartilage;
when feeling there is a soreness of leg bones, sometimes the thickening of the knee joints occurs;
there is a spare at the level of the diaphragm - Harrison of Brozda;
with the intake, a large springkin is closed - in 1.5-2 years;
it is noted later and inconsistent teething, bite disruption, deformation of a solid sky and jaw arcs, defects of dental enamel.
rarely children have pathological fractures, household injuries;
dwarf.

Reducing the muscular tone and weakness of the ligament apparatus:

the kid does not turn into the stomach and back, does it reluctantly and sluggish;
does not want to sit down, even if they are supported by the handles;
due to the weakness of the abdominal wall in children, the lying position is observed as a symptom as a "frog abdomen", and often the abdominal muscles can diverge;
spinal curvature - Rachitic kyphosis;
there is a hyper-adjustment of the joints.

Children, sick Rickets, begin to keep their head late, sit and walk. The gait in the kids is unsure and unstable, the knees during walking are construed, the width of the step is sharply narrowed. The child often complains of fatigue and pain in the legs after walking.

From the side of the nervous system, the symptoms are aggravated by:

excitability and irritability increase;
the child is less likely to go, it is missing at all;
sleep troubled, intermittent;
children are poorly trained, sometimes even lose already acquired skills;
a pronounced red dermographism occurs on the skin - change the color of the skin after its mechanical irritation.

From the digestive tract:

the complete absence of appetite, and no longer intervals between feeding, nor small portions of food do not contribute to its excitation;
oxygen starvation arising from anemia leads to a decrease in the development of many of the enzymes necessary for normal digestion.

From the side of the blood, pronounced iron deficiency anemia is observed:

increased fatigue;
pallor skin;
drowsiness and lethargy.

It gives a failure of the immune system - children are more and harder to hurt.

With rickets, almost all organs and systems suffer from severe. The curvature of the chest and the weakness of the respiratory muscles leads to insufficient ventilation of the lungs and frequent pneumonia. There is an increase in the spleen and lymph nodes. Disorders in protein and fat exchange Substances, there is a lack of vitamins A, B, C and E, as well as micro and macroelements, especially copper, zinc and magnesium.

It is a severe degree of disease that most often leads to complications:

heart failure;
laryngospasm;
frequent cramps, tetania;
hypocalcemia.

Period of recovery

Comes to 3 years and is characterized by improving general status Child, the disappearance of neurological disorders and excessive sprouting of bone tissue. The child becomes active, easily turns out of the back on the stomach and back, it is better sitting or walks (depending on age). Pashes pain in the legs.

Unfortunately, muscle weakness and skeletal deformation disappear very slowly.

Some time, the level of calcium in the blood can be still reduced, and phosphorus, on the contrary, will be normal or even increased. Biochemical blood indicators confirm the transition of the disease into the inactive phase and the final period.

Period of residual phenomena

This stage of the disease is most often no longer, because Rahit is almost always flowing in a light form.

Forecast and consequences of Rakhita

In the midst of Rakhita, the child appears deformations of bones, in particular, o-shaped or X-shaped bends.

For early diagnosis and in a timely basis for the treatment of the disease prognosis is favorable. And only as severe course Rahita is possible some irreversible changes in the body:

low growth;
curvature of tubular bones;
violation of posture - kyphosis;
uneven teeth, incorrect bite;
defects of dental enamel, caries;
underdevelopment of skeletal muscles;
fermentopathy;
the narrowing of the pelvis in girls, which can lead to complications in childbirth.

Diagnosis of the disease

Most often, the diagnosis of rickets is based on a thorough collection of anamnesis and examination of the child, as well as clinical symptoms. But sometimes additional diagnostic measures can be appointed to determine the severity and period of the course of the disease:

clinical blood test shows a degree of anemia;
biochemical blood test determines the level of calcium, phosphorus, magnesium, creatinine, and alkaline phosphatase activity;
radiography of the leg and forearm with the wrist;
the level of metabolites vitamin D in the blood.

Treatment Rakhita

Treatment of the disease depends on the degree of severity and period, and is primarily aimed at eliminating causes. It must be long and complex.

Currently, specific and nonspecific treatment is applied.

Non-specific treatment includes a number of activities aimed at improving the overall condition of the body:

proper, full nutrition, breast-feeding or adapted mixtures, timely introduction of dust, and the first children are best to give vegetable puree from zucchini or broccoli;
conduct the correction of mother's nutrition if the child is on breastfeeding;
compliance with the child's day regime, respectively, its age;
long-term walks in fresh air with sufficient insolation, avoiding direct sunlight;
regular air ventilation and its maximum natural lighting;
mandatory daily activities medical gymnastics and a massage course;
air baths;
daily bathing in coniferous or herbal baths to calm the nervous system.

Specific therapy of Rahita is to appoint vitamin D, as well as drugs, which include calcium and phosphorus. Currently, there are many drugs containing vitamin D. But, in any case, they are prescribed only by the doctor, based on the state of the child. Doses are selected individually taking into account the severity of the disease. Usually, 2000-5000 IU (international units) are prescribed, the course is 30-45 days.

The most common drugs:

Aquadeurim - aqueous solution of vitamin D3. It is well absorbed, does not accumulate in the body and easily excreted by the kidneys. Suitable for both treatments and rakhita prevention.
Vigo, Vigantol, Devisol - Vitamin D oil solutions. They are hypoallergenic, suitable children with allergies to aquary. But they should not be given to babies, suffering from dysbacteriosis or having problems with suction.

After the end of the specific treatment, vitamin D drugs can be prescribed for prevention, but in significantly smaller doses. It is usually enough 400-500 meters per day, which give the baby for two years and on the third year of life in the autumn-winter period.

Prevention Rakhita

An important role in rakhita prevention plays breastfeeding.

Rahita prevention should be started long before the child's appearance, even during pregnancy. Therefore, all preventive measures are divided into two groups - before and after the birth of the kid.

During pregnancy, a woman needs to follow these rules:

full-fledged vitaminized nutrition;
long stay outdoors;
moderate physical exertion: special exercises for pregnant women with permission observing physician;
reception complex vitamin preparations throughout pregnancy, especially in the last trimester;
regular observation of doctors to prevent complications during and after delivery.

Rahita prevention in a child:

mandatory prophylactic intake of vitamin D, if the child was born in autumn or in winter (dose and drug appoints a doctor); The duration of the prevention rate is 3-5 months;
proper nutrition, optimally breastfeeding;
strict adherence to the day of the day;
long-term walks in the fresh air, avoiding direct sunlight on children's skin;
air baths;
daily bathing;
gymnastics;
conducting massage courses;
full nutrition of a nursing mother rich in vitamins; With the permission of a doctor, taking polyvitamin complexes.

Summary for parents

Rahit, like many other diseases, is much easier to prevent than cured. Carefully treat pediatricians, do not forget to give healthy The child appointed for a long term "droplets" - Vitamin D preparations. These "droplets" will maintain the health of your baby and get rid of it from Rahita - is sufficiently heavy as you have convinced illness.

To which doctor to turn

The treatment and prevention of Rahita conducts a pediatrician. With severe disorders from the musculoskeletal system, the counseling of the orthopedist is shown, with development iron deficiency anemia - Hematologist. In case the lack of vitamin D is associated with the intestinal disease, you should contact the gastroenterologist. Violation of the formation of jaws and teeth can be corrected by a dentist.

Dr. Eleonora Kapitonova tells about Rahit and its prevention:

Rahit - what to wait for him and how to warn

In order for the kid rose to healthy, physically strong, he must spend a lot of time in the fresh air, to fully eat. The healing effect of sunlight stimulates education in the skin of vitamin D necessary for the development of bones. Rickets more often sick babies, born in winter, when there are cloudy weather, as well as those who live in the northern regions. It is necessary to engage in the prevention of rickets in children. It is important not only to conduct hardening, massage, but also to ensure the replenishment in the body of a child lack of vitamin D, calcium and phosphorus.

Description of the disease
Forms of the disease
Severity

Causes of Rakhita

Avitaminosis during pregnancy
After birth
Other reasons

Symptoms and signs of Rakhita Diagnosis Rakhit Treatment

Specific therapy
Non-specific therapy
Auxiliary treatment with folk remedies

Rahita prevention in children

Description of the disease

Rickets are called the pathology of the development of bone tissue, associated with a lack of vitamin D. This substance contributes to the absorption of calcium and maintaining the calcium balance and phosphorus included in the bones. Rickets are mostly susceptible to children under the age of 2 years, but it is also found in adults. Danger for life This disease does not represent, but its consequences can be very heavy. The deformation of the skeleton (skull, ribs, limbs, spine), violation of the work of the internal organs, the backlog in mental and physical development is occurring. In girls, there is an improper formation of pelvic bones (the so-called flat-profile pelvis appears). Subsequently, this significantly complicates the flow of labor, makes the birth of a child in a natural way impossible.

Forms of the disease

The following forms of Rakhit are distinguished:

Acute. The disease occurs in the kids of the first months of life (especially in premature), which did not receive vitamin D additionally in the form of special drugs. Sometimes in such a form rickets in full children, which are fed mainly with a large content of carbohydrates (porridge, pasta, sweets). The manifestations of rickets at the same time (pain in the bones, weak muscle tone, deformation of the skeleton bones, the occurrence of fractures) are pronounced and quickly progress.
Tajection. "Osteoid hyperplasia" occurs - the formation of frontal and dark bugs, thickening of the wrists, the improper development of the ribs, the joints of the fingers and legs. Such a flow is observed in kids over 6 months, if prevention or treatment with the appearance of the first symptoms was insufficient.
Recurrent (wave-like) form. There are signs of rickets against the background of already existing manifestations of previously transferred disease.

Severity

Pathology proceeds with varying degrees of gravity.

1 degree (light). Start of change, the emergence of the first symptoms.

2 degree (moderate). Moderate changes in the bone system and internal organs appear.

3 degree (severe). There is a damage to bones, internal organs, nervous system, improper formation of the skull.

There are several types of diseases like rickets that can develop in older children. These include, for example, "phosphate-diabetes" - the lack of phosphorus in the bones. In this disease, a person has a low growth, curvature of bones, while he has a strong physique.

There is also a pseudodefinal rickets, which arises due to the inability of the body to absorb Vitamin D.

Video: Causes of Rakhit

Causes of Rakhita

The reasons for the appearance of Rakhita at the kid are:

lack of vitamin D in the body of his mother still during pregnancy;
insufficient receipt of nutrients in the body after birth;
violation of the absorption of vitamin D of the child's digestive system.

Avitaminosis during pregnancy

The lack of vitamin D in the body of a pregnant woman is formed due to improper nutrition, insufficient food use of products containing this vitamin, as well as calcium and phosphorus. It is them that make up the basis of bone tissue and are necessary for the proper formation of the skeleton and muscles of the future kid. Severe pregnancy, stay in a harmful environmental environment, smoking - these factors contribute to the emergence of avitaminosis, lack of vitamin D.

If pregnancy proceeds normally, the woman's nutrition was full, then the newborn is up to 1-2 months in the body there is a margin of these beneficial substances. Subsequently, its receipt is required with maternal milk or in the form of additives to milk mixtures. If the birth was premature, then useful substances do not have time to accumulate, the deficit arises from the moment of birth.

After birth

Factors provoking the emergence of rickets in infants are:

The lack of vitamin D in maternal milk due to the defective nutrition of the mother.
Feeding a child with low content of components required for the formation of bone and muscle tissues.
Too tight swaddling, restriction of kid's movements.
Use of anticonvulsant drugs.
Failleling baby with cow milk, which is poorly absorbed by his digestive system.
Later, the introduction of the feeding. After 6 months, it is necessary to gradually include vegetable, fruit, meat puree in the diet, as one maternal milk is not enough to replenish the reserve of vitamins and minerals. The formation of their deficit contributes to the predominance of KASH (manna, for example). Their consumption contributes to the removal of vitamin D from the intestines along with the faeces.
In children, older causing a rickets caused a lack of a diet of animal products, the predominance of plant food, from which the absorption of vitamin D is worse.
Insufficient toddler stay under the rays of the sun. Vitamin D is formed in the skin under the influence of ultraviolet radiation.

In the risk group, the emergence of Rakhit are premature children.

Other reasons

If the weight of the child at birth was large, then the need for its body in the beneficial substances is higher than in children with normal weight, therefore balanced nutrition has a special meaning for it. The risk of rakhita is raised in twins and twins. The lack of vitamin D, calcium and phosphorus occurs even during the period of intrauterine development, besides, as a rule, such children are born ahead of time.

Probably the emergence of Rahita congenital underdevelopment of the organs of the digestive system, under which the absorption of the useful components of food deteriorates. Calcium assimilation worsens in the presence of diseases thyroid gland. With dark kids, Rakhit happens more often than in the ceiling, since the development of vitamin d under the ultraviolet rays they are weaker.

Rahit's disease is more susceptible to children living in large cities with a rich air, poorly transmitting ultraviolet rays.

Note: Rahitis more often occurs in boys than girls, manifestations are usually heavier. In some families, there is a hereditary predisposition to rickets.

Symptoms and signs of Rakhita

The kids have an uncomplicated disease undergoing 4 development periods: the initial, period of gap, repair and recovery.

At the beginning of the disease, such manifestations are observed as the baldness of the nape, bad Son., increased irritability, softness bones around the spring. This period lasts from 2 weeks to 2 months.

During the period of ripping the disease, the bone curvature is observed, muscle weakness, poor teething, violation of psychomotor development. The period lasts 3-6 months.

Reparation arises as a result of a proper treatment. Pathological changes in the bones are stopped, the muscles are stronger, the signs of disorder of the nervous system disappear, after which the recovery comes.

The first signs for which the mother may notice the development of Rakhita in 1-2 month old, is the decline in his appetite (the feeding process becomes short). The kid sleeps badly, shudders from the slightest sound, sweats heavily in a dream. He has a bolt bald. Digestion is broken (diarrhea is replaced by constipation).

It is necessary to draw the attention of the children's physician to the appearance of such signs.

Symptoms of Rakhita in children appear within a few next monthsIf pathology starts progressing. In this case, the following happens:

the muscle tone is weakening, the baby becomes sluggish and inactive, can not hold the head, it sits badly, felling a lobby, can not turn over to the belly;
the child delabs the teething of the teething, the Spring rises late, it is difficult for him to climb the legs, he begins to walk late;
there is a bloating;
gradually progresses the deformation of the skull: the head becomes flat, the head is pulled in length, frontal bumps appear;
the legs become curves, the pelvis does not develop, the chest is incorrect;
the work of the internal organs deteriorates, signs of difficulty breathing, disorders appear heart Rhythm, the liver increases;
mental development occurs, mental disorders arise.

During the rank of disease, the child becomes noticeable trembling of hands and chin.

Diagnostics Rakhita

Signs of Rakhita, as a rule, do not cause doubts about the doctor. However, to confirm the diagnosis, the determination of the period of development of the disease and the degree of calcium deficiency in the body is carried out by urine analysis, the so-called "sulk sulkovich". Urine collected in the morning before the first feeding. If necessary, the urine analysis is carried out, allocated during the day, on the content of calcium and phosphorus.

Way biochemical analysis The concentration of calcium, phosphorus and vitamin d in blood is determined, the content of the enzyme in it required to absorb phosphorus ("alkaline phosphatase") is established.

The degree of deformation of bones and the state of internal organs is established using ultrasound and X-ray.

Treatment

To eliminate and facilitate the manifestations of Rakhit, specific and non-specific therapy is carried out. They must be started immediately after diagnosis.

Specific therapy

Therapy is carried out by vitamin D drugs in a dose corresponding to the period of development of the disease and the nature of the symptoms. Sulkovich's test is carried out 1 time in 7-10 days to control the course of treatment and adjust the dosage. If a tangible effect appears, then after 1-1.5 months, the dose is reduced.

For the prevention of relapses, the drug is adopted in a reduced dose to 2 years of age, and then before execution of 3 years - only in winter.

There are preparations of vitamin D dissolved in water, and drugs in the form of oil solutions. Water soluble vitamin D digested by the body better and longer delayed in the liver, showing its activity. Oil preparations (Devisol, Video) are more often appointed in cases where the baby has a tendency to constipate.

The main drug in Rakhit's therapy in kids is aquadeurim. The dose is selected individually for each child to avoid the occurrence of side effects.

A course of ultraviolet irradiation with a gradual increase in dose is carried out. This stimulates education in the body of its own vitamin D and improves its suction.

Video: The first signs of Rakhita

Non-specific therapy

It is carried out to improve the absorption of calcium in the child's body by restoring acid-alkaline balance. For this purpose, a citrate mixture (aqueous solution of sodium citrate) and dimfosphon are used. To improve the metabolism, the orotat potassium is given.

For reduced content Calcium in the blood is assigned to the reception of calcium gluconate and its other drugs. To strengthen the body, therapy is carried out by vitamins C and group B. In the presence of anemia, the reception of iron preparations (Malto, Tardiferon) are prescribed.

Medicated baths are used. A special massage and therapeutic gymnastics are carried out.

It is recommended to increase the duration of the outdoor walks, as well as make adjustments to the nutrition of the child, include egg yolk yolks, cottage cheese and other products with elevated calcium and phosphorus in the diet. When treating infants, it is recommended to reduce the use of porridge, introduce adhesive, catching the baby to vegetable and meat puree.

Auxiliary treatment with folk remedies

When the first signs of developing Rakhita, the kid is useful to bathe it in salted water or with the addition of coniferous bravery. Conifer baths are used to calm the nervous system of the child. For its preparation in warm water, a coniferous extract is poured (1 teaspoon per 1 liter of water). The child is placed in the bath for 10-15 minutes.

Swimming in salted water is carried out if the child is sluggish. Used cooking or sea \u200b\u200bsalt At the rate of 2 tbsp. l. on 10 liters of water. After the bath, it is necessary to wash off the salt, toddling with clean water.

To replenish calcium deficiency, you can prepare a composition of a fine egg shell, a glass of lemon juice and 1 cup of water. Give medicine after eating.

Rahita prevention in children

To prevent the development of Rakhita, the child needs to take care before his birth. During pregnancy, women should take vitamins (for example, Gends) to replenish the deficit of useful elements, which inevitably arises due to the increased need associated with the growth of the fetus. It is important to take vitamin D in tablets in the last 2 months before childbirth, especially if a woman lives in areas where summer is short, or the child should be born in the autumn-winter period. Reception of the drug is carried out strictly in doses assigned to the doctor, as the excess of vitamin D is also harmful for the future child, as well as its flaw.

A pregnant woman must fully feed, spend a lot of time in the fresh air under the influence of ultraviolet emitted by the Sun, avoid infectious diseases and colds, regularly donate the necessary tests.

After the birth of a child, it is necessary to strive to keep the possibility of feeding it with full-fledged breast milk at least for 5-8 months. From 6 months it is necessary to begin the feeding, gradually introducing in a diet of nitamined food, rich in calcium, phosphorus (egg yolks, liver, meat, butter).

If necessary, the pediatrician prescribes children in the risk group, preventive reception of fish oil or drugs with vitamin D.

Video: Recommendations of doctors about the detection and treatment of rickets

Pretty common in pediatric practice It is a diagnosis of rickets in children. The incidence depends on the socio-economic and cultural level of the population, hygienic living conditions, feeding the child, genetic predisposition. What is the essence of pathology? How long is it longer and dangerous to the health of the child? And what needs to be done to avoid this disease? We will understand everything in order.

Pathogenesis

As a result of the impairment of mineral metabolism, primarily phosphorous calcium, the proper formation of the skeleton is disturbed and the function of internal organs and integer systems changes.

Many know that in the pathogenesis of Rakhit's development, the lack of vitamin D plays a decisive role. But not everyone is informed that the deficiency of calciferol in food, but a violation of the synthesis of metabolites of vitamin D in the epidermis and skin capillaries leads to the development of such a disease as Rahit.

It is active metabolites that contribute to the best suction of calcium and phosphorus in the digestive tract, block excessive selection of these elements with urine, catalyzing the synthesis of calcium binding protein. And the most important thing is to stimulate the "embedding" calcium into bone tissue.

But other vitamins are also necessary for the normal development of bone tissue. So lack of vitamins A and B1 leads to the development of osteoporosis. Vitamin C contributes to the best absorption of calciferol and enhances its action. Therefore, the cause of Rakhit is actually polyhypovitaminosis.

The same applies to trace elements. Not only calcium and phosphorus deficiency leads to a disease, although it is a leading pathogenetic factor. Children develop rickets and with a concomitant lack of zinc, iron, cobalt, copper and magnesium.

The essence of the disease

The lack of calcium directly in the bones leads to their softening. As a result, the bone load is deformed. This situation is not dangerous in general for the vital activity. But from the lack of microelements in the blood also suffer from other organs and systems: cardiovascular, nervous.
Against the background of mineral imbalance, bacterial and fungal infections are joined. Therefore, the body is trying to level the level of calcium and phosphorus in the blood and by means of the enhanced function of the parachitoid glands their bones. It further aggravates the condition of bone tissue.

Ultimately, hypovitaminosis D leads to the disorder of other types of exchange: protein, carbohydrate and fat.

Causes and Rachitogenic factors

The development of the disease contributes to the insufficient synthesis of vitamin D and its metabolites, as well as an exogenous calcium deficiency and its excessive selection.

Vitamin D is synthesized under the influence of ultravioletTherefore, insalation can lead to its deficit in the body. This is mainly related to children living in areas with insufficient insolation. Also, pathology can develop in children who are contraindicated in the sun. Although the 10-minute stay in the sun, even in clothing is enough to synthesize vitamin D in the amount of daily need.
Insufficient flow of calcium from outside is associated with defective nutrition of both a pregnant woman and a child. Intensive bone occasion of bone tissue occurs in the last months of pregnancy. Therefore, a greater risk of getting rickets - in premature newborns. During the first two months of life, calcium received from the blood of the mother during the first two months of life. Then, due to intense growth, its reserves are depleted. Unbalanced artificial or feeding with cow milk, late lures contribute to the deficiency of exogenous calcium.
The absorption disorder in the digestive tract is due to the immaturity of the enzyme system, perverted by binding with phytinic or oxalic acid into persistent compounds, disease of the stomach, intestines, liver, obstruction of bile ducts.
The massive excretion of calcium through the gastrointestinal discharge occurs at a steamer ("fat" chair), through the kidneys - with nephrological diseases and the same disadvantage of vitamin D.

Diagnostics

The leading role in the diagnostic search is played by symptoms of rickets, radiographic examination of tubular bones, blood tests and urine for trace elements and enzymes, setting in children Sulkovich samples (determining the level of calcium in the urine).

Clinical and laboratory studies are necessary to eliminate diseases with similar changes in the skeleton: tuberculous spondylitis, congenital dysplasia of hip joints, hyondrodstrophy, hypothyroidism, congenital syphilis, Down disease.

Symptoms of the disease

The appearance and intensity of symptoms depends on the period of Rakhit, the severity of the process and the nature of the flow. In this regard, there are 3 working classifications of the disease.

By periods:

reconciliation;
residual phenomena.

By severity:

easy (I) - weakly pronounced changes of the side of the nervous and bone systems;
average (II) - moderate signs of damage to nervous, muscular and bone systems, increase in liver and spleen;
heavy (III) - a bright clinical picture with the deformation of bones, the separation of joints, muscle hypotension, increasing liver and spleen, involvement in the process of cardiovascular, respiratory and digestive systems.

By the nature of the flow:

acute (phenomena of softening and deformation of bone tissue are dominated - signs of rickets in infants);
subacute (characterized by bone hyperplasia with the formation of tubercles and nodes);
recurient flow (Periodic change of acute and subacute flow).

From two months of the child's life, when calcium reserves are depleted, diagnose the initial period of Rakhita. First there are changes from the vegetative nervous system: anxiety, poor sleep, increased sweating (especially heads), excessive vasomotor skin sensitivity.

Approximately a month later, changes in bone tissue are joined, which indicates the beginning of the sickness of the disease.

Important! With rickets, the entire skeleton is affected, but above all those bones that are growing most intensively in this age period. Therefore, according to bone deformations, one can judge the time of the appearance of the disease. Usually all Rakhit's bone symptoms in children have time to develop up to the year.

The deformation of the bones of the skull occurs in the first 3 months of life, the body and chest - from the third on the sixth, and the limbs - in the second half of the year.

With rickets in babies, the rear springs soften, and the edges of the front - become soft.
The flat bones of the skulls are softened, which can be fed when pressing, and then return to the previous position (Craniotabes). As a result of the uneven distribution of pressure on the head (with constant lying on the back or side), the deformation of the skull is developing - flat heads, asymmetry of the head. For balancing intracranial pressure, frontal and dark bugs increase, which gives the head square shape.

Photo: Cranics Without with rickets in children, changes in the chest in the acute period are characterized by the softening of the ribs with the appearance of lateral presses, transverse deepening corresponding to the attachment of the diaphragm. At the same time, the yard protrudes in the form of a keel, and the moving process is pressed. This is quite frequent symptoms of rickets in infants. In the future, kyphosis or scoliosis is possible. In the subacute period in the field of breast-ripe compounds appear thickening - rosary.

The bones of the limbs and the pelvis are involved in the process. For acute flow, the curvature of long bones is characterized, mainly legs (O-shaped or X-shaped deformations), as well as the pelvis (flat rachitic pelvis). In the subacute period in the field of epiphysses, "Rachitic bracelets" (or "pearl threads" are formed).

Simultaneously with the lesion of the bone skeleton, muscle hypotension develops, which leads to the separation of the joints, an increase in the motor range in them, the molding of the abdomen ("frog abdomen").

During the reconnaissance period, the main symptoms subside: The work of the nervous system is restored, the bones are compacted, their deformation decreases, the exchange processes are normalized.

With a timely manner and adequate treatment, signs of Rakhita in children disappear after the year. After the moderate or severe rickets, bone deformations, enlarged liver and spleen can remain.

Rare forms

Congenital Rakhitdevelops intrauterine. It is due to defective nutrition, hypovitaminosis, the pathology of the endocrine or bone system of a pregnant woman. Especially if the listed problems arose in the third trimester. The child is born with everyone clinical manifestations Rakhita.
Late Rakhit - In essence, progression or aggravation of the process in children is 5 years. It is manifested by a decrease in appetite, increased sweating, deformation and legs in the legs, which is accompanied by anemia.

Did you know? The averages are most often sick of children up to the year, less often - up to 2 years, and very rare - for 3-4 years of life.

Treatment

Nonspecific treatment includes:

diet and therapy (food correction, fresh juices, boiled vegetables 1 month earlier than the laid, liver, meat, yolk);
active motor mode, air baths;
massage and therapeutic physical culture;
medical baths (salt, needles);
thermal procedures (paraffin applications, sand heating).

Specific treatment Based on the introduction of vitamin D under the control of the calcium content in the blood and the urine. How to treat Rickets drugs, only a doctor knows who individually selects the dosage of medicines, depending on the Rahita clinic. In addition to ergocalciferol, other vitamins are prescribed, as well as ATP, Dibazole. Calcium preparations are shown only in the acute period.

After the end of the specific therapy is prescribed a citrate mixture for a month, and then 2 courses of irradiation with ultraviolet with an interval per month.

Prevention

Similar to treatment, the prevention of children's rickets consists of non-specific and specific methods.

In the antenatal period it is - rational full-fledged food of a pregnant woman, its motor activity and stay in the fresh air. Of specific methods - ultraviolet irradiation and artificial vitaminization in the last trimester.
In the postnatal period - Massage and gymnastics, air baths, breastfeeding or feeding with adapted mixtures, timely and full (by age) lures. As a specific prevention of premature children in 2 weeks after birth, an ergocalciferol course is prescribed, then a citrate mixture, and finally exposure to ultraviolet. In the ended children, such specific events begin 1 month after birth. If the mixtures are rich in vitamins, the dose of ergocalciferol is reduced by half.

Video about the right massage

One of the important methods of treating Rakhit is a common body massage. But it is necessary to know the sequence of massage movements and their strength. The video will tell about all the intricacies of therapeutic massage in children.

Under the regime of planned pediatric examinations, the doctor will identify the symptoms of rickets in children and prescribe appropriate treatment. Do not ignore hiking in the clinic - and everything will be fine with you! Have you come across the problem of Rahita in your family? Did you conduct the antenatal prevention of hypovitaminosis D? It will be very interesting for us to learn from your comments.