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Brain damage in infancy and dietary vitamin B12 deficiency
Insights
A breast-fed infant experienced severe neurological decline due to vitamin B12 deficiency from a vegetarian diet. Supplementation improved health, but neurological recovery was incomplete, highlighting the need for vitamin B12 in strict vegetarian mothers.
Area of Science:
- Nutritional Neuroscience
- Pediatric Neurology
- Maternal-Fetal Medicine
Background:
- Exclusive breastfeeding is crucial for infant nutrition.
- Maternal diet significantly impacts nutrient transfer to the infant.
- Vitamin B12 deficiency can arise from strict vegetarian (vegan) diets.
Observation:
- A previously healthy, exclusively breast-fed infant exhibited progressive neurological deterioration starting at three months of age.
- The infant developed severe megaloblastic anemia and reached a comatose state by nine months.
- The mother, a strict vegetarian, showed mild vitamin B12 deficiency.
Findings:
- The infant presented with profound vitamin B12 deficiency, correlating with neurological and hematological abnormalities.
- Treatment with vitamin B12 led to rapid clinical and hematological recovery.
- Neurological recovery was incomplete despite timely intervention.
Implications:
- Dietary vitamin B12 deficiency is a critical, preventable cause of severe neurological impairment in exclusively breast-fed infants.
- Strict vegetarians, particularly women of childbearing age, should ensure adequate vitamin B12 intake through supplementation or fortified foods.
- Routine screening for vitamin B12 levels in infants of vegetarian mothers may be warranted.
Abstract:
A case of the exclusively breast-fed infant of a vegetarian mother is reported. Neurological deterioration commenced between three and six months of age, and progressed to a comatose premoribund state by the age of nine months. Investigations revealed a mild nutritional vitamin B12 deficiency in the mother, and a very severe nutritional B12 deficiency in the infant, with severe megaloblastic anaemia. Treatment of the infant with vitamin B12 resulted in a rapid clinical and haematological improvement, but neurological recovery was incomplete. Evidence is presented that dietary B12 deficiency was the sole cause of the infant's deterioration, and the literature relating to the condition is reviewed. It is recommended that all strict vegetarians (vegans), especially women in the child-bearing age group, take vitamin B12 supplements.