Osteomalacia - Preventing rickets

There are several steps you can take to help prevent rickets.

These include ensuring your child has a healthy, balanced diet and spends some time outside in the sun.

Diet

If you're breastfeeding your baby, take a daily supplement of 10 micrograms (µg) of vitamin D.

For older children, make sure their diet contains plenty of foods rich in calcium and vitamin D.

Sources of vitamin D include:

oily fish, such as salmon, sardines and mackerel
eggs
fortified fat spreads
fortified breakfast cereals

Sources of calcium include:

dairy products, such as milk, cheese and yoghurt
green vegetables, such as broccoli and cabbage
soya beans and tofu
nuts
fish where you eat the bones, such as sardines and pilchards

If you have a restricted diet ‐ for example, if you're vegetarian or vegan ‐ you may not be getting essential vitamins and minerals, and may need to take vitamin supplements.

Sunlight

Sunlight is a good source of vitamin D and it's where we get most of our vitamin D from. The vitamin forms under the skin after sun exposure.

In the UK, about 10 to 15 minutes of exposure on the hands and face when the sun is at its strongest (between 11am and 3pm) a few times a week during the spring and summer is enough for most people.

You won't get vitamin D from the sun if you wear sunscreen, but you should apply sunscreen with a sun protection factor (SPF) of at least 15 if you're outside for longer than 10 to 15 minutes. This will help protect your skin from sun damage.

Babies and young children have very sensitive skin that burns easily, so they need to use stronger sunscreen and be covered up when out in the sun.

In the UK, your skin isn't able to make vitamin D from the sun during the winter (November to March) because the sunlight isn't strong enough. However, you can get vitamin D from your body's stores and from food sources during this period.

Read more about vitamin D and sunlight and staying safe in the sun.

Supplements

Most people can get all the vitamin D they need through their diet and by getting a little sun.

However, certain groups of people have an increased risk of developing a vitamin D deficiency and may need to take supplements to avoid getting rickets and osteomalacia (the adult form of rickets).

These at-risk groups are discussed below.

Pregnant and breastfeeding women

The Department of Health recommends all pregnant and breastfeeding women should take a daily supplement of 10µg of vitamin D to reduce the risk of their child developing rickets.

Babies and children

In the UK, the Department of Health recommends the use of vitamin drops for all babies and young children aged six months to five years.

For breastfed infants, vitamin drops are recommended from one month if their mother hasn't taken vitamin D supplements throughout pregnancy.

Infants who have infant formula won't need vitamin drops until they're receiving less than 500ml of infant formula a day, as these products contain added vitamin D.

It's important that children in high-risk groups take vitamin D supplements. These include children who don't get enough vitamin D from their diet and those with certain medical conditions, such as kidney disease. Your GP can advise you about how much vitamin supplementation is needed.