1, pediatric “calcium deficiency disease” is actually a lack of vitamin D, medically known as rickets The people say “calcium deficiency disease”, medically known as rickets, is actually vitamin D deficiency rickets, the cause is the lack of vitamin D in the child’s body, resulting in The cause is a series of pathological manifestations of the disorder of calcium and phosphorus metabolism in the body due to the lack of vitamin D in the child’s body. The incidence is very high nationwide and therefore very common. The real cause of the disease is not really a calcium deficiency, but a lack of vitamin D, resulting in calcium malabsorption. 2, clinical manifestations of rickets: rickets usually has neuropsychiatric symptoms and skeletal system signs Neurological symptoms: is the main manifestation of rickets at the beginning, manifested as excessive sweating, night terrors, good crying, etc.. Due to the stimulation of sweat and friction of the occipital area, occipital baldness or ring-shaped hair loss is formed. This is a sign of increased neuromuscular excitability due to a decrease in serum free calcium. Skeletal system performance: mainly fontanelle is too large, ping-pong skull, square skull, delayed teething, bracelet sign, ankle bracelet sign, rib beads, etc. 3, rickets prevention: supplementation of vitamin D Usually we require children to take 1 capsule of cod liver oil (containing about 1000 units of vitamin A and 400 units of vitamin D) every day after birth, until about 2 years of age, which is through the daily supplementation of vitamin A and D. This supplementation of D is exogenous vitamin D (usually the daily demand is 400 units), while people can also synthesize their own Vitamin D, the prerequisite is skin contact with ultraviolet light, so it is recommended that children get more sunlight and more outdoor activities, so that after skin contact with ultraviolet light, the body can synthesize part of the vitamin D itself, which is endogenous vitamin D. The 2 together can basically meet the needs of growth and development and achieve the purpose of preventing pediatric rickets (commonly known as pediatric calcium deficiency disease, which is actually vitamin D deficiency). However, due to the differences in light and ultraviolet light intensity in different regions and seasons, the length of time children spend outdoors, the differences in skin exposure and size, whether the child is born prematurely or at term, the amount of outdoor activities the mother does during pregnancy, and the differences in the child’s growth and development and personal physical condition, the amount of vitamin D required by each child varies, so in order to achieve the best effect in preventing rickets, the amount of vitamin D required by each child is very important. The amount of vitamin D required for exogenous supplementation also varies from child to child to achieve the best results in preventing rickets. The basic requirement of taking one capsule of cod liver oil daily from birth to about 2 years old does not mean that rickets will not occur if you take cod liver oil in this way. In the north of China, especially in winter, when newborn babies have almost zero outdoor activities due to cold weather, it may be necessary to increase the amount of supplemental vitamin D to 800 units or even higher to achieve the purpose of preventing rickets. In this case, if the dose of cod liver oil is simply doubled, i.e., if 2 cod liver oil capsules are taken daily, it is bound to increase the dose of vitamin A supplementation to more than 2000 units while meeting the demand for vitamin D. This is not a big problem for a short period of time, but if taken for a long time, it may lead to vitamin A overdose and even poisoning. Therefore, in northern areas, especially in winter and spring, infants should supplement one capsule of cod liver oil daily along with one capsule of 400-500 units of vitamin D. This will meet the child’s demand for vitamin D while avoiding vitamin A overdose. 4, the treatment of rickets Since the people mistakenly call rickets a calcium deficiency disease, so calcium supplementation is the main method of treatment usually considered by the people. In fact, it is completely wrong. Usually pediatric rickets does not require calcium supplementation, but only vitamin D supplementation. After supplementing with vitamin D, the D that enters the body can be regulated by a series of mechanisms to increase the absorption rate of calcium and can fully absorb the calcium elements in breast milk or formula. As long as the child drinks more than 500 ml of milk every day, the calcium content inside the milk is sufficient if it is fully absorbed with the help of vitamin D. There is no need for additional calcium supplements. Therefore, when a physician diagnoses a child with active rickets, he or she usually gives a high-dose vitamin D shock treatment method, that is, a one-time high-dose vitamin D treatment, usually using 150,000 units, or 300,000 units of vitamin D by oral or intramuscular injection. It is also possible to use thousands to tens of thousands of units of vitamin D daily for a certain course of treatment, which is called a small-dose, long-course regimen.