Cobalamin supplementation improves motor development and regurgitations in infants: results from a randomized intervention study
Open accessAbstract
Background During infancy, minor developmental delays and gastrointestinal complaints are common, as is a biochemical profile indicative of impaired cobalamin status.Objective We investigated whether cobalamin supplementation can improve development or symptoms in infants with biochemical signs of impaired cobalamin function and developmental delay or feeding difficulties.Design Infants <8 mo of age (n = 105) who were referred for feeding difficulties, subtle neurologic symptoms, or delayed psychomotor development were assessed for cobalamin status [by the measurement of serum cobalamin, plasma total homocysteine (tHcy), and plasma methylmalonic acid (MMA)]. Infants with biochemical signs of impaired cobalamin function, defined as a plasma tHcy concentration ≥6.5 μmol/L (n = 79), were enrolled in a double-blind, randomized controlled trial to receive 400 μg hydroxycobalamin intramuscularly (n = 42) or a sham injection (n = 37). Motor function [Alberta Infants Motor Scale (AIMS)] and clinical symptoms (parental questionnaire) were recorded at entry and after 1 mo.Results During follow-up, cobalamin supplementation changed all markers of impaired cobalamin status (ie, plasma tHcy decreased by 54%, and MMA decreased by 84%), whereas no significant changes were seen in the placebo group (P < 0.001). The median (IQR) increase in the AIMS score was higher in the cobalamin group than in the placebo group [7.0 (5.0, 9.0) compared with 4.5 (3.3, 6.0); P = 0.003], and a higher proportion showed improvements in regurgitations (69% compared with 29%, respectively; P = 0.003).Conclusions In infants with biochemical signs of impaired cobalamin function, 1 intramuscular injection of cobalamin resulted in biochemical evidence of cobalamin repletion and improvement in motor function and regurgitations, which suggest that an adequate cobalamin status is important for a rapidly developing nervous system. This trial was registered at clinicaltrials.gov as NCT00710359 and NCT00710138.
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Results from a previous Dutch study in adolescents raised on a vegan diet showed associations between early vitamin B-12 status and later cognitive performance.
“Results from a previous Dutch study in adolescents raised on a vegan diet showed associations between early vitamin B-12 status and later cognitive performance (19,21).”
From Vitamin B-12 status in infancy is positively associated with development and cognitive functioning 5 y later in Nepalese children (2017) · cites this paper as [19]
This Dutch study has limited generalizability given the small sample size and specific characteristics of the population.
“This study has limited generalizability, however, given the small sample size and specific characteristics of the population.”
From Vitamin B-12 status in infancy is positively associated with development and cognitive functioning 5 y later in Nepalese children (2017) · cites this paper as [19]
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When do you think that the cause of the problem is vitamin B12 deficiency?
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- Authors
- Torsvik, I., Ueland, P. M., Markestad, T., & Bjørke-Monsen, A.-L.
- Affiliations
- Haukeland University Hospital (NO)
- University of Bergen (NO)
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2013-11
- Volume
- 98
- Issue
- 5
- Pages
- 1233-1240
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W2122528440
- Cited by
- 74
- References
- 50
- Citations by year
- 2026: 4 · 2025: 3 · 2024: 10 · 2023: 8 · 2022: 5 · 2021: 6 · 2020: 8 · 2019: 2 · 2018: 6 · 2017: 6 · 2016: 5 · 2015: 5 · 2014: 5 · 2013: 1
- FWCI
- 3.92
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Metabolism and Genetic Disorders
- Health Sciences › Medicine › Psychiatry and Mental health › Child Nutrition and Feeding Issues
- Keywords
- vitamin B12 supplementation, hydroxocobalamin, infants, motor development, regurgitation, feeding difficulties, developmental delay, total homocysteine, methylmalonic acid, cobalamin status, intramuscular injection, brain development
- MeSH terms
- Child Development, Double-Blind Method, Female, Folic Acid, Follow-Up Studies, Homocysteine, Humans, Hydroxocobalamin, Infant, Injections, Intramuscular, Male, Methylmalonic Acid, Surveys and Questionnaires, Vitamin B 12 Deficiency, Vomiting, Biomarkers, Linear Models, Dietary Supplements
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