Evere Vitamin B12 Deficiency In An Exclusively Breastfed 5 Month Old Italian Infant Born To A Mother Receiving Multivitamin Supplementation During Pregnancy

This case study describes a serious vitamin B12 deficiency in a 5-month-old exclusively breastfed infant whose mother followed a vegan diet. Despite the mother taking standard multivitamin supplements during the second and third trimesters of pregnancy, her baby developed severe symptoms including poor weight gain, extreme paleness, muscle weakness, and developmental delays. The infant's blood tests revealed dangerously low levels of both vitamin B12 and iron, leading to severe anemia and other complications.

The baby required immediate hospitalization and intensive treatment including blood transfusions, vitamin B12 injections, and iron supplementation. While the blood parameters improved quickly after treatment began, the neurological and developmental effects persisted for months. Brain imaging showed delayed development of the protective coating around nerve fibers, which may explain why the child continued to have developmental delays even after vitamin levels were corrected.

This case highlights critical insights for metabolic health, particularly for families following plant-based diets. Standard multivitamin doses may not provide adequate vitamin B12 for pregnant and breastfeeding women on vegan diets, as B12 is primarily found in animal products. The vitamin B12 deficiency was masked by concurrent iron deficiency, making diagnosis more challenging since the typical signs of B12-related anemia weren't obvious.

For clinical practice, this case emphasizes the importance of higher-dose B12 supplementation for pregnant and nursing mothers on vegan diets, continued monitoring during breastfeeding, and awareness that multiple nutrient deficiencies can occur simultaneously and mask each other's typical presentations.