Some infants and children may require vitamin D supplements for weeks, months, or years. Moderate to severe rickets may require higher doses of vitamin D for longer periods of time and this must be supervised by a pediatrician who has experience in treating rickets. X-rays of the knees of children with moderate and severe rickets can help the pediatrician to determine the dose and duration of vitamin D therapy. Most cases of rickets diagnosed in the first few years of life, are responsive to good nutrition and vitamin D supplementation. Children who do not enjoy milk products or are lactose intolerant as many Chinese children are, can get vitamin D in soy erniched products.
Vitamin D is given as a liquid or a chewable as mentioned above.
Severe rickets can be arrested, but the bony deformities may be lifelong. The severity of rickets depends on the duration and extent of nutritional deprivation. The overwhelming majority of the children who I have evaluated from China, have had mild to moderate rickets with excellent response to a simple course of vitamin D therapy and a good old fashioned American dieL Delayed eruption of baby teeth, bow legs, decreased muscle tone and delayed motor development, a box-like shaped head with frontal bossing, and a sweaty head are the most common manifestations of rickets in my daily practice. The Chinese government is very aware of the problem of rickets and is making every effort to prevent and treat rickets. If Chinese children could just spend a little more time in the sunlight and if they just got enough to eat, maybe I wouldn't have to talk about rickets anymore.