How to prevent and treat rickets in infants and children?

       Infantile rickets is a common nutritional deficiency disease in infancy and early childhood. The main causes of rickets are: (a) vitamin D (Vit, D) deficiency, such as insufficient sunlight exposure and insufficient intake of Vit, D-containing foods; (b) calcium deficiency; (c) disease effects, such as gastrointestinal, liver and kidney diseases that affect the absorption and utilization of Vit, D, calcium and phosphorus.  The diagnostic criteria for active rickets are: children under 2 years of age, who have never or rarely been exposed to sunlight, who have not taken Vit, D prophylaxis, who have obvious symptoms (night terrors, excessive sweating, restlessness) and who have: two major signs: cranial softening (in infants over 3 months of age), square skull, rib cage, rib cage, rib cage, chicken chest, bracelets, “O” and “X” shaped legs, etc.  Or one major sign and one minor sign (occipital baldness, exostosis, late closure of fontanelle, delayed teething, muscle and ligament laxity, etc.).  Or two secondary signs with obvious causes (prematurity, low birth weight, artificial feeding, frailty, partiality, etc.) can be diagnosed as active stage. After appropriate treatment, the above symptoms and signs may gradually decrease or tend to disappear, but a few of them may leave skeletal deformities or motor disorders of different degrees. In addition, infants and children with rickets may suffer from convulsions, hand and foot twitching, laryngospasm, and even death by asphyxiation due to the decrease of serum calcium in their bodies.  (a) dietary supplements and outdoor exercise: insist on breastfeeding, add complementary foods in time from 4 to 6 months, foods containing more Vit and D include liver, egg yolk, fish roe, etc., and foods containing more calcium include soy products, spinach, fish and shrimp, etc. Milk and dairy products should be used as a staple food until the age of 3. Milk contains 104mg of calcium per 100ml, and it is more appropriate to replace fresh milk with formula for small infants. In addition, should also go outdoors for at least 2 hours a day to increase their own Vit, D production.  (ii) Drugs: 1. Preventive amount: 15 days after birth, start to supplement Vit, A : Vit, D = 3 : 1 cod liver oil, the daily preventive amount of Vit, D is 400 IU. The standard supply of elemental calcium (RDA) is 400-800mg/day for children.  And the choice of calcium supplements depends on two main points: (1) the dose of elemental calcium contained; (2) the absorption rate of the chosen calcium supplements.  2, the amount of treatment: active period with Vit, D 10,000 ~ 20,000 IU / day orally, one month later reduced to the maintenance amount continue to take orally for 2 months and then changed to preventive amount, six months later review. And the principle of calcium supplementation is the principle of how much is missing and specificity. After treatment, motor function is restored faster, but excessive exercise should be limited to prevent deformity.  (iii) Treatment of sequelae period: increase nutrition, strengthen exercise, no need to give drug treatment, mild pheochromocystis can be gradually corrected by push-ups or chest expansion exercise to make the thorax expand, serious skeletal deformity will eventually be corrected by surgery.