World Pediatric Bone and Joint Day: What parents need to know about bone health amongst children – Times of India


From March 2020, the pandemic COVID-19 in India and the resulting health emergency prompted several restrictions. Since then, schools and universities have been shuttered due to the quarantine, which has resulted in the closure of practically all public enterprises and work activities.

Read more: Lifestyle habits that weaken your bones and joints

Children have been denied access to outdoor educational, work, and sporting activities, which substantially impacts their physical health and development. Even though we are all facing additional obstacles due to the crisis, parents are frequently concerned about how they would care for their children while working and learning at home and remain calm throughout this unusual outbreak.

Children’s bone disease refers to illnesses that impair bone strength, growth, and overall health. Children’s bones are constantly growing and reshaping themselves. The growth plate is a vulnerable part of the bone where insults to growth can potentially occur. Old bone is gradually replaced by new bone tissue during growth remodeling. As the child grows, many growth abnormalities may improve or worsen. Other bone disorders can be inherited or develop spontaneously in childhood.

Some of the key points parents should keep in mind to nourish their child’s bone health are:

⦁ Encourage your children to participate in physical activities at least 5 times a week

Encourage your child to participate in age-appropriate, fun, and diverse activities. This varies depending on your child’s age, ranging from being active all day for preschoolers (ages 3 to 5) to be active for 60 minutes or more for school-aged children and teenagers (ages 6 through 17 years). Include muscle-strengthening exercises, such as climbing or doing push-ups, in your child’s daily 60 minutes or more at least twice a week.

⦁ In terms of nutrition, provide your children with a calcium-rich diet

Calcium is found in moderate amounts in dairy products. Ragi is a fantastic source of calcium for individuals living in the south. Ragi contains 350-375 mg of calcium per 100 grammes. It is critical to incorporate ragi into one’s diet. If ragi is unavailable, people from north India can substitute Rajma or Sesame. Calcium is found in 275-300mg in rajma and 800mg in sesame. As a result, it’s a highly concentrated form of calcium that’s readily available.

⦁ Colas, sodas, and aerated drinks should be avoided in a child’s diet

There is adequate data to suggest that excessive soda and carbonated beverage consumption is linked to reduced bone mass in youngsters. Although the actual cause of the problem is unknown, researchers believe that consuming soda, particularly colas, has several adverse effects on bone density. One reason could be that people who drink colas are less likely to acquire adequate calcium and vitamin D in their diets since they are replacing more nutritious beverages like milk or calcium-fortified juice with soda.

⦁ Keep an eye on your child’s posture while they are taking online classes or watching television

The ’90-90-90′ guideline should be followed when sitting for children. Your child’s elbows, hips, and knees should all be at a 90-degree angle when he sits. This means that your child’s workstation should be at the same height as their elbow. To obtain the proper seated position for young children, the chair may need to be raised in size. If your child’s feet are dangling in mid-air rather than resting firmly on the floor, foot support or stool should be provided.

Common growth abnormalities that are concerning to families-

1) In-toeing/Sitting in W- position
2) Bowlegs and knock knees
3) Spine curvature abnormality
4) Flat foot

In toeing

As kids start walking, a significant number of kids tend to have in-toeing, which could be because of simple toe problems or the architecture of the hip. Generally speaking, there is no major cause for worry- a consultation with a trained pediatrician or a pediatric orthopedic surgeon will help.

Bowlegs and Knock knees

Most kids at birth tend to have bow legs which become exaggerated up to the age of 18 months and then will progress to knock knees by 36 months. Gradually they settle in subtle knock knees by age 7.

Spine curvature

Scoliosis is a change in curvature of the spine, and many times this tends to get missed out. We would encourage families to examine the spine in kids from the back and look for subtle changes and esp. this is common in teenage girls.

Flat foot

This is another presentation that is usually benign and does not cause any functional limitation. Around 10% of flat feet in kids can be problematic and thus lead to problems. Most newborns are born with flat feet, and the arches start to develop by the age of 3, and arches of feet mature by 10 years of age.

A variety of disorders can cause bone disease in children:

Bone diseases can be triggered by trauma, infection, or cancer; they can also be inherited, develop as a child grows, or develop for no apparent reason. Some bone disorders cause pain and make it difficult to walk, while others have no symptoms.

A thorough history, close observation and examination, and the selective use of x-rays or MRIs are used by doctors to diagnose.

– Deficiency in vitamin D: Vitamin D helps the body absorb calcium and phosphorus from a diet that works together to form strong bones. A severe deficit can cause thin, brittle, or deformed bones.

– Rickets: A disorder in which the bones become mushy and fragile in youngsters. The majority of youngsters have rickets as a result of a long-term, severe vitamin D deficit. Bowed legs are a common symptom.

– Imperfect osteogenesis: Osteogenesis imperfecta, often known as brittle bone disease, is a hereditary illness that affects people from birth. Bones that shatter readily are a sign of brittle bone disease.

– Osteopetrosis: Infantile osteopetrosis is an uncommon hereditary disorder that manifests itself from birth. The bones do not usually form in this condition, resulting in overly thick yet fragile and easy to break. Short stature, hearing and vision loss, frequent fractures, and infections are all possible consequences of this illness. Low blood calcium and parathyroid hormone levels are common in children with this illness.

Bone disease can be easily diagnosed using various methods and can be treated with the help of Vitamin D and calcium supplements. Depending on the severity of the condition, some types of bone diseases also necessitate prescription drugs, physical therapy, or surgery.

This article is authored by Dr. Mohan Puttaswamy, Senior consultant – Reconstructive orthopedic surgeon, Fortis Hospital, Bannerghatta Road

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