Infantile Acquired Vitamin B12 Deficiency

Reply to “Infantile Acquired Vitamin B12 Deficiency”

We read the article on “Acquired Vitamin B12 Deficiency in Infancy” with a great interest.[1] Fadilah et al concluded that “We recommend early detection by screening in infants with suggestive clinical presentations, using urine methylmalonic acid/plasma homocysteine as screening tools, maternal screening during pregnancy, and long-term neurodevelopmental follow-up.”[1] We would like to share ideas on this topic.

First, vitamin B12 deficiency is usually seen in the areas where the local people have strict vegetarianism. In endemic area of vitamin B12 deficiency, the screening test might be useful in detection of the deficient mother. However, this might be expected. Whether the universal vitamin B12 supplementation to the mother is more useful approach should be discussed. In our setting, Indochina, the supplementation is uncommon in Cambodia and the problem of vitamin B12 deficiency in mother and infant is reported.[2] It is the recommendation for this setting that the maternal vitamin B12 supplementation is raised.[2] [3]

• References

• 1 Fadilah A, Musson R, Mordekar SR. Acquired vitamin B12 deficiency in infancy. Pediatr Neurol 2019; 17: 213-218
• 2 Chebaya P, Karakochuk CD, March KM. , et al. Correlations between maternal, breast milk, and infant vitamin b12 concentrations among mother-infant dyads in Vancouver, Canada and Prey Veng, Cambodia: an exploratory analysis. Nutrients 2017; 9 (03) E270
• 3 Srinivasan K, Thomas T, Kapanee AR. , et al. Effects of maternal vitamin B12 supplementation on early infant neurocognitive outcomes: a randomized controlled clinical trial. Matern Child Nutr 2017 13. (02). https://doi.org/10.1111/mcn.12325