A lot of children in the world suffer from a deficiency in Vitamin B12. Unfortunately, most parents do not know this. In fact, studies suggest that this problem is widespread because most people do not know about it. It is one of those things that we take for granted.
In children, this deficiency results in symptoms that in most cases are not specific. As a result, we ignore them and assume the infant is just going through a phase. They will outgrow it. Some of the things that are likely symptoms of Vitamin B12 deficiency include neurological problems, irritability, weakness, and anorexia. Since these might be common in some kids, parents assume they will pass eventually.
During the first year of birth, the amount of Vitamin B12 that the infant receives is largely dependent on the amount of Vitamin B12 they were receiving in the course of the pregnancy. Therefore, so much of this deficiency hinges on the mother.
When babies are born, their livers should have around 25 ųg of Vitamin B12. To get them through the first year of birth, this is enough, even if their subsequent consumption after birth is not sufficient. However, in the unlikely event that the mother has a Vitamin B12 deficiency that has never been treated, the baby’s liver will be lacking in Vitamin B12. In fact, by the time the child is 3 or 4 months old, the signs of deficiency might be apparent.
It is important to understand the ramifications of a Vitamin B12 deficiency, especially during the early stages of life. This deficiency hinders the functions of the central nervous system. In fact, over the years, neurological deterioration among other serious clinical symptoms have been reported in children who have a deficiency in Vitamin B12.
This deficiency is so bad that the infant can experience dire side effects from a mild deficiency. When this deficiency is detected early enough, it becomes easier to provide treatment and prevent irreparable damage which might affect the growth and development of your child.
In children under the age of 19, a deficiency in Vitamin B12 is a serum with less than 229 pmol/L. After birth, the B12 serum gets depleted over time, only to increase again after 6 months, and peaks between 3 – 7 years, then it decreases again to the normal adult values.
Vitamin B12 Deficiency Symptoms
Cobalamin is another name for Vitamin B12, a water-soluble vitamin that is important for proper growth and development in children, and adults. The production of DNA and red blood cells is possible thanks to Vitamin B12. It is also because of this vitamin that the baby’s nervous system can perform its functions well.
This vitamin is available in a lot of animal foods, though you can also find it in products that have been supplemented with Vitamin B12, including plant-based milk and some types of bread. Deficiency in Vitamin B12 is very common, especially if the baby cannot get it from their diet, or if they can, but their bodies are unable to absorb as much as they need from the food.
One of the main reasons why diagnosing a deficiency in vitamin B12 can be difficult in children is because the symptoms can at times be confused with normal challenges that children have when they are growing up. In fact, in some cases, the symptoms can take a very long time to openly manifest, even years. It gets even worse, diagnosis can be a complex affair altogether, especially since in some cases this deficiency can be assumed to be a folate deficiency.
The following are some of the common signs and symptoms that you should be on the lookout for in your child. The earlier you notice them and seek treatment, the earlier you can rule out the possibility of other conditions, and narrow down to a deficiency in Vitamin B12.
Jaundice. In children who have a deficiency in Vitamin B12, you will notice they have pale skin, or their skin might have a yellow tinge. The yellow tinge might also be present in their eyes. This is a sign of jaundice.
Your child will develop jaundice because the body cannot produce sufficient red blood cells. Vitamin B12 is an important factor in DNA synthesis, which is necessary for producing red blood cells. Lack of Vitamin B12 will mean incomplete instructions, and as a result, the cells cannot multiply.
This condition is also responsible for megaloblastic anemia. This is a type of anemia where the red blood cells that are produced in the bone marrow are too big, hence they become fragile. Because of their size, the red blood cells are unable to exit the bone marrow into the bloodstream for circulation. Because of this, the baby’s skin becomes pale since they do not have enough red blood cells in circulation.
Other than their size, these red blood cells are also fragile. Most of them will break down, leaving a lot of bilirubin in the blood. Bilirubin is a brownish or reddish substance that the liver produces when breaking down old blood cells. It is this excess amount of bilirubin that causes a yellow tinge in the eyes.
Fatigue. Fatigue and weakness are some of the most obvious symptoms of a deficiency in Vitamin B12. This is because the body is not receiving sufficient oxygen. The body is not producing enough red blood cells. Red blood cells are needed to transport oxygen-rich blood to the vital organs all over.
Since most of the baby’s organs are lacking sufficient oxygen, their metabolism is too low, hence your child will feel tired and weak. If this is not treated as early as possible, your child will grow up with this deficiency and might develop pernicious anemia. Pernicious anemia forms in people whose bodies are not producing the protein intrinsic factor in sufficient quantities.
Besides, the intrinsic factor is important in preventing a deficiency in Vitamin B12. This takes place in the gut by binding with vitamin B12, making it easier to absorb.
Nerve Damage. Vitamin B12 deficiency should be diagnosed as early as possible. Failure to do this might leave your child at risk of nerve damage. This is something that develops with time. Vitamin B12 is one of the factors needed in the production of myelin. Myelin is a fatty substance that insulates and protects the nerves.
In the absence of vitamin B12, or presence of insufficient quantities, the production of myelin is affected, and the nervous system cannot perform optimally. One of the symptoms of nerve damage is paresthesia. Your child will feel a prickling sensation.
Mobility Challenges. When left untreated, a deficiency in Vitamin B12 can damage the nervous system such that your baby might not be able to move or walk properly. In some cases, this can also affect their coordination and balance, which will give them a difficult time growing up.
Glossitis. Glossitis refers to an inflamed tongue. The baby’s tongue will change shape and color. It is too painful and it might even be swollen. Because of the inflammation, the tiny bumps that are present on the tongue, which contain the taste buds can disappear, leaving your child with a smooth looking tongue.
Other than the pain, glossitis also affects the way your child talks and how they eat. In fact, this is one of the earliest symptoms of Vitamin B12 deficiency.
Short Breath. When your child develops anemia because of a deficiency in vitamin B12, they run out of breath and feel dizzy most of the time, especially when you try to engage them in any physical activity. This happens because the body is not producing enough red blood cells, so it is deprived of oxygen.
However, it is important to get a doctor’s opinion first, because this is a symptom that is associated with a lot of conditions, so the best thing for you to do would be to see a doctor and get the right perspective.
Vision Problems. Your child might suffer blurry vision as a result of an untreated Vitamin B12 deficiency. This happens especially when there is serious damage to the nervous system, especially on the optic nerve.
Damage to the optic nerve affects the signal transmission between the brain and the eyes, impairing their vision. This is referred to as optic neuropathy. However, though this condition sounds alarming, it can be reversed with vitamin B12 supplements.
Mood Swings. If your child is always moody, you need to get them to see a doctor because they might not be getting the right amount of Vitamin B12. The problem with this is that they have a high likelihood to develop brain disorders if this is not unchecked.
Low levels of Vitamin B12 in the blood result in a high level of homocysteine. This can damage the brain tissues, interfering with the transmission of signals hence drastic changes in their moods from time to time.
There are studies that suggest the possibility of a reversal if the right supplements are provided in good time. However, at the same time, it is important to understand that mood swings in your baby can be attributed to lots of reasons. Do not just rush to conclusions and start purchasing products. See a doctor for them to advise you on the best course of action for your baby.
High Temperature. This is a rare but possible symptom that is associated with a deficiency in vitamin B12. Most doctors cannot explain why it happens, but upon treatment, the fever often subsides. That being the case, however, fever is a common symptom in so many illnesses. This, therefore, cannot be the only thing that would alert your suspicions of a deficiency in vitamin B12.
The following are other common symptoms that might indicate a deficiency in Vitamin B12 in your child.
- Personality changes
- Concentration and memory problems
- Involuntary movement
- Mild paralysis
- Delayed or regressive development
- Delayed growth
- Poor appetite
Vitamin B12 Deficiency Causes
There are three major causes of Vitamin B12 deficiency in children:
Malabsorption. This is a situation where there is no intrinsic factor, or presence of insufficient intrinsic factor as a result of anemia, bowel resection or hereditary abnormal/absent intrinsic factor. If the mother has been receiving treatments from acid-inducing medicines for a long time, this can reduce the level of stomach acid.
It is also possible because of reduced pancreatic function. Bacterial overgrowth is another reason for the deficiency, given that bacteria and parasites will be competing for the available Vitamin B12.
Mothers who have Crohn’s disease or celiac disease also have a predisposition to Vitamin B12 deficiency, as do those who have undergone small intestine surgery in the past.
Reduced Intake. This is common in families that strictly follow macrobiotic, vegan or vegetarian diets. As a result, a mother who follows these diets or is breastfeeding but has an untreated case of Vitamin B12 deficiency might induce a deficiency in their child. The deficiency can also be genetic, especially if there is a history of untreated phenylketonuria in the family.
Congenital Errors. Congenital disorders that affect the metabolism of Vitamin B12 or transport to different parts of the body where it is needed can also cause the deficiency.
Diagnosing Vitamin B12 Deficiency
A complete diagnosis of Vitamin B12 does not always have to depend on the blood values. A good example is a macrocytosis, one of the common symptoms of this deficiency. It is not specific to a deficiency in vitamin B. Other than that, anemia might also not be a factor. Therefore, for accurate and precise diagnosis, there should be a combination of factors that lead the doctor to convincingly conclude that the baby is suffering from a deficiency in Vitamin B12.
According to doctors, if the values of hematocrit, hemoglobin, and MCV are normal, at least 30% of deficiency cases might be missed. If the baby has metabolism disorders, the serum B12 value will be normal because Vitamin B12 is available in their blood but not within the tissues. It is possible to have a deficiency in the tissues even before the serum values decline.
In case doctors suspect a deficiency in vitamin B in your child, but the serum B12 value does not show this, they often recommend that you test for MMA and homocysteine. Once the diagnosis is done, they can then perform tests to identify the real reason behind the deficiency.
The following are some tests that can be performed:
- Analyzing amino acids
- Analyzing your diet
- Testing for parasites
- Studying the transcobalamin levels
- Measuring the binding capacity of Vitamin B12
- Testing for parietal cell antibodies
- Testing for intrinsic factor antibodies
Treating Vitamin B12 Deficiency
Treatment will always depend on the cause. In case the deficiency is asymptomatic and mild, the doctor can recommend making some changes to the diet, or that you remove the causative. In some cases, supplements might be recommended.
Sadly, more often it is impossible to remove the causative, and as a result, you have to get Vitamin B12 injections from time to time.
If the symptoms are severe, injections will be mandatory to ward off permanent damage. If your child lacks B12 binding proteins, or if they have metabolic disorders, they might need Vitamin B12 in high doses, and might also require other forms of treatment.
While treatment can yield significant improvement in some children, it is not always the case across the board. In fact, there are cases where the neurological damage will last their lives. The duration and seriousness of the deficiency can have a lasting impact on the child’s life. Because of this reason, you need to go for diagnosis as early as possible.
Foods That Are Rich in Vitamin B12
Vitamin B12 is one of the important nutrients in the body. If the body cannot produce it on its own, you can help your child by preparing food rich in vitamin B12 or administering supplements according to the doctor’s specifications.
Mothers who practice a strict vegetarian diet and are breastfeeding have a high chance of giving birth to children who have a deficiency in Vitamin B12. You, therefore, need to make sure you supplement accordingly. You need to take at least 2.4 mcg a day if you are breastfeeding or pregnant.
Animal Kidneys and Liver. Some of the best sources of nutrition are organ meats. The kidneys and liver from lamb, in particular, provide a good amount of Vitamin B12. A lamb liver serving of 100 grams provides more than 100% the amount of vitamin B12 needed. You can also consider veal or beef liver.
Other than vitamin B12, lamb liver also provides other useful nutrients like vitamin B2, vitamin A, selenium, and copper.
Beef. Beef is a good source of vitamin B12. Other than that, it is a healthy meal and provides other nutrients like vitamin B6, B3, and B2. For the best quantity of vitamins per size of beef, go for low-fat meat cuts.
Salmon. In the fish family, salmon is one of those that are notorious for having a very high concentration of omega-3 fatty acids. Other than that, it is also a good source of vitamin B12. You will also get a good amount of protein in a serving of salmon.
Sardines. These small saltwater fish are another good source of vitamin B12. While you can buy them fresh, you can also find them in stores, canned in sauces, oil or water. One of the reasons why sardines are perfect for fighting the deficiency is because they contain most nutrients the body needs in large quantities.
Other than providing vitamin B12, sardines also are a good source of omega-3 fatty acids. Omega-3 fatty acids play an important role in the growth and development of your child, given that they help improve their heart health, reducing inflammation, among other health benefits.
Clams. These tiny chewy shellfish are not just full of vitamin B12, they are also packed with a lot of other nutrients. They contain a very high content of vitamin B12 and will help you surpass the daily recommended intake.
Baby clams, for example, provide a very high quantity of iron. They are good for your baby because their meat contains antioxidants, which will help in fighting some diseases. You can also prepare a broth of boiled clams, or buy canned clams, and still, enjoy sufficient amounts of vitamin B12.
Fortified Cereal. Have you been feeding your baby the right cereals? Their favorite breakfast meal might actually go a long way in helping them fight the risk of vitamin B12 deficiency. Since fortified cereal is not produced from any animal sources, but made synthetically, it will also work well for your vegan or vegetarian family.
Fortified cereal might not be one of the most often recommended foods in a healthy diet, but they are a good source of vitamin B12, as well as the other B vitamins. According to recent research, eating fortified cereals on a daily basis can increase the concentration of vitamin B12 in the blood.
If you decide to include fortified cereal in your family diet so that you can increase your intake of vitamin B12, make sure you select one that does not have a lot of added sugar and is pure whole grain, or high in fiber.
Fortified Nutritional Yeast. This is one of the best sources of minerals, vitamins, and protein. This yeast species is specifically grown for use as food, not for leavening bread. While vitamin B12 might not be originally present in nutritional yeast, it is fortified in production, making it one of the best sources of vitamin B12 that you can come across.
Like most synthetic foods, it is one great option you should consider if your family leads a vegan or vegetarian lifestyle.
Tuna. This is a common meal in most households today. Tuna is one of the best sources of minerals, vitamins, and protein. The concentration of vitamin B12 in tuna is very high, especially in the dark muscles right under the skin.
Other than vitamin B12, tuna also provides selenium, phosphorus, lean protein, and vitamins A and B3. If you cannot find fresh tuna, you will still enjoy good results with canned tuna. Canned tuna provides more than 85% of the recommended daily intake of vitamin B12.
Rainbow Trout. According to doctors and nutritionists, this is one of the safest, healthiest types of fish you can feed your family. It is a freshwater type of fish. In one meal, your family will enjoy a significant amount of B vitamins, healthy fats, and protein.
Rainbow trout is also one of the best sources of minerals like selenium, phosphorus, and manganese.
Fortified Nondairy Milk. For vegan families that do not take dairy milk, fortified nondairy milk can also provide a good amount of vitamin B12. The common options include rice milk, almond, and soy milk. However, these types naturally do not contain a high amount of vitamin B12. But, during the production process, they are fortified with vitamin B12, making them an excellent option for your household.
Dairy Products. Unless your family is strictly vegan or vegetarian, milk and dairy products are some of the best sources of minerals, vitamins, and proteins. A small cup of milk around 240ml contains around 18% of the recommended daily intake of vitamin B12.
Different cheese products produced from dairy can also provide a good amount of Vitamin B12 for your baby. However, Swiss cheese has been known to provide the highest amount, around 16%.
Other options that will support your quest to fight the vitamin B12 deficiency include full-fat plain yogurt. In fact, this yogurt has been documented in the past by researches and nutritionists alike to improve the vitamin B12 status in people who are highly deficient.
One of the reasons why you should strongly look into dairy products is that the body absorbs vitamin B12 in dairy products faster than it does the vitamin B12 in eggs, fish or beef.
Eggs. Eggs have always been a good source of vitamins and proteins. The egg yolk contains a higher level of vitamin B12 than the egg white. Other than that, the body absorbs the nutrients in the egg yolk better and faster. For this reason, try and encourage your child to eat the whole egg, instead of just eating the egg whites as most children do.
Apart from providing a good amount of vitamin B12, eggs also provide vitamin D, and they are one of the very few foods that have this nutrient.
Supplements. For the sake of your child, you should consider supplementing with vitamin B12 in case you are breastfeeding or pregnant and have a history of vitamin B12 deficiency. Other people who need to consider supplements include vegans, vegetarians and anyone who might have had a stomach surgery, or intestinal problems in the past.
The supplements are available in the market in different forms, so choose the one that best suits your needs. You can stick them under your tongue, drink, chew, swallow or have them injected into your bloodstream.
According to recent research, the supplements that are injected into the bloodstream and those ingested through the mouth are both effective in restoring vitamin B12 levels. With supplements, you can restore your vitamin B12 level in around 3 months. For pregnant mothers, this might be worth considering.
Precaution for Mothers
While addressing vitamin B12 deficiency in children, it is important also to look at some concerns that you should be aware of as a parent. Some babies develop a deficiency in vitamin B12 as a genetic concern, passed down from their mothers. Besides, babies born to mothers who have a deficiency in vitamin B12 usually have a high risk of developing type 2 diabetes among other metabolism problems later on in life. Get screened early enough so that you can protect your baby.
Overdose. Is it possible to overdose on Vitamin B12? No. it is not. Vitamins that can have dire side effects in your body when they accumulate are often fat-soluble vitamins. Vitamin B12, on the other hand, is a water-soluble vitamin. The body will only absorb the content that it needs, and then pass out the excess through urine.
That being said, however, you should not intentionally overdose on vitamin B12. In fact, taking too much of this vitamin can make your body feel itchy, and might even be responsible for diarrhea. If you are using supplements that are recommended by doctors, always read the labels, and take only the amount that your doctor suggests.
Weight Loss. You have a higher risk of a deficiency in vitamin B12 if you recently had a weight loss surgery. Any surgery that affects the digestive tract, especially a gastric bypass might give you a hard time absorbing vitamin B12. This is because it affects your ability to digest food. Unfortunately, this might be a permanent problem, and if this is the case, you might be forced to take vitamin B12 supplements throughout your life.
Cervical Cancer. Cancers are the rage at the moment. A lot of people rush to hospitals for frequent checkups to make sure they are safe, which is a good thing. How does a deficiency in vitamin B12 affect you? When you visit your gynecologist for your regular Pap test, a deficiency in vitamin B12 can present a false positive result. Low levels alter the outlook of some cervical cells. A false positive can give you false hope. Therefore, if you have ever had a problem with your vitamin B12 levels, you need to make sure you have sufficient amounts.
Birth Control. Using birth control pills for a long time comes with side effects. If you have been using oral contraceptives for a while, your body might struggle to absorb vitamin B12. In fact, this is common in birth control pills that have a high content of estrogen. This is responsible for so many cases of folate and vitamin B12 deficiency. If you are on any pill, discuss the options with your doctor. They can recommend some supplements so you can stay safe.