Journal
PEDIATRIC EMERGENCY CARE
Volume 24, Issue 8, Pages 538-541Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/PEC.0b013e318180ff32
Keywords
vitamin B-12; infant; developmental regression; involuntary movements; failure to thrive; macrocytic anemia
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In developed countries, the vitamin B-12 deficiency usually occurs in children exclusively breast-fed, whose mothers are vegetarians, causing low stores of vitamin B-12. Symptoms of vitamin B-12 deficiency appear during the second trimester of life and include failure to thrive, lethargy, hypotonia, and arrest or regression of developmental skills. A megaloblastic anemia can be present. One half of the infants exhibit abnormal movements before the start of treatment with intramuscular cobalamin, which disappear 1 or 2 days after. More rarely, movement disorders appear a. few days after treatment, whereas neurological symptoms are improving. These abnormal movements can last for 2 to 6 weeks. If not treated, vitamin B-12 deficiency can, cause lasting neurodisability. Therefore, efforts should be directed to preventing deficiency in pregnant and breast-feeding women on vegan, diets and their infants by giving them vitamin B-12 supplements. When preventive supplementation has failed, one should recognize, and treat quickly an infant presenting with failure to thrive and delayed development.
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