Does B12 Deficiency Affect Young Children’s Development?

Overview Of Vitamin B12 Deficiency and Its Effect on Children’s Development:

There are a plethora of non-specific symptoms that lead to the diagnosis of vitamin B12 deficiency. For instance, children with a deficiency often present symptoms such as anorexia, cranky nature, weakness and fatigue, developmental delays, neurological defects, and drifted growth curve. However, if the symptom diverged growth curve is seen with neurological abnormality, then vitamin B12 deficiency can be the causative factor behind it. There is a significant relationship between a balanced diet and the development of the human body.

Even during pregnancy, the mother is advised to take a good diet full of all the nutrients to provide adequate growth to the fetus. Even the deficiency of new vitamins can lead to major developmental abnormalities in the fetus. Also, there have been well-established relations between folate and vitamin B12 found by many studies that show that when one vitamin level drops, it significantly affects the other.

To commence with, if the mother is not deficient in any nutrition or vitamins due to her imbalanced diet, the baby is born with the same nutritional value. On the other hand, between 6 to 12 months, if the baby is deficient in vitamin B12, it is either because of breastfeeding by a vitamin-deficient mother or low consumption of animal-source foods. The chronic deficiency of vitamin B12 is not only responsible for neurological manifestation such as peripheral neuropathy or loss of proprioception and vibration senses but also many skin abnormalities such as hyperpigmentation or glossitis.

What Are the Causes of Vitamin B12 Deficiency in Children?

Diet: If a mother is vitamin B12 deficient, there are high chances for the infant to be born with the same or developing the same deficiency because of lack of nutrition while breastfeeding. Also, if the children eating solid food are restricted to a vegetarian, vegan, or macrobiotic diet, there are chances of them developing various deficiencies such as vitamin B12. Additionally, a genetic condition such as phenylketonuria (an increased level of phenylalanine substance in the body causing brain damage) can also be the etiological factor behind the deficiency.

Congenital Defects: The cobalamin R-protein deficiency or transcobalamin-II deficiency can cause this abnormality.

Malabsorption: Owing to conditions like anemia, bowel restriction surgery, or hereditary, the vitamin B12 deficiency can affect children of any age. If the child is suffering from Crohn’s disease or celiac disease, there are chances of developing the scarcity. In the end, when there is abnormal pancreatic function seen, there is a chance of children lacking vitamin B12.

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): 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 different sizes of red blood cells.

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

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

• Homocysteine Test: Homocysteine-amino acid, shows the inversely proportional relation with vitamin B12 level in 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, usually, the dietary changes can fix the situation.

• However, if the deficiency is 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 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.

Conclusion:

The 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.