title: Solid food refusal as the presenting sign of vitamin B12 deficiency in a breastfed infant.
abstract: Dietary vitamin B(12) (vitB(12)) deficiency, although common in the elderly, is rare in childhood. We report on an exclusively breastfed 8-month-old infant, presenting with persistent refusal of solid foods. Three months later, developmental regression and failure to thrive led to the diagnosis of vitB(12) deficiency, as a consequence of a subclinical pernicious anaemia with vitB(12) deficiency in the mother. Treating the infant with parenteral vitB(12) induced prompt recovery including acceptance of weaning food.
  
  
  CONCLUSIONS
  This case illustrates refusal of complementary foods as a presenting symptom of vitB(12) deficiency in a breastfed infant. Symptoms, diagnostic tests and treatment of vitamin B(12) deficiency are reviewed. Early diagnosis and treatment are important to prevent irreversible neurological damage.
authors: Paediatric Gastroenterology and Nutrition, Ghent University Hospital, De Pintelaan 185, 9000 Ghent, Belgium.
authors: Els
authors: E
authors: Ide
authors: Stephanie
authors: S
authors: Van Biervliet
authors: Joke
authors: J
authors: Thijs
authors: Saskia
authors: S
authors: Vande Velde
authors: Ruth
authors: R
authors: De Bruyne
authors: Myriam
authors: M
authors: Van Winckel
mesh_terms: D000752:Anemia, Pernicious; D001942:Breast Feeding; D016241:Child of Impaired Parents; D002658:Developmental Disabilities / Q000209:etiology; D005183:Failure to Thrive / Q000209:etiology; D019959:Feeding and Eating Disorders of Childhood / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D014806:Vitamin B 12 Deficiency / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D014886:Weaning