Rickets in Children in Grand Rapids, Michigan

Rickets is a bone disease that affects infants and young children. In rickets, a child’s growing bones do not mineralize (harden) properly, usually because of a lack of vitamin D, calcium, or phosphate. This can lead to:

  • Soft, weakened bones
  • Bone fractures (sometimes with very little trauma)
  • Bone and muscle pain
  • Visible bone deformities

In Grand Rapids and across Michigan, most cases of rickets are linked to low vitamin D levels.

Why Rickets Matters in Grand Rapids, MI

Local factors that affect vitamin D

In West Michigan, including Grand Rapids, several factors increase the risk of vitamin D deficiency:

  • Long, cloudy winters – Michigan has many overcast days, especially from fall through early spring, which limits sun exposure.
  • Spending more time indoors – Cold temperatures and snow mean many children get less outdoor playtime in winter.
  • Higher latitudes – Northern states like Michigan receive less intense UVB sunlight, especially in late fall and winter, which reduces the skin’s ability to make vitamin D.

Because of these factors, pediatricians at Corewell Health (formerly Spectrum Health), Trinity Health Grand Rapids, Metro Health – University of Michigan Health, and Mercy Health often monitor vitamin D levels in infants and young children who may be at higher risk.

Signs and Symptoms of Rickets

If you live in the Grand Rapids area and notice any of the following in your child, talk with your pediatrician or family doctor:

  • Bone problems

    • Increased risk of broken bones
    • Fractures that happen with minimal or no clear injury
    • Bowed legs or knock-knees
    • Abnormal shape of the skull
    • A prominent forehead or a large soft spot (fontanelle) that stays open longer than expected in infants
    • Deformities of the spine:
      • Kyphosis (rounded, “hunch-back” upper spine)
      • Scoliosis (sideways curves of the spine)
    • A breastbone that sticks out (pigeon chest)

  • Muscle and growth issues

    • Painful bones
    • Muscle weakness, cramps, or spasms
    • Slowed growth and development
    • Delayed milestones (such as sitting, crawling, or walking)

  • Dental problems

    • Teeth that are slow to come in
    • Deformed teeth or soft tooth enamel
    • Increased risk of cavities

If you notice these symptoms in your child in Grand Rapids or Kent County, contact your child’s healthcare provider promptly.

Who Is at Higher Risk for Rickets in Grand Rapids?

In the United States, rickets is more common in:

  • Recently arrived migrant, asylum seeker, and refugee children
  • Children whose parents migrated from countries closer to the equator, where sun exposure is higher and vitamin D deficiency may be more common

Children in Grand Rapids may be at increased risk of developing rickets due to vitamin D deficiency if they:

  • Have naturally very dark skin

    • Darker skin has more melanin, which reduces the skin’s ability to make vitamin D from sunlight.

  • Are born to women with vitamin D deficiency

    • If a pregnant person has low vitamin D, the baby may be born with low stores.

  • Cover most of their body for religious or cultural reasons

    • Long sleeves, long skirts, and head coverings reduce the amount of skin exposed to sunlight.

  • Rarely go outside or always use heavy sun protection

    • Children who are sick, have disabilities, or spend most of their time indoors
    • Children who never go outside without sunscreen, hats, and full clothing coverage

  • Have certain medical conditions, including:

    • Bowel diseases or intestinal disorders that reduce absorption of nutrients
    • Liver or kidney disorders that prevent vitamin D from being converted into its active form
    • Disorders that reduce digestion or absorption of fats (vitamin D is a fat-soluble vitamin)

  • Have a diet low in vitamin D or calcium, such as:

    • Limited intake of fortified milk or formula
    • Very restricted diets
    • Vegan diets without appropriate supplementation or fortified foods

Families in Grand Rapids who are unsure about their child’s nutrition can seek guidance from pediatric dietitians at local health systems such as Corewell Health, Trinity Health Grand Rapids, and community programs through the Kent County Health Department.

The Role of Vitamin D in Bone Health

Our bodies need vitamin D to:

  • Absorb calcium and phosphorus from food
  • Support the growth and development of strong, healthy bones and teeth

Without enough vitamin D, the body cannot properly regulate calcium and phosphorus levels. This leads to poor bone mineralization and increases the risk of rickets in children.

Where vitamin D comes from

About 90% of our vitamin D typically comes from sun exposure:

  • When UVB rays from sunlight hit the skin, they convert a substance called 7-dehydrocholesterol into vitamin D.
  • The liver and kidneys then convert vitamin D into its active hormone form, which helps build strong bones and teeth through mineralization.

Small amounts of vitamin D are also found in some foods, such as:

  • Fortified cow’s milk
  • Infant formula
  • Fortified cereals
  • Fatty fish (like salmon and tuna)
  • Egg yolks

However, food sources alone are usually not enough to maintain optimal vitamin D levels, especially in northern climates like Michigan.

Sun Exposure and Vitamin D in Michigan

UV levels in Grand Rapids

UV radiation levels vary based on:

  • Location (latitude)
  • Time of year
  • Time of day
  • Cloud coverage
  • Surrounding environment (buildings, trees, snow reflection)

In Grand Rapids:

  • UV levels are stronger in late spring and summer, especially midday.
  • UV levels are lower in fall and winter, which limits vitamin D production from sunlight.

Balancing sun safety and vitamin D

Babies and young children are particularly vulnerable to UV damage and skin cancer risk. In West Michigan, it’s important to balance sun protection with vitamin D needs:

  • When UV levels reach 3 or above (more common in late spring and summer):
    • Use dense shade when outdoors
    • Dress children in cool, covering clothing
    • Use wide-brimmed hats
    • For infants 6 months and older, apply a sensitive, child-safe sunscreen on small areas of exposed skin not covered by clothing or hats

Overuse of sun protection without considering vitamin D intake may contribute to increasing rates of vitamin D deficiency and rickets. Talk with your child’s healthcare provider in Grand Rapids about the right balance for your family.

Preventing Rickets in Grand Rapids Children

Rickets can often be prevented by:

  1. Preventing or treating low vitamin D levels

    • Vitamin D drops or supplements for infants and children at risk (as advised by a healthcare provider)
    • Ensuring adequate vitamin D intake in breastfeeding parents and pregnant people

  2. Ensuring enough dietary calcium and phosphate

    • Age-appropriate intake of:
      • Breastmilk or fortified infant formula
      • Fortified dairy or dairy alternatives
      • Other calcium-rich foods as children grow

  3. Appropriate, safe sun exposure

    • Short periods of outdoor play when weather allows, while following sun safety guidelines
    • Discussing with your pediatrician how much sun exposure is appropriate for your child in Michigan’s climate

Local public health resources, such as the Kent County Health Department and Grand Rapids Public Health programs, may offer nutrition counseling, WIC services, and education on vitamin D and childhood bone health.

Diagnosis of Rickets in Grand Rapids

If a Grand Rapids pediatrician or family doctor suspects rickets, they may:

  • Perform a physical examination
  • Order blood tests to check:
    • Vitamin D levels
    • Calcium and phosphorus levels
    • Alkaline phosphatase (an enzyme related to bone turnover)
  • Request long bone X-rays to look for classic changes in the bones
  • In some cases, order bone scans or other imaging if needed

Early diagnosis is important to prevent long-term complications.

Treatment of Rickets

Treatment depends on the cause of rickets but often includes:

  1. Improved sunlight exposure

    • Safe, moderate outdoor time as recommended by your child’s doctor, tailored to Michigan’s seasons and UV levels.

  2. Improved diet

    • Ensuring your child’s diet includes enough:
      • Vitamin D (fortified milk or formula, fortified foods, supplements if recommended)
      • Calcium and phosphorus

  3. Oral vitamin D supplements

    • Standard vitamin D supplements for most children
    • Special forms of vitamin D for children whose bodies cannot convert vitamin D into its active form (such as those with liver or kidney disease)
    • Supplements may need to be taken for about 3 months or longer, depending on severity and underlying cause.

  4. Treatment of underlying disorders

    • Managing bowel, liver, kidney, or fat absorption disorders that interfere with vitamin D or calcium use in the body.

  5. Surgery (in severe cases)

    • For children with severe bone deformities, orthopedic surgery may be needed, often at specialized centers such as pediatric services within Corewell Health Helen DeVos Children’s Hospital in Grand Rapids.

Bones that are poorly mineralized often respond quickly to dietary supplementation with calcium and vitamin D. Improvements may be seen on X-ray after only a few days to weeks of treatment, although full correction can take longer.

If rickets is treated while the child is still young, there is a good chance that skeletal deformities will improve or disappear as the child grows. However, if rickets is not treated before puberty is complete, some deformities and reduced height may become permanent.

When to Seek Help in Grand Rapids

Contact a healthcare provider if you are concerned that your child may have rickets or vitamin D deficiency, especially if you notice:

  • Bone pain or tenderness
  • Frequent fractures
  • Bowed legs or other bone deformities
  • Muscle weakness or delayed milestones
  • Dental problems or delayed tooth eruption

Local resources

  • Your GP (family doctor) or pediatrician – first point of contact for evaluation and testing
  • Pediatric services at:
    • Corewell Health (Spectrum Health) and Helen DeVos Children’s Hospital
    • Trinity Health Grand Rapids
    • Metro Health – University of Michigan Health
    • Mercy Health facilities in the Grand Rapids region
  • Kent County Health Department – for public health information, WIC, and nutrition support
  • Grand Rapids Public Health programs – for community education and support

If you need after-hours advice, many Grand Rapids health systems offer 24/7 nurse advice lines; check your insurance card or health system’s website for the correct number.

Key Points About Rickets in Grand Rapids, MI

  • Rickets is a bone disease in infants and young children caused mainly by vitamin D deficiency, often combined with low calcium or phosphate.
  • Michigan’s long winters, frequent cloud cover, and limited sun exposure increase the risk of vitamin D deficiency in children.
  • Overuse of sun protection without adequate vitamin D intake may contribute to rising vitamin D deficiency, but sun safety remains essential—especially for babies and young children.
  • Children are at higher risk if they have dark skin, limited sun exposure, certain medical conditions, or a diet low in vitamin D and calcium, or if they are recent migrants or refugees.
  • Food sources alone are usually not enough to maintain adequate vitamin D levels in northern states like Michigan; supplements are often recommended for at-risk children.
  • Rickets can usually be prevented and treated with vitamin D and calcium, appropriate sun exposure, and management of underlying conditions.
  • Early diagnosis and treatment in Grand Rapids give children the best chance for normal growth and bone development.