Children with 'prominent' forehead may in fact be suffering from illness

10 December 2023 , 07:52

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Children with protruding foreheads may be suffering from rickets. File image (Image: Getty Images/Tetra images RF)

Children with prominent, protruding foreheads and heavy brow ridges (otherwise known as frontal bossing) may be suffering from a serious illness first identified in 1645.

Rickets is a condition that affects bone development in children, sometimes leading to bone deformities. It is most commonly caused by prolonged vitamin D deficiency, as vitamin D helps the body absorb calcium from food.

Genetic defects can also play a role. Hypophosphatemic rickets, for example, is a genetic disorder where the kidneys and bones deal abnormally with phosphate such that there is too little in the blood and bones, leaving them weak and soft.

In addition to a pronounced forehead, swollen and painful wrists and ribs are another symptom of rickets. The mass-production of foods like margarine and cereal fortified with vitamin D meant that rickets all but disappeared in the western world during the early 20th century.

But malnutrition due to declining living standards is thought to have contributed toward an uptick in cases. According to the Big Issue, 10,986 people were diagnosed with malnutrition after being admitted to English hospitals last year, including 312 children - a number that has quadrupled in 15 years and doubled over the last decade.

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And as the cost-of-living crisis shows little sign of abating, nutritious, Vitamin-D-rich produce is beyond the financial reach of many families. Changing cultural habits, such as spending more time indoors, may also be a factor.

Although any child who isn't getting enough vitamin D or calcium can develop rickets, the disease is more common among children of Asian, African-Caribbean and Middle Eastern descent as their skin typically has more of the pigment melanin, which reduces the skin's ability to produce vitamin D from sunlight.

Premature babies are also at greater risk as they may have not had the chance to build up sufficient stores of vitamin D while they were in the womb. A blood test is usually sufficient to confirm a diagnosis of rickets, though your child may also undergo X-rays or a bone density scan (DEXA scan), a type of X-ray that measures the calcium content in bones.

If left untreated, rickets can lead to:

• Significantly stunted growth

• An abnormally curved spine

• Bone deformities

• Dental defects

• Seizures

Sources of vitamin D are:

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• Sunlight

• Food, such as oily fish, eggs and fortified breakfast cereals

• Dietary supplements

Mizy Judah Clifton