Rickets and osteomalacia can easily be prevented, as detailed in the topics below.

Diet

Make sure you and your child eat a diet that includes plenty of vitamin D and calcium.

Sources of vitamin D include:

• oily fish
• liver
• eggs
• margarine
• breakfast cereals with added vitamin D

Sources of calcium include:

• dairy products, such as milk, cheese and yoghurt
• green vegetables, such as broccoli and spinach
• wholemeal bread
• dried fruits
• beans and pulses, such as lentils

If you or your child eats a restricted diet, for example if you are vegetarian or vegan, you may be missing out on essential vitamins and minerals and may need to take a supplement.

Sunlight

We get most of our vitamin D from sunlight as the vitamin forms under the skin in reaction to exposure to the sun. In the UK, about 15 minutes' exposure on the hands and face a few times a week during spring and summer is enough.

Too much sun is bad for our skin. In bright weather it is important to keep out of the sun during the hottest part of the day (11am-3pm), to use sunscreen and keep young children mostly covered up when in the sun. Babies and young children have very sensitive skin that burns easily.

If you do not get enough sunlight because you spend a lot of time indoors, or wear clothes that completely cover your skin, you may be at a higher risk of vitamin D deficiency and therefore at risk of rickets or osteomalacia. Ask your GP about vitamin supplements.

Supplements

Most people should be able to get all the vitamin D they need from their diet and by getting a little sun. However, certain groups are at a higher risk of vitamin D deficiency and may need to take supplements to prevent rickets and osteomalacia.

Pregnant and breastfeeding women

The Department of Health recommends that all pregnant and breastfeeding women take a supplement of 10 micrograms of vitamin D a day to ensure they get enough for themselves and their baby.

Children

In the UK, the government recommends the use of vitamin D supplements for:

• breastfed infants from six months (or from one month if there is any doubt about the mother's vitamin status during pregnancy)
• formula-fed infants who are over six months old and taking less than 500ml infant formula a day
• children under five years old

It is important that children in high-risk groups, such as those who do not get enough vitamin D from their diet, and those with certain medical conditions such as kidney disease, take supplements. They may need extra supplements to prevent rickets and make sure their bones grow strong and healthy.

Your GP can advise on the levels of vitamin supplement needed.

Other risk groups

Other people at a higher risk of vitamin D deficiency, and who may need to take supplements, include:

• the elderly
• people of Asian, African Caribbean and Middle Eastern origin
• those who always cover up all of their skin when outside
• people who rarely get outdoors
• people who eat no meat or oily fish