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Reemerging nutritional rickets: a historical perspective.

Kumaravel Rajakumar¹, Stephen B Thomas

¹Department of Pediatrics, University of Pittsburgh School of Medicine and Children's Hospital of Pittsburgh, 3705 Fifth Avenue, Pittsburgh, PA 15213, USA. Kumaravel.Rajakumar@chp.edu

Archives of Pediatrics & Adolescent Medicine

|April 6, 2005

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Nutritional rickets is resurging in exclusively breastfed infants without vitamin D. Early 20th-century research by Alfred F. Hess demonstrated cod liver oil

Area of Science:

Nutritional science and pediatric health.
Public health and epidemiology of bone diseases.

Background:

Rickets, a bone disease caused by vitamin D deficiency, is re-emerging in exclusively breastfed infants.
Historically, nutritional rickets was prevalent in dark-skinned infants in northern climates, a problem largely overcome by vitamin D fortification and supplementation.

Discussion:

Alfred F. Hess's 1917 study in New York demonstrated cod liver oil's efficacy in preventing and treating rickets in infants.
The study highlighted the vulnerability of dark-skinned infants to nutritional rickets, especially when exclusively breastfed without vitamin D.

Key Insights:

Cod liver oil therapy was highly effective, preventing rickets in 92% of infants treated for 6 months.
Untreated infants showed unremitting progression of rickets, underscoring the critical need for intervention.

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Outlook:

Hess's work led to public health initiatives, including the first rickets clinic, contributing to the conquest of early 20th-century rickets epidemics.
Understanding historical research is crucial for addressing the current resurgence of nutritional rickets in vulnerable infant populations.