Original ArticlesNutritional rickets in African American breast-fed infants☆
Section snippets
Methods
Records were reviewed on all patients with a diagnosis of nutritional rickets between the years 1990 and 1999. The patients were seen by at least one of the authors in the pediatric endocrinology clinic at Wake Forest University School of Medicine or in the pediatric endocrinology or genetic/metabolic clinics at the University of North Carolina School of Medicine at Chapel Hill and were referred from community health clinics and primary care providers from throughout North Carolina. Information
Results
Thirty patients with nutritional rickets were referred to the two medical centers between 1990 and June of 1999; 17 patients (57%) presented in 1998 and the first half of 1999. Of the total number of patients, 57% were male (n = 17) and 43% female (n = 13). All were African American. According to dietary history provided by the mother at the time of the referral visit, all were breast fed, with an average duration of breast-feeding of 12.5 months. Those children over 1 year of age had a history
Discussion
All of our patients with nutritional rickets were breast fed without vitamin D supplementation and all were African American, the largest minority group in North Carolina. As in other studies,3, 5, 6, 8 the vast majority of the patients were growth retarded in both height and weight by the time of diagnosis, and nearly one third were severely growth retarded. There are several possible causes for the increase in the number of cases of nutritional rickets seen at our two medical centers over the
Acknowledgements
We thank Alice Lenihan, RD, MPH, LDN, for providing the breast-feeding data on North Carolina women enrolled in the WIC program.
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Reprint requests: Shelley Kreiter, MD, Department of Pediatrics, Wake Forest University School of Medicine, Winston-Salem, NC 27157.