Wernicke's encephalopathy in exclusive breastfed infants

Area of Science:

• Neurology
• Pediatrics
• Nutritional Science

Background:

• Kashmir's population consumes polished rice, leading to thiamine deficiency.
• Lactating mothers in Kashmir practice food avoidance, increasing deficiency risk.
• Exclusively breastfed infants of deficient mothers are vulnerable to infantile beriberi.

Purpose of the Study:

• To investigate infantile encephalopathy in exclusively breastfed infants in Kashmir.
• To identify clinical, biochemical, and radiological features of the condition.
• To assess the therapeutic response to thiamine supplementation.

Main Methods:

• A one-year prospective, hospital-based study of 50 exclusively breastfed infants.
• Comprehensive septic and metabolic workups were performed.
• Demographic, anthropometric, treatment, and mortality data were collected.

Main Results:

• 80% of mothers followed traditional food avoidance practices.
• Irritability (80%) and blepharoptosis (60%) were common symptoms.
• Low whole blood thiamine diphosphate levels (10-49 nmol/L) and basal ganglia hyperintensity on MRI were observed.

Conclusions:

• Acute infantile encephalopathy with features of Wernicke's encephalopathy was observed in exclusively breastfed infants.
• The condition is linked to thiamine deficiency in mothers and infants.
• Thiamine supplementation showed a favorable therapeutic response during the acute stage.