Rickets, How to raise the subject with a parent ?

[Norem]

Hi am looking for some ideas about how to raise the subject with a schoolgate friend.
I am worried her 2 year old dd has rickets, she has extremely bowed legs however I am not a paediatrician therefore I don't know she has iykwim.
I am a nurse and am worried I will put real stress on her if I mention it though.
What would you do?

If I were the schoolgate friend I would be grateful you spoke to me.

Just tell her you've noticed his legs look a bit bowed and has she had him looked at. It could be that she's already aware.

Thanks for your reply, I will speak to her tomorrow and suggest she see her gp if she is not already.

May I ask what nationality/religion the lady and her child are? I'm familiar with rickets and this has a lot of significance.

Hi yes the childs parents are from pakistan and we live in Glasgow so a recognised at risk group.
I hope they are already aware of the problem, my dh who is not medical and hardly notices other people's kids knew exactly what I was talking about when I mentioned my worry to him.

Could you approach from the angle of 'the increasing vitamin D deficiency in children who don't have much exposure to the sun.'? It's quite possibly a Vit D deficiency which prevents the calcium absorbing, thus leading to rickets.

I personally think that Vit. D deficiency would be much easier for her to cope with than 'rickets' because rickets is associated with nutritional deficiency, whereas Vit. D deficiency is just unfortunate due to our climate.

If you know a HC practitioner or the local health visitor, I suggest that you ask them to talk to her about it urgently. I've tried to educate friends over the years (friends of similar backgrounds) about the dangers of covering one's body completely and not acknowledging the desperate need for vitamin D.

You will unfortunately find, as I have, that people see it as an attack on their religion or race, which is why it is best that advice comes from a health visitor. I knew a friend who was mostly Black but had a White ancestor and due to this, she thought ethnically that she wasnt at risk from vit D deficiency. Unfortunately she was severely when she had tests and her dc was diagnosed with the early stages of rickets. The dc's teeth took a long time to come through and he was a very sickly baby. The lack of education in many communities is astounding to say at least from a medical perspective.

Thankfully things are getting better and people are more aware, I have many Muslim friends who are educated and take precautions against the risk of rickets. Do try and get a local HP or HV to speak to her if you can. Having seen the effects first hand, it's a subject close to my heart.

Thanks scottydoc unfortunately I don't know the gp or hv as they are from out of area to our school.
I will have a think about how best to approach this, we are friends, do go for coffee ect, really don't want to cause upset but really can't say nothing.