By Kimberly Beauchamp, ND

Healthnotes Newswire (June 29, 2006)—Could a milk allergy cause rickets? Apparently so, according to the Annals of Allergy, Asthma, and Immunology. The journal recently reported a case of vitamin D–deficiency rickets in a two-year-old boy who was allergic to cow’s milk.

This case adds to a growing number of reports of rickets—a softening and weakening of the bones caused by extreme vitamin D–deficiency—in children, raising concerns over whether children are getting enough vitamin D.

Until recently, rickets was uncommon, but the apparent resurgence of the disease might be due to children getting less sunshine exposure and mothers consuming less vitamin D during pregnancy. Breast-fed babies who don’t receive a vitamin D supplement are at particularly high risk for deficiency.

Vitamin D is produced by a chemical reaction when the skin is exposed to sunlight. People who limit their time in the sun have to rely on foods and supplements to get enough of the vitamin. Cod liver oil and vitamin D–fortified foods are the richest sources.

The new case of vitamin D–deficiency rickets was found in a boy living in northern Canada, where sunlight exposure is limited. After the boy was breast-fed for the first six months of his life, he was given a cow’s milk formula, which caused a rash on his face. His parents avoided giving him more milk products and did not replace the formula with another source of vitamin D.

Over the next year and a half, the little boy’s health deteriorated, and he was unable to walk or even pull himself to a sitting position.

The boy was diagnosed with rickets and hospitalized. After being given vitamin D and calcium, his health soon returned. He was able to stand again two weeks after his discharge.

The American Academy of Pediatrics (AAP) recommends that all infants over two months old have a minimum of 200 IU of vitamin D per day; this amount should be continued throughout childhood and adolescence.

Parents who are concerned about their children’s vitamin D intake might wonder if simply exposing them to sunlight would provide enough of the vitamin. The problem with this approach, according to the AAP is that, “[It is] very difficult to determine what is adequate sunshine exposure for any given infant or child.”

What’s more, new studies show that the earlier a child is exposed to sunlight is more important than total lifetime sun exposure in terms of skin cancer risk. The AAP advises that children younger than six months of age be kept out of the sun entirely, and that older children wear protective clothing and use sunblock.

On the other hand, Dr. Michael Holick from the Boston University School of Medicine recommends “exposure of the arms and legs or the hands, arms, and face to sunlight for 5 to 15 minutes two to three times a week between 10 a.m. and 3 p.m. during the spring, summer, and autumn” for people of light to medium skin tone. This amount of sunshine should be ample to produce enough vitamin D to reduce the risk of rickets, certain cancers, autoimmune disease, and cardiovascular disease, according to Holick.

The authors of the report suggest, “Consultation with a qualified nutritionist may aid [parents of children with cow’s milk allergy] in the selection of a well-balanced, nutritionally complete diet, especially for picky eaters.”

(Ann Allergy Asthma Immunol 2006;96:615–9)

Kimberly Beauchamp, ND, earned her bachelor’s degree from the University of Rhode Island and her Doctorate of Naturopathic Medicine from Bastyr University in Kenmore, WA. She cofounded South County Naturopaths in Wakefield, RI. Dr. Beauchamp practices as a birth doula and lectures on topics including whole-foods nutrition, detoxification, and women’s health.

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