B-12 Deficiency and Developmental Delays in Breast Fed Infants
I am a strong advocate of breastfeeding, and would never encourage formula feeding. There is, however, a challenge that we have been missing that can have devastating effects on our unborn children and infant babies. This has to do with low B-12 levels in our moms during pregnancy and that first year of nursing. Vitamin B-12 is only obtained from animal products (fish, shellfish, eggs, and dairy) and so for our health conscious vegetarian and vegan moms, the deficiencies can at times be severe and undetected. This can lead to death or permanent brain injury to the unborn child or developing infant. I would encourage all pregnant moms, and those who want to become pregnant, to get your B-12 level checked and to aggressively treat any level below 500 pg/ml. “Normal” is often thought of as levels above 270, but for brain development and adequate B-12 in your breast milk, levels near 1000 or above would be ideal.
Because we are aware that folic acid is needed to prevent neural tube defects, this vitamin in included in prenatal vitamins. The Journal of Pediatrics March 2009, Molloy et. al. showed that women with B-12 deficiency in early pregnancy were up to 5 times more likely to have a child with neural tube defect. Women deficient in B-12 have been shown to have children with abnormal behavior stemming from basal ganglia involvement. It is also important to know that even women with adequate stores of B-12 need to take extra Vitamin B-12 during pregnancy as the stored B-12 does not cross the placenta, and those who are deficient must take extra while breastfeeding.
Classic B-12 deficiency can cause symptoms similar to autism including aloofness, loss of speech and social skills, and movement abnormalities. Various doctors have found improved symptoms by giving B-12 injections for a subset of autistic children and those with other neurological abnormalities. I have seen this in a small subset of my autism patients, but would definitely encourage every parent who is contemplating having children to have mom’s B-12 status checked and to supplement pregnancy with at least 1000 micrograms of methyl B-12. Any child with neurological symptoms should be tested for B-12 and consider a urine MMA to get a handle on severity and as a confirmation that the methylation pathway is indeed impaired.