Rachet treatment after 2 years. Causes and factors of development of rickets in children

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 state lead different reasonsCaller 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 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 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 various substances From food, often leads to the formation of various deficient 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 intrauterine development Often the reason for 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 changing it 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.

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 Rakhita: Pressure or blowing the bottom 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.

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 will help to avoid the development of remote complications and will help return the kid 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, you can identify specific features for Rakhita: "Rachitic bracelets", pathological curvatures spinal column, "Rachitical rosary", the pathology of the chest, bone seals in the 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 mandatory Rehabilitation events. To frequent consequences of Rakhita transferred to childhoodThese include: a moderate reduction in muscle tone, small curvature of the lower extremities, an incorrect bite and others.

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 daily diet The baby 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 sun ray And only a small part of it enters the body with food.

• Promotes calcium transportation through the intestinal wall.
• Enhances the holding of calcium and phosphorus ions in kidney tubulesthat prevents their excessive losses in the body.
• Promotes accelerated impregnation of bone tissue minerals, that is, strengthens the bones.
• 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 intestines are absorbed by calcium, the necessary organism for the normal formation of bone tissue, full-fledged work 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:

1. 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.

1. 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;
• incompute food 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.

1. 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.

1. 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.

1. 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).

1. 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.
• because of reduced level Calcium in blood porish-shaped glands They begin to actively develop the parathgoron, 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.
• 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.

1. 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;
• the face and the sickness of the head 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 muscle tone and weakening binder apparatus;
• 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.

1. 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 suggest, 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.

Gives failure the immune system - Children are more and harder.

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 the protein and fat metabolism of substances occur, 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.

1. 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.

1. 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.

With early diagnosis and timely treatment, the forecast of the disease 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-fledged nutrition, breastfeeding or adapted mixtures, timely administration of the feeding, and the first children are best possible to give a 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 studies of therapeutic gymnastics and massage courses;
• 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 medicinescontaining vitamin D. But, in any case, they are appointed only by the doctor, based on the child's condition. 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 exercise: Special exercises for pregnant women with permission observing physician;
• reception of 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 consultation of the orthopedist is shown, with the development of 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:

1. 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 special preparations. 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.
2. 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.
3. Recurrent (wave-like) form. There are signs of rickets on the background already existing manifestations Transferred previously 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 appear in bone system and internal organs.

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 arrival useful substances in the body after birth;
• violation of Vitamin D digestive system Child.

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:

1. The lack of vitamin D in maternal milk due to the defective nutrition of the mother.
2. Feeding a child with low content of components required for the formation of bone and muscle tissues.
3. Too tight swaddling, restriction of kid's movements.
4. Use of anticonvulsant drugs.
5. Failleling baby with cow milk, which is poorly absorbed by his digestive system.
6. 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.
7. Children are older causes a rakhita disease in the diet of animal products, predominance vegetable foodFrom which the absorption of vitamin D is worse.
8. 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.

Contribute to the emergence of Rakhit congenital underdevelopment of the organs of the digestive system, under which the assimilation deteriorates useful components Food. 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 baldness of the nape, poor sleep, increased irritability, softness of 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.

The symptoms of Rakhita in children appear over the next few months if pathology will begin to progress. 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, heart rate disorders, 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.

By biochemical analysis, the concentration of calcium, phosphorus and vitamin d 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 oil solutions. Water soluble vitamin D is absorbed by the organism 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.

With a reduced content of calcium in the blood, the reception of calcium gluconate and other drugs is assigned. 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. Conducted special massage and physiotherapy.

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 on 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. The cook or sea salt is used 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 fine egg shells, a glass of glass lemon juice and 1 glasses 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.

Pregnant woman should eat fully, spend a lot of time on the outdoor air under the influence of ultraviolet emitted by the Sun, avoid infectious diseases and colds, regularly donate the necessary analyzes.

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 . 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 the symptoms of Rakhita, x-ray examination 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: tuberculosis spondylitis, congenital dysplasia hip joints, Hondrodastrophiya, hypothyroidism, congenital syphilis, Dauna 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) - 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 all the clinical manifestations of 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, as well as ATP, Dibazole are prescribed. 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. From 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 specific prophylaxis Premature children 2 weeks after birth appoint an ergocalciferol course, then a citrate mixture, and finally - ultraviolet irradiation. 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 important methods Rahit treatment 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.

In this article:

Rickets in babies develops due to lack of vitamin D in the body. The priority changes affect the bone and nervous systems. The disease is known from the II century to our era. In ancient portraits, they portrayed children who had smoothed outlet bones, abrupt arcs in the form of hanging rollers, curved hands and feet, as well as a belly having a splaspling form.

To date, pathology has widespread: more than 20% of children, and in some countries this figure reaches 60%, have a diagnosed diagnosis. Children living in the northern regions are falling into the risk group, where there are not enough sunny days a year, and major cities With the developed industry, because there is a high level of air pollution by exhaust gases and other waste.

Classification

There are several systematization of such a disease as rickets in children, each of which indicates the characteristics of the flow, stage and etiology of the disease.

With respect to vitamin D, vitamine-deficient and vitaminoresistant forms are isolated. In the first group, those patients in whom pathology is caused by a disadvantage of this substance, and to eliminate disorders, it is sufficient to receive drugs containing vitamin D in the therapeutic dosage.

The second group includes kids who receive standard dosages does not give effect, and recovery is possible only when using vitamin in quantity, several times higher than it.

In the classification of Rakhita in children in the stages allocate:

• period of the beginning of the disease;
• the midst of the disease;
• recovery;
• stage of residual manifestations.

Degree of rickets in children in the severity of the flow:

1. Easy - The symptoms are poorly pronounced, minor disorders are noted on the part of the bone-muscular apparatus and the nervous system.
2. Average - pronounced disorders of the skeleton and innervation of the limbs, there are deviations in the functioning of the cardiovascular and respiratory system, failures in the work of the gastrointestinal tract.
3. Heavy - High degree of pathological changes in all systems and organs that provide normal life.

By the nature of the course, Rakhit happens:

• sharp;
• subacute;
• recurrent.

The reasons

Rahit in newborns and children up to 1 year inozskayt because of insufficient synthesis of calciferol in the body. Vitamin D is able to assimilate from food and maternal milk, and can also be formed in skin cells under the influence of sunlight or ultraviolet rays. In violation of the intake of the substance, the disease develops. Vitamin failure distorts calcium-phosphorus exchange, which negatively affects the state of the bone system.

The reasons for the occurrence of Rakhita include the following:

• the low nutritional value of food, which contains a small amount of calciferol;
• lack of ultraviolet rays (accommodation in the north, rare walks);
• pathological processes in the intestine, due to which a violation of the absorption of vitamins occurs;
• endogenous causes, among which diseases of the liver and kidney, disturbing the absorption of calciferol;
• feeding the newborn with non-adapted mixtures, where the correct ratio of useful elements is not met;
• continuous use of anticonvulsant medicines.

Often Rahit is diagnosed in children born, because the bookmark and formation of the bone skeleton occurs during the period of intrauterine development.

Symptoms

Rahit is usually found like young children up to a year, so after the year. The first changes are detected at the age of 1-2 months after birth.

First of all, the changes affect the nervous system:

• sleeping is broken, the mode of wakefulness and night rest changes;
• there is irritability, a plasticity;
• the kid eats badly, refuses or, does not eat the required norm, and the feeding process is stretched for a long time;
• there are violations of the chair, without visible, the causes appear diarrhea or;
• there is an increased sweating;
• developed baldness on the back of the head.

The last two symptoms are closely interrelated. During night sleep, a child has increased sweating, which is why the wet plot (wet spot syndrome) is formed on the pillow). The kid often turns his head, as sweat leads to the appearance unpleasant sensations and skin itchWhat is why the hair on the back of the head is wiping away.

After a couple of weeks, others join the listed symptoms. A bright sign of Rakhita in kids is a reduced muscular tone, as well as the "frog" belly - he is as if attached to something heavy, which is why he accepted such a form. The symptoms of the disease belongs to the delay in teething, late ingroup of the spring, deformation of legs and hands, change the shape of the head.

Diagnostics

Set the presence of rickets in kids is often not difficult, since pathology has characteristic external manifestations. In the first stages, neurological disorders appear, after which violations occur in bone apparatus. It is at this time most of the moms and turn to the pediatrician.

In order to reliably determine the diagnosis and determine the degree of failure of calciferol, it is necessary to pass tests for the content of calcium, phosphorus and vitamin D in the body.

The norm of these substances consider the following indicators:

1. Calcium - 2.5-2.7 mmol, if the value is lowered below two, then in this case they say the presence of rickets.
2. Phosphorus is the normal magnitude of the microelement in the blood - from 1.3 to 2.6. For heavy forms Diseases this indicator Capably decreases to 0.6 mmol.

Another reliable way to determine the presence of rickets in a child in 1-3 years is a radiograph. It shows the deformation of the skeleton and the level of bone mineralization. You can more accurately consider developing violations using computed tomography.

What is dangerous Rahit?

If you do notice the treatment of the disease in a timely manner, the signs of the launched Rakhita can be observed even in children of 5 years and older. Pathology disrupts the shape of the skull, spine, limbs, as well as chest.

Bone Violations are manifested at high age:

1. Rachitic rosary - plots of thickening at the ends of the ribs.
2. "Olympic" forehead - frontal and dark bugs increase in size, which is why the head acquires the form of Cuba.
3. The deformed pelvic bones in girls will bring problems when carrying pregnancy and childbirth.
4. The depressed lower third of the sternum interferes with full breathing.
5. Foot curves in the form of the Latin letter "X" violate the gait and create an additional burden on the hip joints.

Treatment

The treatment of rickets in early childhood consists of specific and nonspecific methods. The first group refers to the reception of calcium and vitamin D. Dosage of medicines is determined individually, depending on the degree of insufficiency of substances and the level of demineralization of the bone skeleton according to laboratory tests. Even after lifting the concentration of calciferol, Vitamin D must be taken in preventive purposes for several more months.

Nonspecific therapy is as follows:

• establishing breastfeeding or selection of high-quality adapted mixing mixture;
• regular walks in the fresh air;
• gymnastic exercises;
• solar baths;
• massage;
• harding procedures;
• treatment of concomitant diseases.

The most commonly found rickets in children. Such a violation does not allow the child to move fully, and at the started states, it does not even allow him to go. Therefore, it is so important in the early stages to pass appropriate treatment. Fix the curvature of the legs with rickets in a child can be up to 4 years of life, after this attempt may not bring the desired result.

Complications

In the absence of therapeutic correction of the content of calciferol in the body, further aggravation of the disease occurs. In this case, the violations affect the internal organs and malfunctions are made into their operation.

The following symptoms arise:

• pain in the abdominal cavity;
• student vomiting and tightening after meals;
• pallor skin;
• hepatomegaly;
• stool violations.

Rahit is a frequent reason that the baby cannot hold his head independently, much later, the peers begins to sit and move. If Rakhit appears in a child in 1 or 2 years, then there is a risk that such a baby may not learn to walk. That is why it should be engaged timely treatment Vitamin deficiency, because severe consequences of the disease will remain for life. Rickets in a child appearing after 4 years leads to flatopy and scoliosis, and sometimes even causes myopia.

Effects

What is rickets in a child? In late detection and treatment of the disease has a negative impact on the development of the baby and the state of its health in the future.

The child is threatened:

• disruption of the relationship of the jaws;
• frequent tendency to infectious diseases;
• convulsive syndrome due to lack of calcium and magnesium;
• spazm larynx;
• osteoporosis.

Prevention

A complex of preventive measures aimed at preventing such a childhood disease, as Rahit, consists of events held during pregnancy and after the child's birth.

Intrauterine prophylaxis:

• comprehensive balanced diet;
• consumption of vitamin preparations;
• walking in the fresh air under the sunny rays;
• gymnastics for pregnant women.

After the birth of the baby follows:

• organize proper feeding;
• give vitamin D in drops;
• observe the day of the day;
• organize a daily sleep or walking on the street;
• making a massage and exercise.

The most important place in the warning of Rakhita plays the feeding of the baby with maternal milk at least to the six-month age. Rahit refers to those pathologies that it is easier to warn than in the subsequent to correct violations in the work of the body.

Useful video about what rickets are

Since non-suffering children practically does not happen, parents have to face different pathologies. One of the dangerous states for infants is rickets, and what it is, moms and dads do not fully understand. Often the disease is associated with a depleted child, whose tummy is reproached, and the handles and legs are thinned and weakened. Indeed, such signs indicate the development of Rahita, but the clinical picture of pathology can be more extensive.

The concept of rickets in children

Rahit is not a disease of a particular organ or system. The doctors consider it as a complex of metabolic disorders due to the deficit of the useful substances. Signs of deviations appear on the background lack of vitamin D. - Chief Member of Phosphorous Calcium Exchange. The correctness of the formation of the kostomuscular apparatus of children depends on its quantity.

Why do the kids under a year there are metabolic malfunctions? The reasons of the anomalies are several:

1. Ethrenal nutrition of a woman who has a baby. Food depleted by calcium and vitamin D is useless for pregnant and fetus.
2. Premature childbirth. A significant dose of Kroch calcium receives in the last weeks of intrauterine development. Early appearance on the light does not allow it to get the desired substance fully.
3. Birth in the cold season or in the northern regions. The lack of natural ultraviolet causes rickets in infants. Small residents warm countries suffer pathology less often.
4. Incorrect feeding. Early translation on the mixture, redundant or insufficient food intake causes a distortion of metabolism and impoverish the body with vitamins.
5. Bad ecology. Accommodation of infants in megalopolis and areas with an increased concentration of pollution, as well as long stay in the zones of harsh climate, is fraught with a deficit of "vitamin of sunlight".
6. Violation of metabolism of congenital character. Incorrect course of processes responsible for the absorption of vitamins and minerals provokes the development of certain diseases and affects the balance of beneficial substances.

How the lack of vitamins is expressed

In the period of the newborn, the signs of rickets are usually absent. Its first manifestation of parents can notice for 3-4 months of the baby, when the body of the formation of bones is activated in the body. "British disease" in children under the age of year proceeds in several stages.

At the 1st stage, parents notice changes in the behavior of crumbs. He worries and annoyed without reason either, on the contrary, becomes sluggish and indifferent. The baby sweats richly and suffers from itching. In trying to get rid of discomfort, he can turn his head and rub it about the pillow, which leads to abrasion of the hair on the back of the head.

But these symptoms are not yet direct evidence of the development of the disease. Often they are associated with the finding of children in dry hot conditions causing sweating and anxiety. The shoulders appear due to the fact that excessively active child I am pleased to turn your head. Nevertheless, it is not worth relaxing to parents. Baby need to show pediatrician and pass tests.

With a negligence of the child, signs of avitaminosis are aggravated closer to 8 months. Rachit takes the form of moderate gravity and shows characteristic symptoms:

• spring does not shrink or expand;
• disproportionately increases and sweats the head;
• forehead and tummy become convex;
• the baby can not sit and crawl due to the weakness of the muscles;
• the rapid growth of the lower edges and the sealing of bones on the wrists (this state of the doctors is called "clear").

At stage II, the treatment of children must begin as soon as possible. But if parents continue to ignore the symptoms of Rachitism, until 1 year, the disease takes a protracted turnover and develops into the III degree. Now the signs of avitaminosis will be observed even more clearly and additional anomalies will join them:

1. thoracic deformations;
2. curvature of the legs (O-shaped or X-shaped);
3. disproportionality of the head and body;
4. brake of the psyche and weakness of motor skills.

In premature children, all listed symptoms appear on the basis of unfavorable intrauterine development. Their body weight and so small, but because of bad conditions in the maternal womb and weak mineralization of bones, the weight deficit cannot be corrected from birth to the end of the first year of life.

The danger of rickets for children health

Late to control the state of Rachitism or his incorrect treatment Dangerous for kids with pathological changes. So, soft bone tissue distorts significant parts of the skeleton - spine, cranial box, hips, shin and ribs. In adult life, the consequences of Rakhit are fully felt girls who have difficulties in childbirth. They are explained by the deformation of the bones of a small pelvis and concomitant underdevelopment of reproductive organs.

The late treatment of rickets is fraught with female patients with infertility or complex childbirth, if the conception still occurs. The physical development of children, whether girls or boys are noticeably lagging behind. Mental abilities suffer slightly, but in the later stages Rahit does not allow kids to attend training organizations.

Rachitic state correction

Pediatrician treatment assigns according to the results of the survey. Diagnose deviation help:

• urine analysis on Sulkovsky, which reveals the degree of loss of calcium;
• biochemical blood test, which determines the phosphorus and calcium content.

If the analyzes confirmed the external symptoms of Rachitism, the parents should not panic - adequate therapy is able to fully establish the health of the kid. For the correction of the figure, the treatment is carried out by optimal doses of vitamin D, more specifically - ergocalciferol (D2). Its children are given in the form of oil and aqueous solutions (Wigantol, aquarebel). The second type of medication is considered more efficient, because in oil the substance is absorbed worse. Difficult processing causes failures in the work of the gastrointestinal tract.

Cholecalciferol (D3) with sufficient staying on the Sun is produced by the body independently. Getting it allows prevention in the form of air baths. The substance improves the absorption of phosphorus and calcium and contributes to the normal construction of the skeleton. His shortage is replenished by food animal origin, the vegetable products of D3 do not contain.

Calcium preparations are rapidly absorbed by the digestive system of even those children who suffer allergies or have the problems of the gastrointestinal tract. Accurate dosage Medications allows the child to receive about 500 meters from each drop.

Patients age up to a year therapy begins with 4 drops with a gradual increase of up to 10 per day. High dosages of Rachitichny kid are needed when symptoms show pronounced bone changes.

The average course of therapy is designed for 30 - 45 days, after which prevention begins (1 - 2 drops of medicine per day).

Reception of drops are supported by the use of phosphorus and citric acid preparations - it is needed for better absorption of calcium in the intestine. Avitaminosis symptoms eliminate UV lamp irradiation and natural solar baths. While therapy is carried out, they will be useful, we will have hardware, walks, exercises of therapeutic physical education, massages and salt baths.

Rahit is a disease of children up to three years, associated with a disadvantage of vitamin D, in which phosphorous calcium exchange is disturbed and a specific lesion of bone tissue occurs. Rahit is the state of the growing organism, since changes occur in the growth zones. It is very important to put the correct diagnosis on time (in the early stages of the symptoms of Rakhita similar to the symptoms of intestinal suction disorders, phosphate-diabetes, de Tony-Debrea-Debrea) and begin treatment, since some violations in the bone structure and the changes in the internal organs may be preserved for life .

What are the signs of rickets in children?

At the initial stage, Rahit is striking the nervous system, and the first signs may arise from a child at the age of two or three months. Most often it is sleep disorders, irritability, plasticity, frequent shudding, poor appetite, large springs, increased sweating, butterciphel. If it does not take action on time, the kid can begin violations in bone tissue, softening the bones of the skull and, as a result, the formulation of the head, seals on the rhyres (so-called "Rachitical rosages") and wrists ("Rakhitic bracelets"), curvatical The spine ("Rachitic hump"), chest, pelvis and legs (x and o-shaped), develop flatfoot and incorrect bite.

What is dangerous Rahit?

With the unfolded form of Rahita, a retreat of psychomotor development is possible - the child late begins to turn over, crawl, sit, walk. Also often marked the weakness of the muscles ("frog abdomen"), increased mobility in the joints, later teething. It is possible to reduce immunity and resistance to diseases. IN launched stages Rahit can lead to violation of the functions of internal organs - liver, lungs, heart, gastrointestinal tract. Some changes in the bones can be saved for a very long time or even stay for life.

What tests must be passed to establish a diagnosis?

As a rule, "Rakhit" is diagnosed with a child inspecting. Sometimes the doctor prescribes additional analyzes. In some cases, a biochemical blood test is carried out (with rickets, alkaline phosphatase increases, the level of phosphorus, less frequently calcium decreases). The urine analysis on Sulkovich is practically not used now. Radiography of the bones of the skeleton is carried out with rashita's rashita treatment, and non-treatable forms (hereditary forms of D-dependent and D-resistant forms of Rakhit; if these diseases are suspected another number of additional biochemical samples).

How to protect the child from Rahita?

Starting the prevention of Rakhita should already during pregnancy. Future mom Must walk every day, take multivitamins. The cause of congenital rickets in the child can be late toxicosis in mom. The prophylactic measures against rickets include daily walks, regular gymnastics, massage, swimming, timely administration. For children over 6 months, baths with sea salt will be useful. Preventive reception Vitamin D or other polyvitamins it is better to start only after consulting a pediatrician - it is especially important for children-artificials, since most milk mixtures contain vitamin D.

How to treat rickets in a child?

The treatment of Rakhita must necessarily be complex - specific (drug) and non-specific (properly organized mode of day, walk, long, proper nutrition, massage and swimming). As a first dust for children who are ill rickets, a vegetable puree is recommended (from six months) with subsequent addition to it with egg yolk (with seven-eight months). It is necessary to limit the amount of flour products, as they worsen the suction of calcium in the intestine. The specific treatment of rickets is the purpose of vitamin D, as well as calcium and phosphorus preparations. Calculate the dosage and duration of reception can only children's doctor. Incorrectly selected dosage can lead to hypervitaminosis D, which is also a severe disease.

Is it possible to make vaccinations when rickets?

All vaccinations when rickets can do.

What are the main causes of rickets?

Pathology of pregnancy, improper, lack of the sun, presence, a large mass of the child's body at birth, multiple pregnancy, artificial feeding, later or improper administration of dust, hereditary predisposition.

What products contain vitamin D?

Vitamin D is contained in dairy products, butter, fish oil, egg yolk, vegetable oil, liver, wheat sprouts, nuts and other products. In the human body, vitamin D is produced naturally under the influence of sunlight.

Rahit is a disease in which a disruption of the musculoskeletal system occurs against the background of the lack of vitamin D. Rahit, the symptoms of which are also caused by a violation of phosphorus and calcium metabolism, is accompanied, in addition to the violation of the growth of bones. Despite the fact that death is not a fatal disease, it, meanwhile, provokes the development of irreversible deformation, which the skeleton of a sick child is subject to a "children's" disease), and also contributes to a significant braking of a number of processes related to its development .

general description

Disturbance in Rachet in particular concerns the physical condition of the growing body of the child and the state of mental. Moreover, against the background of Rakhita also increases the risk of subsequent development of various diseases (infectious, etc.).

In general, when considering Rakhita, it is possible to distinguish that this disease in children in the first year of life manifests itself quite often. It is not possible to determine the exact figures in terms of the prevalence of Rakhita, and, nevertheless, in many small patients are detected of one or another type of residual phenomena, directly associated with its transfer. These phenomena include various anomalies of teeth growth and bite, deformation of the lower extremities, chest, skull, etc., given that Rakhit creates certain conditions for the subsequent predisposition of children to infectious and other diseases, suffering from Rakhit, children are often sick.

Under Rakhit, it is usually implied by one disease, but this is not entirely true. The fact is that in reality Rahit is a group of diseases and violations, directly associated with exchange processes, due to the characteristics of which one general feature was determined for them. As such a sign, a decrease in calcium level in bone tissue is considered (this determines such pathology as osteopyation). It can trigger this not only vitamin D deficiency, but also certain internal or external factors. Given this, the first signs of Rahita do not necessarily require treatment using the specified vitamin - to begin with, this issue determine the need to allocate specific reasons that caused these signs. Moreover, in certain situations, vitamin D is generally contraindicated to use, which should also be considered when anxiety signs and symptoms.

The disease under consideration is also made to determine as an active growth as a disease, which is explained by the specifics of its manifestation. Rahit develops, as we have already been isolated, only in small children and only at that stage, in which active growth Their skeleton, in the process of which the temporary imbalance is formed between the incoming vitamin D and calcium and between their consumption by the organism itself.

According to the CIS countries, signs indicating the lack of vitamin D are detected in more than half of the cases among the docking children and in 80% of cases - the children have premature babies. The reasons for rickets (and, actually, the lack of vitamin D, which is also defined as hypovitaminosis, consist in the insufficiency of the formation of vitamin d in the skin due to its contributing effects of sunlight. It is the sun's rays, as probably the reader knows, are the main source of obtaining the specified vitamin.

The solar spectrum determines the relevance of the vitamination effect only by exposure to ultraviolet. Vitamin D, formed in a similar way, begins to accumulate in the form of "stocks" in the skin and in adipose tissue, as well as in the liver muscles. At the expense of these stocks, it is possible to prevent the development of toxic effects from its side, in addition to this, Vitamin D reserve provides it with the body in conditions of cold season, when fewer time goes to stay under the sun and overall the skin is hidden from exposure His rays.

The need for vitamin D is dictated by age in each case. The greatest amount of this vitamin is required, as already understandable, children, in particular during the first months and years of their life - this will ensure an adequate process of forming their bone tissue. Within the framework of the specified age period The need for this vitamin is 1 kilogram of weight of 55 mg. Gradually, as the child's skeleton continues to develop, the need for vitamin under consideration decreases. As for the question of the need for vitamin D in adults, here it is 1 kilogram of weight 8 mg, which, as can be seen, is at times less than the amount that is mandatory for children.

Rahit: Causes

Based on the above features, as well as other additional factors, which cause the development of such a disease as Rahit in a child, one can distinguish the following series of reasons leading to the development of this disease:

• Prematurity.This factor in particular is relevant when considering Rakhit due to the fact that it was during the last months of pregnancy with the greatest intensity to be received by the fetus of phosphorus and calcium.
• Incorrect feeding. For this reason, rickets can also develop, it happens as a result of insufficient admission to phosphorus and calcium food. In addition, it also takes into account the definite irrationality of feeding, if it is determined by the fact that it occurs at the expense of someone else's milk, it, in turn, becomes the cause of ineffective absorption of calcium. Similarly, children and the diet of which include monotonous protein food or lipid food fall into the risk group. Also here refers to the artificial feeding of the child. And finally, this also includes insufficient consumption of vitamin A, B and trace elements.
• Disruption of the transportation of calcium and phosphorus in the kidneys, gastrointestinal tract. This is caused by the immaturity of enzyme systems or the existing pathology, relevant to the listed bodies.
• Elevated level Mineral needs. This factor fully corresponds to the specifics of the disease, given the fact that Rakhit is a disease developing in the process of intensive growth in the body.
• Features of ecology.Under adverse environmental conditions, with a topical excess of chromium, iron, strontium, lead salts, or with magnesium deficiency, the corresponding basis for the development of Rahita is also determined.
• Specific features of the body. It is known that the development of Rakhit is more predisposed by boys, in addition, they also carry it much harder. It is also noticed that dark blood boys with the II group of blood are heavier than children with the first blood group (in the latter case the disease is diagnosed less frequently).
• Endogenous or exogenous deficiency of vitamin D.
• Current violations in work endocrine system (lesion of the thyroid, parachitoid gland).
• Hereditary predisposition.

Rahit: Classification

Classic version of Rakhita (or classic Rahit) With a deficiency of vitamin D, it can be isolated into a particular form, which is determined for it, depending on the specifics of clinical manifestations, features of the flow, the severity of the disease and its specific periods.

• Rahit in terms of clinical options on the basis of the features of changes in phosphorus and calcium serum concentration can be diagnosed in the following form varieties:
• calciumpenical rickets;
• phosphopopenic rickets;
• rachet, manifested without particularly pronounced changes in the level of actual indicators of phosphorus and calcium.
• Rachet, which is determined by the specific features of his own flow:
• Acute course Rakhita. Accompanied by the predominance of neurological symptoms and osteomation phenomena. Under the osteomation is meant a systemic type of a disease in which bone tissue is insufficiently mineralized, which also binds to a vitamin d and with its lack, with a shortage of trace elements or macroelements, a promoted high degree of their kidney filtering or impairment in suction processes (which is already relevant for intestines). As the main phenomena associated with osteomation, it is possible to distinguish pain in the bones, muscle hypotension (reduced muscular tone, combined with impaired muscle strength) and hypotrophy (deficiency of body weight, accompanied by a decrease in the thickness of the subcutaneous fiber), as well as the deformation of the skeleton bones and the appearance of pathological fractures.
• Subighteous course Rachita. This form of rickets is accompanied by a predominance of phenomena, characteristic of osteoid hyperplasia. Osteoid hyperplasia represents such a state at which the osteoid tissue is intensively growing intensely. In particular, these phenomena include such phenomena as the appearance of dark and frontal bugs, the thickening, formed in the wrist area (which is defined as richite bracelets), as well as thickening in the transition areas of the bone part of the cartilaginous ribs (defined as Rachitic rosary) and the thickening of the region Interphalong joints on the fingers of the hands (accompanied by the formation of so-called pearl threads).
• Wavy or recurrent rickets. Actual for a child, a diagnosis of acute rickets in this case is combined with signs of various scale (laboratory, clinical, radiological), on the basis of which a picture is visible, concomitiated by transfer in the past of the active form of Rahita.
• Rahit, due to the characteristics of the severity of manifestation:
• I degree Rahita - easy degree - features of the flow correspond to the initial period of the disease;
• II degree of rickets - the degree of medium severity - the course of the disease is characterized by the moderation of severity of changes affecting the internal organs and the bone system;
• III Degree of Rachita - a severe degree - in this case, at the same time, several departments in the bone system are subject to the defeat, also a heavy lesion of the nervous system and internal organs occurs, there is a lag in the development (physical, mental), which is caused by the squeezing of the skull due to improper formation, is detected Complications of the disease.
• Cyclicity of the course of the disease corresponding to this process The passage through four consistently manifested stages, and this: the initial period of Rakhita, the period of routine, the period of reparation (reconvalues) and the period characterized by residual diseases of the disease.

Rahit may also be secondary (respectively, secondary Rakhit), it often develops against the background of the influence of the following factors:

• The relevance of malabsorption syndromes. Malabsorption implies a literal translation from Latin "bad absorption". If it is more precisely determined, then it implies the loss of powers (in a single or in the multiple version), the receipt of which occurs in digestive tract With an insufficient degree of intensity of suction in the future through the small intestine.
• The presence of chronic diseases of biliary tract or kidney diseases.
• The presence of diseases directly associated with the metabolism (cystinuria, tyrosinemia, etc.).
• Long-term intake of anticonvulsant preparations (phenobarbital, diphenine), glucocorticoids, diuretics; Parenteral nutrition.

Vitamin D-dependent can manifest itself in two types: I type and II type. Vitamin D-resistant Rahit develops against the background of diseases such as kidney tubular acidosis, phosphate-diabetes, hypophosphate, de Tony syndrome - Debre - Fanconi.

Rahit: Symptoms

Depending on the period of the disease, the features of its symptomatics are determined, respectively.

• The initial period Rakhita

The first symptoms of Rakhita, as a rule, are celebrated from the first-third months of the child's life (in premature babies they can even appear somewhat earlier). They consist in a changed behavior, in which the bugs, elevated concern and excitability are traced, when exposed to external stimuli (outbreak of light, noise), the child is noted. Changes concern and sleep - there is also an anxiety and its overall superficiality.

Potting is enhanced, especially this is noticeable on the face and with the scalp. For sweat, an acidic smell is characterized, due to its exposure, the skin annoges, due to which, in turn, itching appears. Because of this, it can be noted that the child begins to rub the head of the pillow, for the same reason in the field of the nape appear the areas of baldness. Actual muscle hypertonus for this age on the background of the disease is converted into muscle hypotension (on which we stopped above). The edges of the large spring and sutures of the skulls and become piety, from the side of the edges there are characteristic thickening, in particular, they focus in the field of rib-cartilaginous joints, as a result of which the so-called "rachistic kits" we also have been formed.

If a radiograph is carried out within this period, then it detects some vacuum on the side of bone tissue. Based on the conduct of biochemical analysis of blood, it is detected or normal, or an increased calcium concentration at the simultaneous decrease in phosphate concentration indicators.

• Ripart period Rakhita

This period is mainly due to the period of completion of the first half of the child's age, the disorders of the musculoskeletal system and the nervous system here are becoming even more significant in the nature of the manifestation. Due to the processes of osteomalysis (which in particular intense in the manifestation within the framework of acute flow of the disease), the flat bones of the skull are subject to soften, then it often develops a unilateral thickening of the head. It may also be a nose, because of which a saddle nose can be formed. Compared with the torso, the impression is that the head is too large. The chest becomes militant, deformed, also develops the crust of the sternum from its lower third of its third (which determines for such a pathology the name "chest of a shoemaker"), in other cases it can, on the contrary, to develop its emotion ("Cileous", "chicken" chest). Long tubular bones are twisted on an O-shaped (somewhat less than x-shaped) type.

Also, against the background of the development of a series of relevant in this case, the processes are forming a plane-chicted narrowed pelvis. Due to the fact that the ribs are subject to significant softening, a deepening is formed along the line of the diaphragm (the so-called Harrison Broker). The prevailing of osteoidal tissue hyperplasia, which prevails in the framework of the subacute flow, in this case, manifests itself in the form of formation of dark and frontal hypertrophied bugs. In addition, there is even greater thickening of the rib-cartilaginous joints, wrists, regions of interphalating joints upper limbs (previously considered "bracelets", "tidy", "thread pearls").

• Recognitive period Rakhita

This period is characterized by improving the health of the child and its overall state. Static functions are subject to improvement or normalization. Normalization is found in the blood or some exceeding the indicators in the content of phosphorus in it. Hypocalcemia can be maintained at a minor level, in some cases its gain is observed.

• Residual phenomena Rakhita

As part of this period of the disease, the indicators of blood test (biochemistry) occurs, the symptoms of the active form of Rahita disappears, which indicates, respectively, the transition of the disease into the inactive stage, that is, in the stage of residual phenomena. Muscular hypotension and residual deformation forms, which was subjected to rickets of a skeleton, during a long period of time can be saved.

We examined the course of the disease in general, to highlight additional points, with it related.

Rachita Symptoms: Muscular System

The decrease in the tone of muscles in children leads to the appearance of a "frog of the abdomen", which is accompanied by its increase due to changes in the tone of the muscles (the abdominal press muscles in particular are in this case in a relaxed state). The jointness of the joints, allocated above, can also be defined as "breaking", because of this, the child starts later, it is also impossible to preserve the body in a vertical position.

Rachita symptoms: internal organs

Due to the lack of calcium and vitamin D, the work of the internal organs is violated (digestive tract, spleen, liver). Quite often in children with rickets such symptoms as anemia, jaundice and constipation are observed. Again, due to the squeezing of the lungs against the background of the altered state of the chest frame, the normal development and growth of internal organs are subject to violation. When squeezing the lungs often develop colds, the deformation of the heart becomes the cause of heart failure. Spring closes later, teething takes place with a delay, an incorrect bite develops. The weakness of the binder determines the ability of the child to fulfill the most unusual joints with joints. Sitting, walking and hold the head. Children with rickets begin later than the peers.

Sources of vitamin D.

As already understandable, the main percentage of vitamin D obtained by our organism occurs by exposure to ultraviolet from sunlight (about 90%). It is insignificantly distributed in other natural resources, for this reason, the preparation of vitamin D through food occurs about only 10% of the required volume. In particular, as sources of vitamin D is considered fish fat (the greatest number For possible consumption), yolks of eggs, margarine and vegetable oil. In the West, the products saturated with vitamin D are in particular in demand, but even if you consume such products, there is no guarantee that the body will receive its required amount.

A separate point concerns constant information, which in particular often sounds during recent yearsindicating the harm from the effects of solar radiation, as well as to the risk that carry ultraviolet rays with themselves, as the main of such risks, the skin cancer in various variations is considered. Based on this, within the framework of official medicine, the corresponding calls are sounding on the need to limit the effects of solar radiation on the skin, which in particular concerns children. Based on this, it can be considered as the main source of vitamin D. medicinal formsDue to the receipt of which the prevention of rickets is ensured. You can learn about certain variants of this type of preparations from the patriatse child.

Diagnosis and treatment

The diagnosis of rickets is established on the basis of blood studies (biochemical analysis), on the basis of the dynamics and the overall ratio of calcium concentration, phosphorus and phosphatases, is determined, which period corresponds to the course of the disease. Also, the diagnosis is based on visual inspection of patients.

The treatment of rickets is determined, again, on the basis of the period of its manifestation, as well as on the basis of the severity of the flow. It is based on the use of specific drugs, which includes vitamin D. No less important role is given to the issue of rational nutrition, a sufficient stay in the air is recommended, the healing gymnastics, massage, salt, solar, coniferous baths, UFO is shown. In addition, the vitaminotherapy and the implementation of measures aimed at achieving a secreting effect is shown. In hypocalcemia, calcium preparations can be appointed, a citrate mixture can be shown to improve its suction.

Forecast with rickets for children is mainly favorable (in case of transferring the classical form of the disease). If the treatment is not produced, it is developing irreversible in the nature of the change, such, for example, as deformation of bone structures. The prevention of Rakhita is the measures implemented both before the birth of the child and after it.

If symptoms appear on the possible rickets in the child, you need to contact the pediatrician.