Rosh Pediatrics Practice Exam

What is the recommended course of action for treating rickets in breastfeeding infants?

1. Supplement breastfeeding with cholecalciferol

2. Supplement breastfeeding with iron

3. Supplement breastfeeding with folic acid

4. Supplement breastfeeding with calcium

The correct answer is: Supplement breastfeeding with cholecalciferol

The treatment for rickets in breastfeeding infants is primarily focused on ensuring adequate vitamin D levels, since vitamin D plays a crucial role in calcium absorption and bone health. Cholecalciferol, also known as vitamin D3, is important for preventing and treating rickets, as it helps maintain proper calcium and phosphate levels in the body, which are essential for the formation and maintenance of healthy bones. Breast milk, while it contains many important nutrients, typically does not provide sufficient amounts of vitamin D. Therefore, supplementation with cholecalciferol is recommended to prevent deficiency in breastfed infants, particularly those who are exclusively breastfed without any other source of vitamin D. While iron, folic acid, and calcium are important nutrients, their supplementation does not address the underlying cause of rickets related to vitamin D deficiency. Iron is crucial for preventing anemia, folic acid is essential for DNA synthesis and overall cellular health, and calcium is critical for bone health; however, without adequate vitamin D, calcium cannot be effectively absorbed and utilized. Hence, supplementing with cholecalciferol is the most direct way to treat and prevent rickets in this context.