Calcium Deficiency and Rickets in Kids: Causes, Symptoms, and Prevention
Quick Answer
Good news - rickets and calcium deficiency are completely preventable and treatable! While these conditions can sound scary, they're uncommon in children who get adequate sunlight, eat calcium-rich Indian foods (doodh, dahi, paneer, ragi), and receive vitamin D supplements when needed. If you're reading this with concern about your child, take a breath - with proper nutrition and sunshine, most children stay healthy.
Understanding Rickets and Calcium Deficiency
Watch: Iron is most important fuel for 🧠 growth. You need to include iron rich food in your babies diet.
What's the difference?
Calcium deficiency: Not enough calcium in the diet or poor absorption
Rickets: Bone disease caused by lack of vitamin D, calcium, or phosphorus
Connection: Vitamin D is essential for calcium absorption - you need both!
Why is this important?
Calcium and vitamin D work together to build strong bones (haddiyan). During childhood, bones grow rapidly and need these nutrients. Without them, bones become soft, weak, and can bend or deform.
What Causes These Conditions?
Primary Causes:
Cause
Why It Happens
Who's at Risk
Low Vitamin D
Limited sun exposure, dark skin
Indoor children, city kids, covered clothing
Poor Diet
Not enough dairy or calcium foods
Picky eaters, restricted diets
Exclusive Breastfeeding
Breast milk low in Vitamin D
Babies without vitamin D drops
Malabsorption
Body can't absorb nutrients
Celiac disease, kidney problems
Common Scenarios in India:
Baby exclusively breastfed without vitamin D supplements
Child who refuses doodh (milk) and dairy products
Kids spending all day indoors (screen time, apartments)
Vegetarian diet without calcium-rich alternatives
Girls with full-body covering limiting sun exposure
Symptoms by Age
Infants (0-12 months):
Delayed closure of soft spot (fontanelle)
Soft skull bones (craniotabes)
Excessive head sweating during feeding/sleep
Delayed teething
Irritability and fussiness
Slow growth
Toddlers (1-3 years):
Delayed walking
Bowed legs (tangdi mudi)
Widened wrists and ankles
Pot belly appearance
Muscle weakness - difficulty climbing stairs
Frequent falls
Older Children (3+ years):
Knock knees
Bone pain, especially in legs
Dental problems - cavities, delayed teeth
Short stature compared to peers
Frequent fractures
Muscle cramps
Diagnosis
Your pediatrician may recommend:
Blood tests: Calcium, phosphorus, alkaline phosphatase, vitamin D levels
X-rays: Show characteristic bone changes of rickets
Physical exam: Check for bone deformities, muscle weakness
Treatment Options
Mild Deficiency (Dietary Changes + Supplements):
Increase calcium-rich foods in diet
Vitamin D drops: 400-1000 IU daily
More outdoor time in morning sun
Monitor with follow-up blood tests
Moderate Deficiency:
Higher dose vitamin D: 1000-2000 IU daily
Calcium supplements if needed
Monthly monitoring initially
Severe Rickets (Stoss Therapy):
Single high-dose vitamin D (60,000-600,000 IU)
Given under medical supervision
Dramatic improvement within weeks
Follow-up doses as needed
Bone Deformities:
Usually correct with treatment over 1-2 years
Physical therapy may help
Bracing in some cases
Surgery only for severe, uncorrected deformities
Prevention Guide for Indian Parents
Daily Calcium Requirements and Sources
Age
Daily Calcium
How to Get It
0-6 months
200mg
Breast milk/formula
6-12 months
260mg
Milk + 1 serving dairy + ragi
1-3 years
700mg
2 glasses milk + curd/paneer
4-8 years
1000mg
2-3 glasses milk + dairy foods
Best Indian Calcium Sources
Dairy Champions:
1 glass milk = 300mg calcium
1 cup curd = 200mg calcium
100g paneer = 200mg calcium
1 glass chaas = 100mg calcium
Non-Dairy Winners:
Ragi (finger millet) - MORE calcium than milk!
Sesame seeds (til)
Amaranth (rajgira)
Methi leaves
Almonds (badam)
Dried figs (anjeer)
Fortified soy milk
Vitamin D Strategy
Sunlight (Best Source):
15-20 minutes morning sun (before 10 AM)
Arms and legs exposed
3-4 times per week
Not through glass windows
Supplements:
All breastfed babies: 400 IU vitamin D drops daily
At-risk children: Discuss with pediatrician
Available as drops (for babies) or chewables (for kids)
Food Sources:
Egg yolks
Fatty fish (salmon, mackerel)
Fortified milk and cereals
Mushrooms exposed to sunlight
Meal Ideas for Strong Bones
Breakfast Options:
Ragi porridge with milk and banana
Milk with ragi ladoo
Paneer paratha
Curd with roti
Lunch/Dinner:
Dal with ghee (ghee helps vitamin D absorption)
Palak paneer
Curd rice
Ragi dosa with chutney
Methi paratha
Snacks:
Til (sesame) ladoo
Cheese cubes
Almond milk smoothie
Paneer tikka
Fruit with curd
When to See a Doctor
Seek Immediate Care If:
Seizures or muscle spasms (sign of severe calcium drop)
Difficulty breathing
Fracture from minor injury
Sudden worsening of bone deformity
Schedule Appointment If:
Legs appear bowed or knocked
Child not walking by 18 months
Significantly shorter than peers
Delayed teething (no teeth by 12 months)
Excessive sweating on head
Concerns about calcium/vitamin D intake
Expert Insight: Dr. Sumitra advises: 'Growth charts are just one tool. Look at the overall trend, not individual measurements.'
FAQs
Q: Mera baccha bahut patla hai aur wajan nahi badh raha - could this be rickets?
A: Being thin (patla) and slow weight gain aren't typical signs of rickets. Rickets primarily affects bones, causing bowing, delayed walking, and bone pain. However, both conditions can occur together if the child has overall poor nutrition. If you're concerned about weight, focus on calorie-dense foods while ensuring adequate calcium. Get your child checked if you notice any bone-related symptoms.
Q: Do I need to give vitamin D drops to my formula-fed baby?
A: Usually not, if your baby drinks adequate formula. Most infant formulas are fortified with vitamin D. If your baby drinks at least 500ml (about 17 oz) of formula daily, they're likely getting enough. Check with your pediatrician to be sure, especially if baby is also getting some breast milk.
Q: My 2-year-old has slightly bowed legs - is this rickets?
A: Mild bowing is NORMAL in toddlers! Most children have some bowing until age 2-3, which corrects naturally as they grow. This is called "physiological bowing." Concerning signs would be: severe bowing, bowing that gets worse after age 2, bowing on only one side, or bowing with other symptoms like bone pain. When in doubt, ask your pediatrician.
Q: Can too much vitamin D be harmful?
A: Yes, vitamin D toxicity is possible but rare with normal supplementation. Don't give more than recommended without medical advice. Signs of excess include nausea, vomiting, weakness, and frequent urination. Stick to recommended doses (400-1000 IU for most children) and consult your pediatrician for higher doses.
Q: My child is lactose intolerant - how do I ensure enough calcium?
A: Many children with lactose intolerance can tolerate:
Curd/dahi (fermentation reduces lactose)
Paneer (most lactose removed)
Hard cheeses
Lactose-free milk
Non-dairy alternatives:
Ragi (richest non-dairy calcium source!)
Sesame seeds/til
Fortified soy or almond milk
Green leafy vegetables
Almonds, dried figs
Q: How long does it take to treat rickets?
A: With proper treatment:
Blood levels improve within 2-4 weeks
Symptoms start improving within 1-2 months
Bone changes visible on X-ray within 3-6 months
Bone deformities may take 1-2 years to fully correct
Some severe deformities may need additional intervention
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This article was reviewed by a pediatrician. Last updated: January 2025
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