Vitamin D deficiency is common among infants, especially breastfed babies who do not get much sunlight. Vitamin D is produced naturally by the skin upon exposure to sunlight and can also be acquired through fortified infant formula, food or supplements. The American Academy of Pediatrics recommends that all breastfed babies receive 400 IU of vitamin D daily to help prevent a deficiency. A severe vitamin D deficiency in an infant may be diagnosed as the disorder rickets.
Craniotabes
Craniotabes, a softening of the skull, can occur normally in premature infants and in some babies under six months of age, but it is also one of the first clinical symptoms of a vitamin D deficiency. In an infant with craniotabes, the bones of the skull and in particular the occipital bone may feel like a ping pong ball, buckling under pressure when pressed gently with the fingertips.
Delayed Fontanelle Closure
A baby is born with six fontanelles, openings between the plates of the skull that are sometimes referred to as soft spots. The two major soft spots are on the top of the baby's head, called the anterior fontanelle, and at the back of the head, called the posterior fontanelle. In most babies, the posterior fontanelle closes by the second month of life, according to American Family Physician. The anterior fontanelle has closed in 38 percent of babies by 12 months of age and in 96 percent of babies by 24 months of age. In babies with rickets, however, these closures will be delayed and the fontanelles may also appear larger than in normal babies.
Delayed Motor Development
Older infants with a vitamin D deficiency may experience delayed motor development, particularly with regard to crawling and walking. Because the bones are weak, the ability of a baby with rickets to support his own weight is compromised, making it more difficult for him to learn to stand, crawl and walk. According to an article in the February 2010 issue of the "Indian Journal of Pediatrics", the majority of toddlers with rickets who presented with delayed walking as a symptom began to walk within 2 to 5 months of treatment for vitamin D deficiency.
Tetany
Tetany is characterized by muscle cramps and convulsions and can be the result of a vitamin D deficiency causing a decrease in calcium levels in the baby's body. As calcium levels fall, the cells in skeletal muscle react by contracting, which causes spasms. The wrist and face are often affected. In severe cases, tetany may cause infantile seizures.
Bone Deformities
The bowed legs of rickets may not develop until later in childhood, but some skeletal abnormalities resulting from a vitamin D deficiency may be noticed even in infancy. The ribs may become abnormally thick and there may be bumps on the ribcage. The bones of the arms and legs may appear slightly bowed in x-rays even if this is not visible upon visual inspection yet.
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