Health officials identified these cases among children who were admitted to Georgia hospitals for malnutrition. Breast milk is the best source of nutrition for infants but parents of breastfed infants should consult with their pediatrician to determine if their infant needs vitamin-D supplementation. Parents also need to ensure that children get enough vitamin-D after they are weaned from breast milk or fortified infant formula. At least three of the Georgia children with nutritional rickets had dark skin complexions. Rickets is not always easy to recognize in infants and toddlers because its early symptoms mimic other conditions.
Infants often present with seizures and high fevers associated with a secondary infection.
If the child is treated for infection and no blood is drawn, there will be no indication of low calcium levels, which would suggest rickets. There are no national rates for rickets because it is not a reportable public health disease, and there are no surveillance systems that capture information about it. The Georgia cases probably represent only part of the true prevalence of rickets, as the study only reviewed cases of children who were hospitalized. In addition to identifying children with nutritional rickets, doctors found three children who had malnutrition associated with inadequate energy or protein in their diet. The protein energy-deficient children had such clinical signs as swelling, weight loss or inadequate growth, or thinning of hair.