Does B12 Deficiency Affect Young Children’s Development?

Introduction:

Vitamin B12 deficiency can manifest through various non-specific symptoms, including anorexia, irritability, weakness, fatigue, and developmental delays in children. A deficiency can also lead to neurological abnormalities and altered growth curves. Adequate maternal nutrition during pregnancy is crucial for fetal development. Studies have shown a significant relationship between folate and vitamin B12 levels, with deficiencies in one impacting the other. Vitamin B12 deficiency can cause neurological manifestations and skin abnormalities.

What Is the Significance of Vitamin B12?

Vitamin B12 is essential for maintaining a healthy nervous system and blood cells. It plays a vital role in the production of red blood cells, which transport oxygen throughout the body and in DNA synthesis. Additionally, vitamin B12 is crucial for brain development in infants and young children. The bodies do not produce vitamin B12. Instead, obtain it from foods rich in B12 or vitamin supplements. Sources of B12 include:

• Meat, such as red meat and poultry.

• Fish.

• Eggs.

• Dairy products like milk, cheese, and yogurt.

• Fortified breakfast cereals.

• Fortified nutritional yeast.

The required amount of vitamin B12 varies for children and increases as they age. Pregnant or breastfeeding women need higher levels of B12 because the vitamin is transferred to their babies.

What Causes B12 Deficiency in Children?

Individuals with intestinal and autoimmune disorders, such as pernicious anemia, may lack the stomach proteins necessary for absorbing vitamin B12. Similarly, those who have undergone stomach surgery may experience difficulties in absorbing the vitamin.

Children who consume limited or no dairy or meat, such as those adhering to strict vegan or vegetarian diets, may not obtain sufficient vitamin B12 from their diet alone and may need to take a vitamin supplement.

Babies may experience low levels of B12 if their mothers had insufficient vitamin levels during pregnancy. During gestation, the fetus accumulates and stores vitamin B12, which is utilized by their bodies during the initial months of life. As a result, signs of vitamin B12 deficiency may not become apparent until the baby is around four months old.

What Are the Signs and Symptoms of Vitamin B12 Deficiency in Children?

There are a plethora of signs and symptoms associated with a vitamin B12 deficiency, for instance:

• Fatigue.

• Weakness.

• Anemia.

• Seizures.

• Irritability.

• Burning sensation in extremities.

• Delayed growth curve.

• Low muscle tone.

• Loss of appetite.

• Involuntary movements.

• Glossitis (when the surface of the tongue is swollen or inflamed, the condition is called glossitis).

• Loss of memory.

• Low white blood count (WBC).

• Low blood platelet count.

• Headache.

• Jaundice.

• Diarrhea.

• Tremor (it is an involuntary shaking movement owing to muscle contraction in the body).

• Ataxia (neurological disorder where the child is unable to balance, coordinate and speak).

• Lower IQ.

How to Diagnose Vitamin B12 Deficiency in Children?

There are a series of tests done according to the severity and age of the children, such as:

• Serum vitamin B12 Test: It is a simple blood test carried out to check vitamin B12, folate, and ferritin levels in blood serum.

• Full Blood Count:

  • Mean Corpuscular Volume Test (MCV): It is an essential test to check macrocytosis in the blood. An elevated level indicates a higher deficiency of vitamin B12 and folate.

  • Mean Corpuscular Hemoglobin Test (MCH): Normally, it shows the same results as the MCV test, except it also determines thyroid issues and liver function abnormality.

  • Mean Corpuscular Hemoglobin Concentration (MCHC): An increase in the level of large red blood cells indicates the deficiency and a low level suggests iron deficiency.

  • Red Cell Distribution Width: This testing indicates the level of red blood cells of different sizes.

  • Eosinophils: An increase in the level of eosinophils suggests infections or allergies.

• Methylenetetrahydrofolate Reductase Test (MTHFR): This test is used to check for genetic mutation.

• Homocysteine Test: Homocysteine-amino acid shows an inversely proportional relation with vitamin B12 levels in the blood. Also, higher levels of homocysteine can be the cause of conditions like Alzheimer's, cardiovascular disease, or neurodegenerative diseases.

• Autoimmune Pernicious Anemia Testing: When the body’s immune system becomes hostile to intrinsic cells in the stomach, it causes a condition like vitamin B12 deficiency. An autoimmune condition such as pernicious anemia is the same condition that requires testing to see if the body is deficient in vitamin B12.

How to Manage Vitamin B12 Deficiency in Children?

• The treatment plan for this condition completely depends upon its severity. When there are no significant physical or neurological changes or abnormalities seen with vitamin B12 deficiency, dietary changes can fix the situation.

• However, if the deficiency is a little more than normal, pediatricians usually go with vitamin supplements until the symptoms are resolved.

• The management of vitamin B12 deficiency includes either an oral dose of vitamin B12 or an intramuscular injection. The dose of the injection is given as per the age and severity of the condition. For instance, newborns to 1-year-olds are prescribed 326 to 591 pmol/L. The dosage increases with age.

• Furthermore, even after the month of treatment of the intramuscular injection course, a follow-up maintenance dose is required. Additionally, due to uncertainty about the saturated level of vitamin B12 in the body, the symptoms are the only measure to see if the deficiency is cured.

What Are the Potential Risks Associated With Vitamin B12 Supplements?

It is important to consult the doctor before beginning vitamin B12 supplements because they can interact with certain medications. B12 supplements may interfere with medications used for prediabetes and diabetes, as well as drugs prescribed for digestive issues such as acid reflux.

Conclusion:

Vitamin B12 deficiency is usually very common in people with certain diet habits, and it is associated with a plethora of health-related complications. Additionally, pre and post-pregnancy care of the fetus and mother plays an essential role in the health of the fetus. As the vitamin B12 level in the body affects the regeneration of intestinal cells, there are chances of absorption of other nutrition being affected. Moreover, an early diagnosis and prompt treatment are very important as the severity of the deficiency can cause long-lasting neurological defects in children.