Vitamin D Deficiency Causes Osteomalacia and Rickets

Fragile and soft bones in the human skeletal system is a sign of Osteomalacia disorder in adults and Rickets in children. Osteomalacia and Rickets occur when the mineralization of the skeleton is defective and inadequate. This generally develops when the amounts of Vitamin D are insufficient in the diet or more often because of the body’s inability to absorb and metabolize Vitamin D, which is an important ingredient that helps in the absorption of calcium, and which is also needed for the bones and teeth to stay strong and healthy. Deficiency of calcium and phosphorous is also a reason for Osteomalacia or Rickets.

In children, Rickets is easily detectable as the disorder tends to cause pronounced skeletal deformities. In adults Osteomalacia is difficult to diagnose as it is difficult to differentiate it from osteoporosis. In some people who have soft bones due to the deficiency of Vitamin D, repeated pressure on these bones may cause fractures or minor deformities.  

Causes

There are several reasons (as detailed below) why, Osteomalacia and Rickets disorders happen.

• In adults - when the intestines are unable to efficiently absorb and process Vitamin D
• When disorders of any other organs such as liver, kidneys and the skin occur, and when these organs are unable to synthesize Vitamin D, consequently this causes Osteomalacia
• When there is a deficiency of Vitamin D in the diet, especially in infants exclusively breast-fed and in the elderly. Vitamin D can be supplied in the diet through fortified cereals and dairy products
• When there is inadequate exposure to sunlight, this results in inadequate production of natural Vitamin D, by the skin
• When there is an abnormal reduction of alkalinity or occurance of chronic acidosis, in the blood, caused by renal failure 
• When complications due to Hemodialysis occur or because of chronic renal failure
• When there is any interference with the normal metabolism of Vitamin D, such as administration of some anticonvulsant medications that are used to treat epilepsy
• When the blood contains low levels of phosphorous (hypophosphatemia), which is caused by rare hereditary disorders. Sometimes Hypophosphatemia may be caused by continuous use of antacids that are non-absorbent 

Symptoms

There are several symptoms that help identify Osteomalacia and Rickets, which include:

• Continuous pain in the bones of the arms, spine, hips and legs
• A waddling gait accompanied by weakness of the muscles
• Unidentifiable reasons for fractures and deformities of the bones occurring
• A rare form of disorder that occurs when the calcium levels in the body are low, which cause painful cramps or spasms in the feet, hands and face
• Bowed legs, a waddling gait, pot belly, and disturbed growth in children affected by Rickets
• Abnormal heart rhythms, deformities of skeletal / skull, knock knees, Pigeon chest (protruding chest), numbness of extremities and around the mouth, impaired growth (short stature), dental deformities, delayed formation of teeth, teeth defects, excessive cavities, sleeping disorders, poor tone and development of muscles, and delayed walking in children 

Preventing Osteomalacia and Rickets

Intake of adequate amounts of fortified, dietary Vitamin D, (such as mushrooms, dairy products -milk, curd / yoghurt and cheese, oil and fat laden fish, egg yolks, soy milk, fortified cereals, and cod liver oil) and from naturally available sunlight, will help prevent deficiency of Vitamin D.

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Treatment

Osteomalacia caused by Vitamin D deficiency can be cured generally in 6 months. Rickets can be arrested in children, though the deformities will be permanent. Rickets is very common in underdeveloped countries.  

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Nutrition for your Baby

What’s Best for the Baby?

Food is one major source that nourishes the body, making one healthy and strong. Infant nutrition is important for ensuring right development, preventing illness and maximizing cognitive skills and mental capacities. No other developmental stage calls for such strong attention towards nutrition. But which food is best for the baby?

A Mother’s Concern

Nourishing your baby with the right kind of food can be the biggest concern for a mother. If you are a nursing mother, then you may believe that your child gets all the necessary nourishment through the mother’s milk. It may be true if you watch your own diet and ensure that it is well balanced with micronutrients such as vitamins, minerals and phytonutrients. A typical modern diet composed of sugar products, white flour, additives and commercial fats and oils which do not build or nourish will obviously result in mother’s milk lacking in quality nutrients. Good quality proteins, fats and complex carbohydrate rich diet will be the perfect nutrition for a nursing mother and eventually her baby. It is strongly recommended that a baby is nourished with mother’s milk at least for a minimum period of 8-12 months. This is essential to build resistance and for various other vital purposes.

Bottom line,every woman will breast feed in a perfect world with perfect nourishment. But regrettably, that perfect world is a far off dream. What would mothers with low milk supply do? What if the mother is unwell or what if the baby is adopted? Fortunately it is possible to prepare wholesome baby formula at home, devoid of chemicals and artificial additives, though it may not come as a perfect substitute for mother’s milk.

Supplementary Diet for your Baby

An infant requires a full spectrum of nutrients during the first year of life, which only mother’s milk can provide. But when it is no longer a sole source of nutrition, then here are a few options that you can look at.

• At four months, egg yolk can be introduced. It is found to be rich in cholesterol, choline and other brain nourishing food. A pinch of salt will supply a variety of trace elements too.

• Cod liver oil, an excellent source of omega-3 fatty acids, DHA, EPA, Vit D and A can be introduced slowly starting with ¼ teaspoon mixed with fresh orange juice.

• If the baby seems hungrier, then a mashed ripe banana can be added to the diet. It has a rich supply of amylase enzyme that helps to digest carbohydrates.

• After six months pureed meat can be introduced to add iron, zinc and protein in the diet.

• By eight months to one year the baby can be introduced to a variety of homemade foods, one at a time going easy on the cereals as they may develop allergies, not having the enzymes to handle it.

• Say no to juice, soy foods, margarine, shortening and commercial dairy products in the first few months.

• Cereal gruels can be added on completion of one year.

Maximize your baby’s health with minimum efforts at home.

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Breast Feeding- The Best Diet For Your Baby!

“While Breastfeeding may not seem the right choice for every parent, it is the Best choice for every Baby” - Amy Spangler.

WHY BREASTFEEDING?
A newborn baby has only three demands. The warmth felt while being nestled in the mother’s arm…life sustaining liquid food in the form of mother’s milk and security in the knowledge of her presence. Breastfeeding satisfies all these three needs. One must realize that a mother’s feed is anytime better than a baby formula, however tall the claims may be and the thirty years of technology cannot replace or surpass the three million years of nature’s evolution.
Scientific literature has concrete evidence that exclusive breastfeeding for the first six months of a life cut down under-five child mortality by 13-15%. There cannot be more compelling reasons for breastfeeding the baby.
Apart from all the benefits to the baby in the form of rich nourishment and total protection through a tough immune system, there is a package of benefits to the nursing mothers as well.
• Reduces the risk of ovarian cancer
• Increases post-partum weight loss
• Reduces risk of breast cancer
• Prolongs lactational Amenorrhea
• Reduces cardiovascular risk
• Decreases Visceral Adiposity
• Reduces type 2 diabetes risk

WHAT MAKES IT SPECIAL?
It is quite difficult to list out all the properties and ingredients of mother’s milk. But it has been found that the nutrient content is consistently maintained. It includes the nutrients in the mother’s bloodstream along with the bodily stores. It contains an optimal balance of proteins, sugar, water and fat required for a baby’s growth and development. It also enhances biochemical reactions in the infant allowing the hormones, enzymes, growth factors and immune system to defend against infections. The polyunsaturated fatty acids in the milk help in normal neural and retinal development. Lactation involves usage of 500 calories per day which helps the mother to lose weight after delivery.
The first milk produced during the first few days of childbirth is called colostrum. It is more concentrated and easy to digest than mature milk. Its laxative property allows easy bowel movements, thus preventing Jaundice in the infant by expelling excess bilirubin through the stools. It also seals the gastrointestinal tract from foreign substances which may be passed on from sensitive food that the mother might have consumed.

REMINDERS TO LACTATING MOTHERS:
• Alcoholic beverages and smoking can be avoided during this period to avoid subjecting the infant to potential risks however minimal they may seem.
• Confer with lactation consultants for necessary advice and support in case of uncertainties.
• Nursing mothers should start nursing typically within one hour of birth. Skin to skin contact also called Kangaroo care should be established to make subsequent feeding significantly easier.
• Be aware of the Baby’s feeding intervals and quantity required as per the infant’s stomach capacity.
• Try different positions and find out the preference to a particular position to avoid ineffective feeding which could lead to infant health concerns.

Remember moms, “Breastfeeding isn’t just about Milk…It’s also about Love”

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Diabetes - A Major Risk Factor for Kidney Disease

Diabetes is the commonest reason for chronic kidney failure. Longstanding uncontrolled diabetes harms blood vessels within the kidney. Microalbuminuria (leakage of small quantities in urine) is the earliest sign of kidney damage. Protein leakage increases gradually following which hypertension and renal failure may develop. Dialysis and kidney transplantation can be safely performed in diabetics with kidney failure. 

Dr. R Balasubramaniyam MBBS, DNB (Gen.Med), DNB (Neph)
Chief Nephrologist, Kauvery Hospital

Watch his video interview on diabetes & the kidney.

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Immunization Chart for Babies in India

This chart is a ready reckoner to remind you about the vaccine schedules of your child. Click on link below chart to download to print. 

Click here to download the Immunization Chart.

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What is food intolerance?

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When a person has difficulty in digesting certain foods it is termed as Food Intolerance. The symptoms are Nausea, Stomach Bloating, Diarrhea, Vomiting, Cough and in some cases Heart Burn, Headaches, Irritability and Nervousness.

Most common foods which people might be intolerant to are Dairy Products, Wheat, certain vegetables like Capsicum, Cucumber, Peanuts, undercooked beans, caffeine, tea, chocolates, some kinds of fish, Mint, Tomato sauce, Citrus fruits and foods with added preservatives. 

The best current treatment for food intolerance is to either avoid the suspected foods or eat them less often and in smaller amounts, as well as taking some supplements that may help digestion.

Food Allergy is different from Food Intolerance. Food Allergies cause an immune system reaction which can become serious or life threatening. Food intolerance symptoms are less serious and mostly limited to digestive problems. 

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