Rickets in children is a condition that many people are not concerned about in modern times, however it ‘is now making a re-emergence', a public health nurse has warned.

Rickets is caused by a deficiency in vitamin D, especially in children. It leads to a bending or distortion of the bones. Vitamin D is essential for healthy bones, but is present in very few foods. It is known as the sunshine vitamin, because it is made in the body when ultraviolet rays from sunlight strike the skin.

Rickets in children was a problem in Ireland up to the mid 20th century, but due to better nutrition in our population over recent decades, it was thought to have been eradicated. However, a number of cases of the condition have been seen here in recent years.

According to Lorraine Murphy, who works for the HSE in Meath, up to eight in 10 Irish toddlers aged between one and four have ‘very low intakes' of vitamin D. As a result, problems linked with vitamin D deficiency, including rickets, are becoming more common.

Ms Murphy pointed out that this issue emerged in the mid-noughties, when as many as 23 diagnosed cases of rickets were reported over a two-year period. However, this coincided with the H1N1 (swine) flu pandemic.

"The H1N1 consumed health professionals' expertise and the finances and resources of health authorities," she explained.

As a result, health concerns related to vitamin D deficiency received little interest.

"Perhaps if it had emerged at a time where there was not a more pressing national health issue, it may have received more interest from both the health and public forum. The subject of vitamin D is now only coming to the forefront slowly again," she said.

She pointed out that aside from rickets, children with vitamin D deficiency are at risk from a range of conditions, including diabetes, cancer and impaired neurological function.

Symptoms of rickets and vitamin D deficiency are most commonly picked up between the ages of six months and three years. It is at this time that public health nurses are monitoring children's growth and development. As a result, they may be the first to pick up on a problem.

However, midwives and GPs are also ‘key practitioners' in this area. Information and recommendations should be provided to them as this ‘would ensure that individuals and parents are receiving consistent, evidence-based advice'.

Ms Murphy added that taking all things into account, it appears that vitamin D supplementation ‘is the most realistic achievable source of obtaining recommended levels of vitamin D'.

She made her comments in the World of Irish Nursing, the Journal of the Irish Nurses and Midwives Organisation.

Since 2011, parents with infants under 12 months of age have been advised to give their children a daily vitamin D supplement. For more information on this, click here