Rickets is Back

From The November 2000 Issue of Nutrition Science News

Some Breast-fed Babies Need Vitamin D

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Along with scurvy, pellagra and beri beri, rickets is usually assumed to be an extinct nutrient-deficiency disease. But rickets is back. Caused by a deficiency of vitamin D, which is necessary for calcium absorption, rickets causes improper bone mineralization in children. In 1998 and 1999, S.R. Kreiter, M.D., of Wake Forest University School of Medicine in Winston-Salem, N.C., studied 30 patients, ranging from 5 to 35 months old, with nutritional deficiency-induced rickets. All were African-American children who were breastfed for a year on average without taking supplemental vitamin D. Dark-skinned babies are at special risk because their skin makes less vitamin D from sunlight than light-colored skin. Kreiter determined that rickets has increased because more African-American mothers are breastfeeding, fewer babies are being given vitamin D supplements, and both mothers and babies are getting less sunlight than in the past.

This North Carolina study is complemented by another done in Texas, where M. Shah, M.D., of the University of Texas Medical Center at Dallas, at the Texas Scottish Rite Hospital, studied eight toddlers and one infant who showed biochemical and X-ray evidence of nutritional rickets. All had been breast-fed without vitamin supplementation; eight were African-American, one Hispanic. Two children lived in upper middle-class households. Finding rickets in North Carolina and in Texas was unexpected because both locations receive abundant sunlight. Both studies conclude that breast-fed, dark-skinned babies should receive vitamin D supplements.

Journal of Pediatrics 2000 (Aug); 137 (2): 143-145

Texas Medicine 2000 (Jun); 96 (6): 64-68

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