Pediatric nutrition: Severe deficiency complications by using vegetable beverages, four cases report

Introduction > The use of vegetable beverages improperly called vegetable milk is promoted by food faddism to replace dairy products, even in infant diet whereas it is totally inadequate. Case reports > Case 1: a 9 month- old infant fed by a rice beverage for 2 months presented hypoalbuminemia (7 g/L) with kwashiorkor syndrome complicated by severe sepsis. Case 2: a 14 month- old infant fed by a rice beverage for 2 months had iron and vitamin B12 deficiency with deep anemia (Hb 35 g/L) and tissue hypoxia (hyperlactacidemia). Case 3: a 13 month-old infant fed by an almond beverage during 3 weeks presented metabolic alkalosis with hypochloremia due to sodium and chloride deficiency and revealed by hypoventilation. Case 4: a 2,5 month-old infant with epileptic encephalopathy was fed by several vegetable beverages (almond, nut, chestnut and soy) for a month and a half and presented deep hyponatremia (96 mmol/L) with coma and respiratory acidosis caused by aspiration pneumonia. He died secondarily. Discussion > Deficiencies promote infections and severe metabolic disorders. Clinical polymorphism lead to diagnosis wandering that can be noxious. The reasons of these diet changes can be nutritional ignorance, perceived milk intolerance or food faddism, sometimes on the advice of an alternative medicine physician. Parental restricted diet or infant immunization recommendations negligence should warn about associated nutritional errors in young infants. Conclusion > These avoidable pathologies frequently caused by well-intending but misinformed parents must be reported to Nutrivigilance. This behaviour can be life threatening and must lead, in the most severe cases, to prosecution.