Bone problems in infants and children

Bones provide the frame for the growing body and while it is a solid structure, it is a living system that removes old bone and replaces it with new bone. Bones grow in size and increase their density during this period because more bone mineral is being deposited than removed.

There are many factors that contribute to optimal bone formation, but two of the most common factors that parents can control are:

• Optimal micronutrients: including comprehensive nutrient-rich diets containing reliable sources of protein, calcium, phosphorus, vitamin D, magnesium, zinc, vitamin C, manganese, can help to ensure that bones get what they need.
• Physical activity: the skeleton doesn’t just support muscles, it responds to movement, through the living cells that deposit minerals inside the bone. Even with an optimal supply of nutrients, children who are less active may be missing out on the bone development benefits of moving their bodies around
• Sleep: although this may sound like the same as inactivity, it is slightly different. Sleep encourages the rest and repair of all tissues, and this includes bone, muscle and skeleton formation.
• Genetics: cultural background, including the pigmentation of skin, affects the ability of sun to activate vitamin D in the skin. So darker complexion children are more prone to getting vitamin D deficiency.

Rickets, as the name suggests, refers to when children’s bones become thin and don’t develop optimal density, remaining in the softer cartilage form. Another word for bone softening is “osteomalacia”. As a result, they tend to bend under the child’s weight, leading a “bow leg” or “knock knee” stance.

One of the main causes of childhood rickets is a lack of vitamin D and calcium in the diet ^[1], which leads to a slowing down of the formation of the hard, mineralized bone. This is also called nutritional rickets and has contributed to an increasing incidence of the condition in European children since the 1990’s^[2].

Osteoporosis is a problem that occurs in older people, caused by a loss of bone density, which decreases bone mass (also called “osteopenia”). It is when the internal part of bone becomes more like honeycomb and is more prone fracturing.

Although kids are less like to get osteoporosis during childhood, since their bones are still forming, it is still related to a decreased level of vitamin D and calcium in the diet. The longer younger and older children are deprived of these and other bone forming nutrients, the more likely they are to develop osteoporosis when they get older. In fact, childhood bone mass is now considered an indicator of future osteoporosis risk^[3].

Children are prone to breakages, because they often have falling accidents or bump themselves, as become more physically coordinated. This kind of problem is more likely in older children when they start playing sports, because infants’ and toddlers’ bones are still made of mostly cartilage, so are more flexible.

Although they are painful, most breaks can self-heal within 6-8 weeks and just need to be immobilized and kept straight, to allow the broken parts to mend together.

Children of African background with lower vitamin D in their bodies have been shown to have a higher likelihood of getting arm fractures^[4]. So, bone nutrients are important for different types of bone problems.