Preventative guidelines to reduce the incidence of rickets
Although rare, rickets has seen a spike in occurrence since the year 2000. There are even concerns that despite preventative measures, rickets remains consistent in children particularly those born to mothers who are substantially vitamin D deficient themselves.
This group includes those who live in Northern areas, as well as dark-skinned children who are breastfed without the use of vitamin D supplementation. The rise of rickets is such a concern that in 2016 an international panel published a global consensus in order to come up with preventative guidelines to help physicians reduce the incidence of rickets.
Here are highlights of some of their recommendations:
- A daily dose of 400 IU of vitamin D is enough to prevent rickets and is recommended for all babies from birth to 12 months, regardless of whether the baby is breastfed or formula fed.
- The fact that the recommendation is the same for both breastfed and formula fed babies demonstrates that the medical panel’ guidelines intend to ensure that all infants receive the adequate amount of vitamin D to protect them from developing rickets.
- Rickets can be treated with a minimum dose of 2000 IU per day of vitamin D for at least a 3-month period. This treatment should be accompanied by 500 mg per day of oral calcium. A patient may need to be treated for a longer period.
- When treating rickets with a daily vitamin D regimen, vitamin D2 or D3 are considered to be equally effective. However, when a single large dose is given as treatment, vitamin D3 is considered is more advantageous. 
- Pregnant women should ensure that they are vitamin D sufficient themselves, and therefore should take 600 IU per day of vitamin D along with the other recommended micronutrients for prenatal care.
- When the baby starts eating solids, which should be no later than 26 weeks of age, it is recommended that they continue to take 400 IU per day of vitamin D along with foods that are rich in calcium. 
- Breastfeeding mothers should continue to take 600 IU per day of vitamin D for themselves. The medical panel advises that the lactating mothers should not increase their vitamin D dosage to a large amount as a means to supplement their infant from their breastmilk. 
 Mayo Clin Proc. 2013 Feb; 88(2): 176–183. doi: 10.1016/j.mayocp.2012.10.018, PMCID: PMC3612965, NIHMSID: NIHMS43411
 Tom D. Thacher, MD et al. Increasing Incidence of Nutritional Rickets: A Population-Based Study in Olmsted County, Minnesota
 Craig F. Munns et al. Global Consensus Recommendations on Prevention and Management of Nutritional Rickets. J Clin Endocrinol Metab, February 2016, 101(2):394-415.