Rickets is a bone disease in children that causes weak bones, bowed legs, and other bone deformities. Children with rickets do not get enough calcium, phosphorus, or Vitamin D — all of which are important for healthy growing bones.

Although considered a disease of the past, rickets has not been eliminated in the world, and it seems to be getting more common in the United States.

In some children, rickets is an inherited disease. Hereditary rickets requires very specialized medical care. This article does not provide detailed information about hereditary rickets, but focuses on nutritional rickets caused by Vitamin D and calcium deficiency.

Who Is At Risk for Rickets?
Because breast milk contains very little Vitamin D, rickets is seen most commonly in babies who are exclusively breast fed for a long time.

Other factors that contribute to rickets include:

Low calcium. Children with rickets usually take in less than 300 mg of calcium per day (about one cup of milk). Growing children need from 400 mg (babies) to 1500 mg (teens in the adolescent growth spurt) of calcium daily for good bone health.
Lack of sun exposure. Our bodies make Vitamin D in our skin when it is exposed to good sunlight. Not enough sun means not enough Vitamin D.
Darker skin. People with darker skin require more sun to make Vitamin D.
Poor diet. Children adopted from abroad or other children experiencing extreme poverty sometimes have rickets due to a poor diet history. Lack of variety in the diet, such as eating lots of unleavened bread or a strictly vegetarian diet, can contribute to rickets, as can intake of too much fluoride.
Lactose intolerance. Children who are lactose intolerant or on diets that restrict dairy intake are at higher risk for rickets.
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A child with rickets may have the following symptoms:

Weak muscle tone
Delayed development, decreased growth, or “failure to thrive”
Bowed legs and widening of the wrist and ankle bones
Stooped posture
Chest and rib deformities – Some children develop nodules (bumps) at the end of their ribs (known as “rachitic rosary”). Chest deformities can develop from deformities of the ribs, and lead to lung infections.