In this study of rickets in Toronto, there were 17 cases in a 5 years period
( average 3 cases per year). Note their recommendations  So how did we get
from these small numbers of babies with multiple risk factors to a blanket
recommendation to all breastfed babies?

Barb Whitehead, BS, IBCLC, RLC




Persistence of Vitamin D-deficiency rickets in Toronto in the 1990s.

Binet A, Kooh SW.

Department of Paediatrics, University of Toronto, Ontario.

To assess the current picture of vitamin D deficiency, we reviewed all 17
cases of vitamin D-deficiency rikets seen in the referral clinic of a
children's hospital in Toronto between 1988 and 1993. The diagnosis was made
at 7 to 33 months of age. All the children were symptomatic all had
biochemical and radiographic abnormalities, two suffered hypocalcemic
seizures, and all had bowing of the extremities. Twelve of the children were
born to parents who were recent immigrants to Canada. All were of Asian or
African origin with dark skin. All the children had been exclusively
breastfed with no vitamin D supplementation, and had had little or no
sunlight exposure. All the patients responded to vitamin D therapy. We
conclude that vitamin D-deficiency rickets remains an
environmental/nutritional deficiency disease in this city and that efforts at
prevention should target children with pigmented skin from families who are
recent immigrants.    (My highlights-Barb)




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