Although there are no data from national surveys, vitamin D deficiency is common in many parts of sub Saharan Africa, usually starting during the second half of the first year. For children who were born premature, the deficiency is diagnosed
- Children present with poor growth
- Delayed or regressed milestones
- Recurrent pneumonias
- Widening of the wrists
- Prominence of costo-chondral junctions (rickety rosary)
- X-ray wrist – cupping of radius and ulna
- Serum calcium, phosphate
- Alkaline phosphatase
- Urine to exclude renal causes
- Give vitamin D2 at 2,000–5,000 IU per day for 6–12 weeks or D3 at 0.05μg/ kg/day.
- Supplements of calcium and phosphate will also be beneficial. Advise parents
to expose their children to sunshine as a preventive measure against rickets.
- Children should be exposed to sunlight with minimal clothing for 30 minutes a day.
- For infants born preterm, supplementation with vitamin D at a dose of 4,000 IU/day is recommended.
- In addition, there should be provision for calcium and phosphate in the diet, which is usually adequate from milk for the infant and