Is Milk Good for Rickets? The Role of Fortified Milk and Nutrients

October 18, 2025 •

4 min read

Rickets, a condition of weak and soft bones in children, was nearly eradicated in developed countries in the 1940s largely due to milk fortification. Fortified milk is a key dietary component that provides essential nutrients, like calcium and vitamin D, that are crucial for preventing and managing rickets.

Quick Summary

Fortified milk is an effective dietary measure to prevent and treat rickets by supplying vital vitamin D and calcium. These nutrients are essential for proper bone mineralization, growth, and strength.

Key Points

Essential for Absorption: Milk, when fortified with vitamin D, is an excellent source of calcium, but vitamin D is the key nutrient that allows the body to absorb calcium effectively.
Historical Success: The fortification of milk with vitamin D played a crucial role in dramatically reducing the prevalence of rickets in the 20th century.
Balanced Approach: For preventing and treating rickets, a combination of fortified milk, other fortified foods, and safe sunlight exposure is recommended.
Supplementation for Infants: Since breast milk contains insufficient vitamin D, breastfed infants need vitamin D supplements to prevent deficiency and rickets.
Treatment, Not Just Prevention: Beyond prevention, fortified milk is a core part of the nutritional therapy for children diagnosed with nutritional rickets.
Dairy Alternatives: Individuals with lactose intolerance or milk allergies can find similar nutrients in other fortified foods like cereals and juices, or through supplements.

The Connection Between Milk and Rickets

Rickets is a medical condition characterized by the softening and weakening of bones in children, which can lead to skeletal deformities such as bowed legs. This is most often caused by a prolonged and severe deficiency of vitamin D, which impairs the body's ability to absorb calcium and phosphorus from food. While milk naturally contains calcium, it is not a natural source of vitamin D. The widespread practice of fortifying milk with vitamin D in many countries has made it a cornerstone in the fight against this disease.

During the early 20th century, before vitamin D fortification became common, rickets was a prevalent public health crisis. The discovery that vitamin D could be added to milk was a major breakthrough, leading to its near elimination in many developed nations. Today, public health organizations recommend ensuring adequate intake of calcium and vitamin D, with fortified milk being a convenient and accessible option. However, it's important to distinguish between fortified and unfortified milk, as the latter does not provide the necessary vitamin D to combat the deficiency.

The Nutrients in Fortified Milk That Combat Rickets

Fortified cow's milk contains two of the most critical nutrients for preventing and treating rickets: calcium and vitamin D.

Vitamin D: This vitamin acts as a facilitator, helping the intestines absorb calcium from the food we eat. Without enough vitamin D, the body cannot effectively utilize the calcium it consumes, leading to weakened bone formation. Since natural dietary sources of vitamin D are limited, fortification is a key strategy.
Calcium: As the primary mineral component of bones, calcium is essential for skeletal structure and strength. Milk is a naturally rich source of calcium, and when combined with added vitamin D, it becomes a powerful tool for promoting bone health.
Phosphorus: Milk also provides phosphorus, another mineral vital for bone mineralization. Working with calcium and vitamin D, it helps build and maintain a strong skeletal system.

Other Sources of Rickets-Fighting Nutrients

While milk is an excellent source, a balanced diet includes various foods to ensure adequate nutrient intake for preventing and treating rickets.

Sunlight Exposure: The human body can synthesize its own vitamin D when the skin is exposed to direct sunlight. However, factors like geographic location, season, and skin pigmentation can affect the amount of vitamin D produced. Concerns about skin cancer also limit sun exposure, making dietary and supplemental sources crucial.
Other Fortified Foods: Many other food products are also fortified with vitamin D and calcium, such as infant formulas, cereals, and some orange juices. This offers important alternatives for individuals with lactose intolerance or milk allergies.
Natural Food Sources: Outside of fortified products, some foods naturally contain vitamin D, including fatty fish like salmon and tuna, and eggs yolks.

Comparing Fortified and Unfortified Milk for Rickets


Feature	Vitamin D-Fortified Milk	Unfortified Milk (Cow's or Breast)
Vitamin D Content	Excellent source, added for prevention	Contains very little, if any, vitamin D naturally
Calcium Content	Naturally rich in calcium, crucial for bones	Naturally rich in calcium, but absorption is limited without vitamin D
Benefit for Rickets	Highly effective in preventing and treating nutritional rickets	Insufficient for preventing or treating rickets caused by vitamin D deficiency
Target Population	Recommended for toddlers and older children to boost bone health	Not adequate for infants' vitamin D needs; supplementation is required for breastfed babies

The Role of Milk in a Comprehensive Approach to Rickets

For most children with nutritional rickets, treatment involves increasing dietary intake of vitamin D and calcium. Fortified milk is a central component of this strategy due to its balanced nutritional profile. However, dietary adjustments alone may not be sufficient, and healthcare providers often recommend vitamin D and calcium supplements, sometimes in high doses, for effective treatment. Regular sunlight exposure is also encouraged, within safety guidelines, to naturally boost vitamin D production. In severe cases, particularly if skeletal deformities have occurred, medical interventions such as braces or corrective surgery may be necessary. It is essential to consult a healthcare provider for a proper diagnosis and personalized treatment plan, as different types of rickets (e.g., nutritional vs. genetic) require different management strategies.

Conclusion: Fortified Milk's Indispensable Role

In summary, milk is highly beneficial for rickets, but specifically when fortified with vitamin D. While milk provides a natural and abundant source of calcium, it is the added vitamin D that enables the body to properly absorb and utilize this mineral for strong bone development. The historical success of milk fortification in combating rickets demonstrates its indispensable role in public health. A balanced dietary approach, including fortified milk, other enriched foods, and safe sun exposure, remains the most effective strategy for the prevention and treatment of this bone-weakening disease. For infants and those with specific dietary restrictions, supplementation is often required to ensure adequate nutrient levels. Ultimately, understanding the synergistic effect of vitamin D and calcium found in fortified milk is key to supporting healthy bone growth in children.

Visit this resource to learn more about the history and eradication of rickets.

Frequently Asked Questions

Regular, unfortified milk contains calcium but very little vitamin D. Since the body needs vitamin D to absorb calcium, unfortified milk alone is not an effective solution for preventing or treating rickets.

In the 1930s, milk was chosen as a vehicle for vitamin D fortification because it was widely consumed by children. This public health initiative ensured that children received the necessary vitamin D to properly absorb calcium, thus preventing the bone-softening effects of rickets.

The most common cause of rickets is a deficiency of vitamin D. Less common causes include a lack of calcium or phosphorus, or rare genetic disorders that affect how the body processes these nutrients.

Yes, breastfed infants are at risk because breast milk naturally contains very little vitamin D. The American Academy of Pediatrics recommends that all breastfed infants receive vitamin D supplements.

Milk is a natural source of calcium and phosphorus, which are the main minerals that build bone structure. When fortified, it also provides vitamin D, which is essential for the absorption of these minerals.

The adult form of rickets is called osteomalacia, which also results from prolonged vitamin D or calcium deficiency. Since adult bones are no longer growing, they do not show the bowing characteristic of rickets, but they do become soft and weak.

Other sources of vitamin D include sunlight exposure, fatty fish (like salmon and tuna), eggs yolks, and fortified foods such as cereals, infant formula, and some juices.