Fractures: Is Your Child at Risk?

How to catch problems, protect young bones

Fractures: Is Your Child at Risk?

Your 11-year-old has already had a couple of broken bones. Should you worry?

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Fractures have increased dramatically in children over the past few decades, says Ryan Goodwin, MD, Director of Pediatric and Adolescent Orthopaedics.

“The upsurge is mainly due to kids’ participation in single-sport activities at younger ages, and easier access to skate parks and trampoline facilities,” he says. “These things are problematic for growing bones.”

But parents can take proactive steps to maximize children’s bone health, he says. Here’s how.

Be aware of red flags

Bone problems are relatively rare in children, says Dr. Goodwin. But these red flags may prompt your doctor to order a bone scan (an X-ray revealing bone quality):

  1. Three or more fractures in a calendar year (two aren’t unusual for kids active in sports or other activities)
  2. A family history of disorders that increase fracture risk
  3. A condition such as vitamin D deficiency

The conditions that increase a child’s fracture risk are often genetic and include:

  • Thyroid problems and other metabolic disorders
  • Lupus and other inflammatory diseases
  • Kidney disease

Any condition that requires treatment with methotrexate — which can interfere with bone production — can also increase a child’s risk of broken bones.

Protect kids properly

You can’t ban trampolines or skate parks. And you don’t want your kid to live in a bubble and avoid sports.

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But when your kids decide to take up an activity, arm them with the right gear.

“Proper protective equipment is essential,” says Dr. Goodwin. “Kids who snowboard should wear a helmet and wrist guards, for instance.”

Foster healthy eating

Calcium and vitamin D are the building blocks for healthy bones. These minerals are plentiful in a normal, healthy diet, says Dr. Goodwin.

“Bone building is critical during childhood, especially in adolescence,” he says. Most girls continue to build bone mass until age 18. Most boys do so into their early 20s.

As kids grow, their daily calcium needs increase:

  • Ages 1 to 3: 700 milligrams
  • Ages 4 to 8: 1,000 milligrams
  • Ages 9 to 18: 1,300 milligrams

When kids don’t get sufficient calcium or vitamin D from food, supplements can help.

“Vitamin D deficiency is probably under-recognized in kids, but easy to correct,” notes Dr. Goodwin.” Most school-aged children can safely take 2,000 international units of vitamin D3 per day.”

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Liquid preparations are available if your child has trouble swallowing pills.

For healthy bones, he also recommends limiting carbonated beverages and soda.

Encourage activity

“Healthy weight-bearing exercise is critically important for kids,” Dr. Goodwin says. “Bones respond to stress, and if you don’t use your skeleton, it assumes you don’t need to use calcium and gets rid of unused stores.”

Steering kids toward a variety of sports is helpful, he says. Playing a single sport year-round puts repeated stress on the same bones and joints.

Exercise will benefit your child’s weight as well. Being overweight can wreak havoc on hormones and even alter bone metabolism, Dr. Goodwin says.

A future payoff

Buying protective gear and promoting healthy eating and weight-bearing exercise will minimize your child’s risk for broken bones — and pay off later in life.

Meanwhile, if you’re concerned about potential red flags, talk to your pediatrician. He or she will advise you on options for testing or treatment.

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