​Osteoporosis is rare in children and adolescents. When it does occur, it is usually caused by an underlying medical disorder or by medications used to treat such disorder. This is called secondary osteoporosis. It may also be the result of a genetic disorder such as Osteogenesis Imperfecta (Brittle Bone Disease).

Any systemic disease that a child has may increase his or her risk of having secondary osteoporosis. A systemic disease refers to a disease that affects part or whole of the body.

Children with certain health conditions and/or taking some medications may be at higher risk.

Conditions that increase the risk of osteoporosis:

• Rheumatological conditions like Juvenile Arthritis or Lupus
• Neuromuscular disorders like Cerebral Palsy, Duchenne Muscular Dystrophy, Immobilisation
• Endocrine conditions like Hyperthyroidism, Hyperparathyroidism, Cushing's Syndrome, Delayed Puberty
• Malabsorption Syndromes
• Anorexia Nervosa
• Kidney disease
• Liver disease

Medications that increase the risk of having osteoporosis:

• Some anticonvulsants (e.g. for epilepsy)
• Corticosteroids (e.g. for rheumatoid arthritis, asthma)

Behaviours that increase the risk of having osteoporosis:

• Prolonged inactivity or immobility
• Inadequate nutrition, especially calcium and vitamin D
• Excessive exercise leading to amenorrhoea

You may want to speak to your child's doctor or see a paediatrician specialising in endocrinology to find out if your child has an increased risk.

​Two or more low impact fractures may be a sign of a disorder. If you are concerned about your child's frequent fractures, talk to his or her doctor for more information.

If your child has a medical condition that may interfere with bone mass development, ask the doctor for ways to minimise the problem and protect your child's bone health.

​You can see a paediatrician specialising in endocrinology to help assess your child's bone health and whether his or her fractures are due to poor bone mass. Treatment will depend on the cause of the problem and needs to be discussed individually.

• It is important to have proper nutrition and plenty of physical activity.
• Try to encourage your child to take plenty of food that are rich in calcium and vitamin D.
• Any kind of physical exercise is great for children but the best ones for their bones are weight-bearing activities like walking, running, hiking, dancing, tennis, basketball, gymnastics and soccer. Children who tend to play outside will also have higher vitamin D levels.
• To reduce the risks of osteoporosis, you can also help by limiting his or her caffeine and alcohol intake and advise him or her to avoid smoking.
• One of the best ways to encourage healthy habits in your children is to be a good role model yourself. Your kids are watching and following your habits, both good and bad.

Useful Links

• https://www.healthhub.sg/live-healthy/192/recommended_dietary_allowances

​Clinical research is vital to the advancement of medical care. Our doctors are passionate about contributing to the future of child health and medicine not only through clinical practice but also research.

1. Goh SY, Aragon JM, Lee YS, Loke KY (2011). Normative data for quantitative calcaneal ultrasound in Asian Children. Annals of the Academy of Medicine, Singapore, 40(2):74-9.