Healthdirect Free Australian health advice you can count on.

Medical problem? Call 1800 022 222. If you need urgent medical help, call triple zero immediately

healthdirect Australia is a free service where you can talk to a nurse or doctor who can help you know what to do.

beginning of content

Rickets

6-minute read

Key facts

  • Rickets is a bone disease that can affect children.
  • It causes weak, soft bones that can bend out of shape.
  • Rickets is caused by not having enough vitamin D, and is rare in Australia.
  • It can be prevented with a good diet and daily, safe exposure to sunlight.

What is rickets?

Rickets is a bone disease that causes your bones to be soft and weak. It can be prevented with a good diet and some exposure to sunlight for vitamin D.

Rickets occurs in children, and occasionally teenagers. It does not occur in adults, as it only affects growing bones. Rickets is not common in Australia.

What are the symptoms of rickets?

If a child has rickets, their bones can bend slightly. Sometimes the bones of the legs will not grow straight. This is called having 'bow legs'. Sometimes the knees tilt inwards. This is called being 'knock-kneed'.

Other symptoms of rickets can include:

  • swollen and sore wrists, knees and ankles
  • teeth that appear late and have poor quality enamel
  • the front fontanelle (the soft part at the top of a baby's head) being slow to close in babies
  • soft skull bones
  • poor growth
  • being slow to crawl and walk
  • breaking bones very easily

Sometimes babies and children with rickets can have muscle cramps or seizures due to low calcium levels.

What causes rickets?

Rickets only occurs in children (and occasionally teenagers) while they're growing. It is usually caused by low levels of vitamin D. Vitamin D forms in your skin when you are exposed to ultraviolet (UV) light from the sun. There is also vitamin D in some foods.

Low calcium or low phosphate levels can also sometimes lead to rickets. These minerals are needed for bone strength. Calcium and phosphate are found in milk and dairy foods.

Most children with low vitamin D alone do not get rickets. The risk of rickets is higher in babies and children who:

  • breastfeed for a long time without starting solids at 4 to 6 months
  • have a diet that does not have enough dairy products

Some kidney problems might also cause rickets. Kidney problems can make it harder for the body to absorb and use calcium and phosphate.

When should I take my child to see a doctor?

Take your child to see your doctor as soon as possible if they have any symptoms of rickets.

Also see your doctor if you're concerned about any aspect of your child's development.

How is rickets diagnosed?

If your doctor suspects rickets, your child will need to have a blood test to check their Vitamin D. The blood test will also check their:

  • calcium level
  • phosphate level
  • kidney function

Your child might also need x-rays to check how well their bones are growing.

They might be referred to a paediatrician (doctor who specialises in the health of children).

How is rickets treated?

Your doctor may recommend changes to your child's diet. They may also refer you to a dietitian.

They might also recommend giving your child supplements to help your child get enough vitamin D, calcium and phosphate.

If your child has very low calcium, they will need to go to hospital. At the hospital, they will have treatment and have their heart checked.

Your child will need regular check-ups to check their vitamin D levels. They may also need regular x-rays to check on their bone growth.

Can rickets be prevented?

Healthy bones are vital to a child's physical growth and development. Eating the right foods and getting enough sunshine helps their bones develop. Good food and sunshine can prevent the development of rickets.

You can help prevent your child from getting rickets by:

  • Seeing a midwife or doctor regularly during your pregnancy and having your vitamin D levels checked during your pregnancy. Have your child's levels checked if there are any concerns.
  • Introducing solid foods when your baby is 4 to 6 months old.
  • Making sure your child has enough calcium and phosphate in their diet — The Australian Guide to Healthy Eating will give you a good idea of which foods your child needs for healthy growth.
  • Spending time outside in the sunshine. This will prevent vitamin D levels from dropping.

Some foods contain vitamin D. These include oily fish such as sardines, tuna and salmon. Milk and soy drinks with added vitamin D can also provide some vitamin D. However, including these foods in your diet is not usually enough to get all the vitamin D that is needed.

The best way for your child to get vitamin D is to get enough exposure to sunlight. The amount of time you need outside will depend on how dark your skin is. It also depends on where in Australia you live.

People with very dark skin may need more sun than people with light skin to reach the same levels of vitamin D.

It's important to find a balance between getting enough sun and staying protected from the sun. The SunSmart app is a great way to find out how much sun protection you need. It can also help you to plan when to get more sunshine.

Resources and support

If you are concerned about your child's development, see your doctor.

For more information about Vitamin D and sunshine, visit the Cancer Council website.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with 24 hours a day, 7 days a week.

Learn more here about the development and quality assurance of healthdirect content.

Last reviewed: October 2023


Back To Top

Need more information?

These trusted information partners have more on this topic.

Top results

Rickets - Better Health Channel

Rickets is a preventable childhood bone disease caused by a lack of vitamin D.

Read more on Better Health Channel website

What is Vitamin D Deficiency? Q & A with Dr. Norman Swan - myDr.com.au

Dr. Norman Swan explains what vitamin D deficiency is and why the elderly and people with darker skin are most at risk of getting it and the problems associated with vitamin D deficiency.

Read more on MyDoctor website

Vitamin D & vitamin D deficiency in kids | Raising Children Network

Vitamin D helps bones grow, develop and stay strong. Children get most of their vitamin D from sunlight as well as a small amount from some foods.

Read more on raisingchildren.net.au website

Vitamin D | Dietitians Australia

Vitamin D is both a nutrient we eat and a hormone our bodies make. We need vitamin D, but it doesn't all have to come from your diet. That’s important to know because there are few foods that are reliable sources of vitamin D. If you spend enough time in the sun, then your body can make all the vitamin D it needs.

Read more on Dietitians Australia website

Vitamin D & Bone Health – Bone Health

Vitamin D & Bone Health Vitamin D is needed to absorb calcium from the intestine to support healthy bones

Read more on Healthy Bones Australia website

Vitamin D | Pathology Tests Explained

Vitamin D is vital for the growth and health of bone; without it, bones will be soft, malformed, and unable to repair themselves normally, resulting in the d

Read more on Pathology Tests Explained website

RACGP - Vitamin D testing

Reproduced with permission from The Royal Australian College of General Practitioners

Read more on RACGP - The Royal Australian College of General Practitioners website

Vitamins & minerals for kids & teens | Raising Children Network

Kids and teens need vitamins and minerals for health and development. They can get vitamins and minerals by eating a variety of foods from the 5 food groups.

Read more on raisingchildren.net.au website

Bow legs & knock knees: 0-18 years | Raising Children Network

Bow legs are when the legs curve outwards. Knock knees are when the legs curve inwards. These conditions are common and usually don’t need treatment.

Read more on raisingchildren.net.au website

Bow legs and knock knees in children

Bow legs and knock knees are a normal part of a child's growth and they usually correct naturally. Find out when to see your doctor.

Read more on Pregnancy, Birth & Baby website

Healthdirect 24hr 7 days a week hotline

24 hour health advice you can count on

1800 022 222

Government Accredited with over 140 information partners

We are a government-funded service, providing quality, approved health information and advice

Australian Government, health department logo ACT Government logo New South Wales government, health department logo Northen Territory Government logo Queensland Government logo Government of South Australia, health department logo Tasmanian government logo Victorian government logo Government of Western Australia, health department logo

Healthdirect Australia acknowledges the Traditional Owners of Country throughout Australia and their continuing connection to land, sea and community. We pay our respects to the Traditional Owners and to Elders both past and present.