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Solid food refusal as the presenting sign of vitamin B12 deficiency in a breastfed infant

Els Ide1, Stephanie Van Biervliet, Joke Thijs

  • 1Paediatric Gastroenterology and Nutrition, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.

European Journal of Pediatrics
|July 8, 2011
PubMed

Insights

Infant refusal of solid foods may signal vitamin B12 deficiency, especially in breastfed infants. Prompt diagnosis and treatment are crucial to prevent developmental delays and neurological damage.

Area of Science:

  • Pediatrics
  • Nutritional Science
  • Hematology

Background:

  • Dietary vitamin B12 (cobalamin) deficiency is uncommon in children but can occur in exclusively breastfed infants.
  • Maternal subclinical vitamin B12 deficiency can lead to deficiency in the infant.
  • Infant refusal of complementary foods is a potential, though rare, presenting symptom.

Observation:

  • An 8-month-old infant presented with persistent refusal of solid foods.
  • Developmental regression and failure to thrive were noted three months later.

Findings:

  • The infant was diagnosed with vitamin B12 deficiency.
  • This deficiency stemmed from the mother's subclinical pernicious anemia and subsequent low vitamin B12 levels.
  • Parenteral vitamin B12 treatment led to rapid recovery, including the infant's acceptance of solid foods.

Implications:

  • Refusal of complementary foods can be an early indicator of vitamin B12 deficiency in breastfed infants.
  • Review of symptoms, diagnostics, and treatment for vitamin B12 deficiency is essential.
  • Early detection and intervention are critical to avert irreversible neurological damage in infants.
Abstract

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