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Risks of alternative nutrition in infancy: a case report of severe iodine and carnitine deficiency
C Kanaka1, B Schütz, K A Zuppinger
1Department of Paediatrics, University of Bern, Inselspital, Switzerland.
Insights
A vegan diet severely depleted this infant of essential nutrients, causing developmental delays and health issues like goiter and osteopenia due to iodine and carnitine deficiency.
Area of Science:
- Pediatric Nutrition
- Endocrinology
- Developmental Pediatrics
Background:
- Infant nutrition requires careful monitoring, especially with restrictive dietary patterns.
- Maternal dietary choices significantly impact infant nutrient status through breastfeeding and subsequent feeding.
- Vegan and lactovegetarian diets, while potentially healthy, necessitate meticulous planning to avoid nutrient deficiencies.
Observation:
- A 7.5-month-old infant presented with failure to thrive, developmental delay, muscular hypotonia, goitre, and severe osteopenia.
- The infant was exclusively breastfed for 2.5 months, followed by a diet including almond extract in water.
- Maternal diet was strictly vegan; paternal diet was lactovegetarian.
Findings:
- Laboratory results showed markedly increased thyroid-stimulating hormone (TSH) with low free thyroxine (T4), indicating hypothyroidism.
- Severe deficiencies in iodine and carnitine were identified.
- The infant's nutritional intake was critically low in calories (-46%), calcium (-73%), and iodine (-88%).
Implications:
- Restrictive alternative nutrition practices can lead to severe, multi-systemic deficiency disorders in infants.
- Early identification and intervention are crucial for managing nutritional deficiencies and their developmental consequences.
- This case highlights the importance of comprehensive nutritional assessment in infants, particularly those on non-standard diets.
Abstract:
A 7.5-month-old infant with failure to thrive, developmental delay, muscular hypotonia, a visible goitre and severe osteopenia is described. Laboratory examination revealed a markedly increased serum TSH with low free T4, severe iodine and carnitine deficiency. The infant was breastfed until the age of 2.5 months and was then given a mixture of almond extract in water. The mother is a strict vegan and the father a lactovegetarian. The nutritional intake of the child was severely depleted in calories (-46%), calcium (-73%) and iodine (-88%). The restrictive alternative nutrition was responsible for the various deficiency disorders.