July 1, 2015

Director's Letter 


As you know, we founded GrassrootsHealth to move resesarch into practice. I learned that vitamin D could have helped prevent cancer, and wanted more people to know. Now, we see the same thing regarding rickets. So much pain could be avoided and children could start off on the right track, if doctors knew that pregnant mothers need to be vitamin D replete and children need it starting their first few days of life.


I recently talked with our lead researcher for Protect our Children NOW! in South Carolina, Dr. Carol Wagner. She had put aside her busy schedule to consult on a case where child protective services had taken away 5 children from their loving family because of un-diagnosed rickets in the 2 youngest. I am glad she could help, but if our information was in every doctor's office around the world - the situation wouldn't have happened.


Please continue to read and where appropriate, apply to your life, your friends', your family's, your acquaintances. The faster we get the word out to the people - the more pain and suffering we can prevent.



Carole Baggerly 

Director, GrassrootsHealth

A Public Health Promotion & Research Organization

Moving Research into Practice NOW!

Rickets is on the rise  


News outlets across the globe have been reporting a resurgence of rickets. The causes being cited are the increased popularity of breast feeding and doctor's failure to prescribe vitamin D supplements to infants. The issue is disproportionately on the rise in (although not limited to) dark-skinned children who cannot make enough vitamin D from their limited sun exposure.


There are no national rates for rickets in the US because it is not a reportable public health disease, and there are no surveillance systems that capture nation-wide information about it. In the UK, however, the Daily Mail cites 833 hospital admissions for rickets in 2012, four-fold the amount 10 years earlier.


What is rickets?


Rickets is a disorder characterized by softening and weakening of the bones resulting from a lack of vitamin D, calcium, or phosphate. Symptoms of rickets include bone pain or tenderness, decreased muscle tone, dental deformities, impaired growth, increased bone fractures, muscle cramps, short stature, and skeletal deformities such as the characteristic bowlegs.  


After being diagnosed with rickets, treatment is to replace the vitamin D, calcium and phosphorus that is lacking. If done during childhood, treatment usually eradicates all symptoms. Vitamin D levels of 20 ng/ml or higher will prevent most cases of rickets, so children diagnosed with rickets are generally severely vitamin D deficient.


Background on rickets


As late as the 1940s, rickets was a common childhood ailment, killing thousands of children annually until doctors learned that that vitamin D in milk and sunlight could largely prevent it. Since that time both infant formula and milk have been fortified with vitamin D and it almost eradicated the disease.  


Three prevalent positions spell trouble for infants


With the resurgence of breast feeding, more babies are off infant formula and are not getting vitamin D supplementation. This would be fine if the mother had a daily vitamin D intake (through sun exposure, food, or supplements) that resulted in 25(OH)D concentration of 40 ng/ml or higher. But most doctors do not know to tell breast feeding mothers this information, nor do they prescribe vitamin D supplementation to infants. In fact,

  • the normal population has a vitamin D blood level of about 25 ng/ml (NHANES)
  • AND... doctors are not recommending supplementation for infants or their mothers
  • AND.... doctors are recommending that mothers and their infants stay out of the sun, cover up, or use sunscreen

The result is that most mothers and their babies are not getting enough vitamin D and rickets is re-emerging.


Lack of vitamin D supplementation in infants


Our panel of scientists recommend infants (< 1 year) take 400 IU vitamin D daily starting a few days after delivery. The easiest way for an infant to receive supplementation is by using drops (Google: 'vitamin D drops').


Carol Wagner, MD studied vitamin D in infants and found that with 400 IU/day the mean vitamin D level in her study group increased from 16 ng/ml (at 1 month) to 43 ng/ml (at 4 months) and 42 ng/ml (at 7 months).


How to get vitamin D in breast milk


Another way to provide vitamin D for an infant is to ensure that there is enough vitamin D in the breast milk. This is possible and has been demonstrated by Dr. Wagner. Wagner ran a lactation study that found women who are replete in vitamin D (> 40 ng/ml) can transfer vitamin D to their babies. She found that 6400 IU/day was necessary for the women to stay replete in vitamin D and that this would be equivalent to babies getting a 400 IU/day supplement.


Wagner's presentation on Vitamin D and Public Health: Integrating sunshine, supplement, and measurement for optimal health includes information from this lactation study (minutes 34:30 -> end).


In his blog Vitamin D and the nursing mother, Dr. Robert Heaney ends with a call to action that all mothers supplement with 5,000 - 6,000 IU/daily because doing so would provide the needed benefit for both the mother and baby, naturally. He also makes a very important point that supplementation needs to be daily:


"There is one important proviso for nursing mothers concerning the needed intake. Those who live in North America and have to rely on supplements should be certain that they take their supplements every day. While for other purposes it is possible to take vitamin D intermittently (e.g., once a week), that doesn't work for putting vitamin D into human milk. The residence time of vitamin D in the blood is so short that, if the mother stops taking her vitamin D supplement for a day or two, vitamin D in her milk will be low (or absent altogether) on the days she skips."


Rickets or Child Abuse?


Because rickets had been so rare, many doctors practicing just ten years ago had never seen a case in person and today many still don't recognize it when they do see it. There have been several cases where children have been pulled away from their families by child protective services (CPS) due to undiagnosed rickets. The children are brought into a medical facility for some treatment (sickness, disease) and broken bones or signs of healing bones are found and presumed to be a result of abuse. At this point CPS is contacted and sometimes the children taken away.


Recently Wagner consulted on such a case where twin 6 month old boys (and their 3 older brothers) were removed from their loving home because of a broken rib and threat of child abuse. The mother was severely vitamin D deficient during pregnancy, and after, and solely breast fed the twins. Vitamin D tests for the twins showed their levels to be < 10 ng/ml. After much work by Wagner and their lawyer the children are now back with their family - and hopefully the whole family is getting sun and supplementation.


Dr. John Cannell, of The Vitamin D Council, has also consulted on such cases. He describes two different, yet similar, cases on his web site. 


Paper of the Week 


Resurrection of vitamin D deficiency and rickets

Michael F. Holick, PhD, MD

Boston University Medical Center

Journal of Clinical Investigation

August 2006



Michael Holick Dr. Holick has made numerous contributions to the field of the biochemistry, physiology, metabolism, and photobiology of vitamin D for human nutrition. Holick has established global recommendations advising sunlight exposure as an integral source of vitamin D.  He has helped increase awareness in the pediatric and medical communities regarding vitamin D deficiency pandemic, and its role in causing not only metabolic bone disease, and osteoporosis in adults, but increasing risk of children and adults developing common deadly cancers, infectious, autoimmune, and other diseases. He has written more than 300 peer reviewed articles and edited or wrote 12 books including "The Vitamin D Solution," and is the recipient of numerous awards and honors, including the Linus Pauling Functional Medicine Award from the Institute for Functional Medicine.


In this paper, Holick starts with a historical perspective on rickets. He explains the production of vitamin D supplements and how vitamin D is metabolized. He also explains that rickets is most often found in an infant 4 - 12 months old, but the skeletal deformities appear later, when they start to stand and walk. He talks about the prevalence of subclinical vitamin D deficiency in our society and provides many facts and figures to support this hypothesis. He discusses the most effective methods of dosing for infants with rickets. He concludes that supplementing at the levels of 400 - 1,000 IU/day would increase most deficient infants to over 30 ng/ml - which he points out is a healthy level for infants and children and would eliminate rickets. He ends with a discussion of sunshine and its potential for eliminating rickets, with no harm to the skin, or risk of skin cancer.


Read Paper 


Editor's Letter 


It amazes me that something so simple and cheap - that improves the mother's health and the health of her children - isn't widely known. I know for myself I only knew about vitamin D for my 3rd child. Luckily I got tons of sun while pregnant with my 2nd child, but that was just sheer luck and my workout schedule.

  • Why don't OB's tell you this?
  • How can we get the word out?

It is sad, but they say that it takes 17 years for research to become standard practice and that is why GrassrootsHealth was formed. We are working to shorten this timeframe of moving research into practice so that people can act NOW! and improve their health today.


Please do me a favor. Next time you see a mother of a young child, if you know them, ask them if they would like to reduce their child's chance of getting cancer by 85%. That is my favorite hook. Then, you are either a quack or they will listen. Hopefully they will listen and then you can send them to our web site for more information.


Thank you for your efforts,



Susan Siljander       

Marketing Director, GrassrootsHealth

A Public Health Promotion & 

Research Organization  

Moving Research into Practice NOW!
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Doctors Say Rickets Is Back
ABC News
Read Article

Rickets soar as children stay indoors: Number diagnosed with disease quadruples in last ten years
Daily Mail, UK
January 2014
Read article

Definition of Rickets
MedLine Plus
View web site

Circulating 25-Hydroxyvitamin D Levels in Fully Breastfed

Infants on Oral Vitamin D Supplementation

Carol Wagner, MD

Research Article

August 2009

Read article 


Prevention of Rickets and Vitamin D Deficiency in Infants, Children, and Adolescents

Call to change RDA to 400 IU for infants starting first few days of life

Carol Wagner

November 2008

American Academy of Pediatrics

Read paper


Vitamin D and the Nursing Mother

Robert P. Heaney

Read Blog 


Paper of the Week

Resurrection of vitamin D deficiency and rickets

Michael F. Holick, PhD, MD

Boston University Medical Center

Journal of Clinical Investigation

August 2006


Read Paper 

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