Consultant Paediatric Orthopaedic and Limb Reconstruction Surgeon Mr Jonathan Wright from The Portland Hospital gives us the low-down on children’s bone health, and what we can be doing as parents to help build strong bones in our kids.

What are the most common bone fractures in young children?

Young children tend to be very active and adventurous, whether that be at school, home, or out and about generally. Therefore, it’s unsurprising that it’s quite common for children to fracture and break bones. In fact, around 40% of young girls and 50% of boys will experience a fracture during childhood.

Forearm fractures are very common in children and more common than fractures of the leg bones. This is often due to the natural reflex of putting your arms out when falling over to ‘catch’ yourself as you fall, resulting in potential injury to the arm(s).

Usually, fractures in children heal quickly after being put in a cast and are not a huge cause for concern. Children’s bones often heal more quickly than adults and in some fractures children will even “grow out” a minor bend in the bone. However, some fractures may need to be treated by a paediatric orthopaedic specialist to improve the alignment of the bones.

How to help promote bone health in children, e.g. diet, calcium intake

Maintaining strong bones by adopting healthy dietary and lifestyle habits in childhood is important for normal growth and development of the skeleton. This can help prevent fractures later in life and bone-related conditions such as osteoporosis – a disease that decreases bone density and can lead to fractures.

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Bone health during childhood is thought to have a significant impact on the likelihood of developing osteoporosis later in life, alongside many other contributing factors. This is because the bone mass obtained in childhood and teenage years is an important determinant of lifelong bone health.

We think of “rickets” (low vitamin D causing bowing of the legs, amongst other problems) as being an illness of the past, but it is a condition that is now being seen increasingly within the UK in recent years. This is easily preventable, as long as we are conscious of how much vitamin D our children are receiving.

During childhood, children’s bones are constantly growing, so it’s a vital time to optimise their bone health.  The main ways to help your child improve and maintain bone health are:

Nutrition

Eating a healthy and balanced diet is key – not just when it comes to bone health, but health generally. Vitamin D and calcium are two key components to help strengthen bones. Sunlight is the best source of vitamin D, but due to British weather lacking in sunshine, many of us are deficient in this vitamin. (The sunlight is not bright enough in the UK to produce vitamin D in our skin between September and May). There are a few foods rich in vitamin D, including oily fish and eggs, but it is difficult to have enough from diet alone.

You can also find supplements that are suitable for children. For babies under 6 months, if they are receiving formula milk, this already contains added vitamin D, however, may benefit from vitamin drops if they are exclusively breastfed. There are supplements designed for children under the age of 5, which will contain the recommended amount of vitamin D. For older children, particularly those at risk and in the winter, a supplement containing 10micrograms (400 units) of vitamin D should be sufficient for most children. Not all supplements contain this, so do check the back of the packet.

Calcium is found in many foods, but the most common source is milk, cheese and other dairy products. Many breakfast cereals are fortified with both of these nutrients too. Ultimately, many nutrients contribute to bone health, not just calcium and vitamin D – so the best advice for bone health is to eat a healthy balanced diet with plenty of variety.

Physical activity

Staying active is a great way to maintain bone health. When bones are being put to work, it strengthens them and helps improve bone density. Activities such as playing in the school playground, spending time outside, dancing or running around, will help your child boost their bone health and reduce the chance of fractures.

If you are concerned about your child’s bone health, for example, if they have suffered multiple fractures, please do speak to a medical professional who can carry out necessary tests and treatments.”

Article by Mr Jonathan Wright, Consultant Paediatric Orthopaedic and Limb Reconstruction Surgeon at The Portland Hospital (part of HCA Healthcare UK).

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