Hesperian Health Guides

Chapter 13: Children Who Stay Small or Have Weak Bones

HealthWiki > Disabled Village Children > Chapter 13: Children Who Stay Small or Have Weak Bones

In this chapter we look at children whose bones are weak and deformed, and at children who do not grow as tall as other children. We include rickets, brittle bone disease, and children who stay very short (dwarfism). In all of these conditions, the legs may become bowed, and the shape or proportions of the bones are often not normal.


Rickets is weakness and deformity of the bones that occurs from lack of vitamin D. Vitamin D occurs in whole milk, butter, egg yolks, animal fats, and liver, especially fish liver oil. The body also makes its own vitamin D when sunlight shines on the skin. Children who do not eat enough foods with vitamin D, and who do not get enough sunlight, gradually develop signs of rickets.

a child with rickets
Soft spot on baby's head is slow to close
bony necklace
curved bones
big, lumpy joints
bowed legs (knees bent out)

Rickets is fairly common in some countries, especially in cool mountain areas of Asia and Latin America where babies are kept inside and wrapped up. Rickets is also increasing in crowded cities where children are seldom taken into the sunlight.

Treatment for rickets is to give fish liver oil, and to spend time in the sunlight. The best and cheapest form of prevention is to be sure sunlight reaches the child’s skin. Foods that contain vitamin D also help.

This page was updated:21 Nov 2019