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How do you prevent rickets?
Medical expert of the article
Last reviewed: 06.07.2025
There are ante- and postnatal specific and non-specific prevention of rickets.
Antenatal prevention of rickets
Antenatal prevention of rickets should begin long before delivery. The pregnant woman should follow a daily routine, get enough rest during the day and at night. It is very important to spend at least 2-4 hours daily (in any weather) in the fresh air, and eat a balanced diet. The daily diet of a pregnant woman should include at least 180-200 g of meat, 100 g of fish, 150 g of cottage cheese, 30 g of cheese, 0.5 l of milk or fermented milk products. The products should contain a sufficient amount of vitamins and microelements. Pregnant women from the risk group (nephropathy, diabetes, hypertension, rheumatism) should be additionally prescribed vitamin D 3 (cholecalciferol) from the 32nd week of pregnancy at a dose of 200-400 IU for 8 weeks, regardless of the season.
It is recommended to take calcium supplements (if possible, simultaneously with dairy products).
Postnatal non-specific prevention of rickets
Postnatal non-specific prevention of rickets involves organizing proper nutrition for the newborn. Natural breastfeeding is ideal. To ensure successful and prolonged lactation, a woman should follow a daily routine and eat properly.
In the absence of breast milk, modern adapted formulas should be recommended, balanced in calcium and phosphorus content (ratio 2:1 or more) and containing cholecalciferol (vitamin D3 ).
Particular attention should be paid to the child's physical development and hardening. In addition to walks in the fresh air and water treatments, rickets is treated with therapeutic exercises and massage, observing the principles of consistency, regularity, duration of treatment, and a gradual, uniform increase in load throughout the year.
Postnatal specific prevention of rickets
Specific prevention of rickets in full-term infants is carried out for all children, regardless of feeding, in the autumn-winter-spring period during the first 2 years of life. For specific prevention of rickets, drugs containing cholecalciferol are used: water-soluble and oily vitamin D 3.
Water-soluble vitamin D3 is absorbed more quickly from the gastrointestinal tract, is well tolerated and is conveniently dosed (1 drop contains about 500 IU of cholecalciferol). The drug is indicated for premature babies with immature intestinal enzymes.
The prophylactic dose for healthy full-term infants is 400-500 IU/day, starting from the age of 4 weeks. It is advisable to prescribe vitamin D for prophylactic purposes in the summer with insufficient insolation (cloudy, rainy weather). In climatic regions of Russia with low solar activity (northern regions of Russia, the Urals, etc.), the prophylactic dose of vitamin D can be increased to 1000 IU/day. For children at risk, the prophylactic dose is 1000 IU/day for a month, then 500 IU for 2 years of life.
Specific prevention of rickets in children with stage 1 prematurity is carried out from the 10th to 14th day of life at 400-1000 IU of vitamin D per day during the first 2 years, excluding the summer months. In case of stage III prematurity, after the establishment of enteral nutrition, 1000 IU of vitamin D is prescribed daily during the first year of life, in the second - 500 IU, excluding the summer months.
Contraindications to the administration of a prophylactic dose of vitamin D may include idiopathic calciuria (Williams-Bourne disease), hypophosphatasia, organic CNS damage with symptoms of microcephaly and craniosynostosis.
Children with small or early closure of the large fontanelle have only relative contraindications to the prescription of vitamin D. With normal indicators of head circumference growth, the absence of neurological symptoms and signs of organic pathology of the central nervous system, specific prevention of rickets in such children is carried out according to the usual method. In some cases, specific prevention of rickets can be delayed by starting to take vitamin D from 3-4 months of life.
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