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A Brief History of Rickets

Before African Americans moved in large numbers to northern cities after World War II, their babies received vitamin D almost entirely from breastmilk, the primary nutrition for most infants during that time, and from UVB rays. Many African Americans worked as sharecroppers and spent well above the current recommended amounts of time in the sun. Although cow's milk was fortified with vitamin D in the 1930s, most African Americans did not buy or consume commercial milk but instead relied on the milk produced by their own cows, which was not fortified.

In the 18th and 19th centuries, the prevalence of rickets was as high as 40 to 60 percent among children in inner-city neighborhoods in England, Germany, Poland, Scandinavia, Canada, and the US.1 The 1960s, 1970s, and 1980s saw a further emergence of rickets among exclusively breastfed infants of some Asian and Muslim women in northeastern US cities. The common factor among these groups was that the women were heavily robed; only their hands and faces were exposed. In the 1990s, there were additional rickets cases in exclusively breastfed African American infants.2