Abstract：
UNASSIGNED: An optimal cobalamin status is necessary for normal neurodevelopment.
UNASSIGNED: To give a description of the epidemiology, pathophysiology and diagnostic challenges related to cobalamin insufficiency in neonates and infants in order to prevent its occurence.
UNASSIGNED: Inadequate cobalamin status is prevalent among neonates and young infants, due to a high prevalence of maternal cobalamin deficiency, exclusive breastfeeding for extended periods and late introduction of animal food. Cobalamin insufficiency is associated with delayed neurodevelopment and subtle clinical symptoms like feeding difficulties, regurgitations and constipation in young infants. Early diagnosis and treatment of impaired cobalamin status is important to prevent neurologic damage.
UNASSIGNED: Clinical suspicion of cobalamin insufficiency in infants should infer immediate biochemical testing and a plasma total homocysteine > 5.0 µmol/L indicate cobalamin insufficiency in need of intramuscular treatment with hydroxycobalamin, followed by introduction of animal food after 4 months of age.
Plain language titleVitamin B12 Is Important for Normal Development in Young ChildrenPlain language summaryVitamin B12, also called cobalamin, is found only in animal-sourced food. As low-meat, vegetarian, and vegan diets are increasingly popular in Western countries, vitamin B12 deficiency has become common, also in pregnant women and babies. Vitamin B12 status is essential for normal development and adequate levels of this vitamin is particularly important during pregnancy and the first years of life. In pregnancy, vitamin B12 is transferred from the mother to the fetus, so the baby has a store of this vitamin at birth. However, if the mother has vitamin B12 deficiency or the baby is born premature or with a low birth weight, the vitamin store may be insufficient and the baby may develop vitamin B12 deficiency. Maternal vitamin B12 status is important as long as the baby is exclusively breastfed. Breast milk contains vitamin B12, but the concentration decreases after 4 to 6 weeks and may be too low to support the baby until animal-sourced foods are introduced. The vitamin B12 content in formula milk is higher than in breast milk, and vitamin B12 deficiency is more common in exclusively breastfed babies. Vitamin B12 deficiency is associated with diffuse symptoms in small babies and may be difficult to detect, and the diagnosis have a mean delay of 4 months in this age-group. Typical symptoms are regurgitations or spitting up, constipation, problems with feeding and swallowing, and delayed psychomotor development. Suspicion of vitamin B12 insufficiency in babies should prompt immediate biochemical testing. Plasma total homocysteine is a metabolic marker of vitamin B12 status and can be measured in a blood sample from the baby. A level >5.0 µmol/L indicates probable vitamin B12 insufficiency and the baby should receive vitamin B12 supplementation, followed by introduction of animal-sourced foods at 3 to 4 months of age.
UNASSIGNED: To give a description of the epidemiology, pathophysiology and diagnostic challenges related to cobalamin insufficiency in neonates and infants in order to prevent its occurence.
UNASSIGNED: Inadequate cobalamin status is prevalent among neonates and young infants, due to a high prevalence of maternal cobalamin deficiency, exclusive breastfeeding for extended periods and late introduction of animal food. Cobalamin insufficiency is associated with delayed neurodevelopment and subtle clinical symptoms like feeding difficulties, regurgitations and constipation in young infants. Early diagnosis and treatment of impaired cobalamin status is important to prevent neurologic damage.
UNASSIGNED: Clinical suspicion of cobalamin insufficiency in infants should infer immediate biochemical testing and a plasma total homocysteine > 5.0 µmol/L indicate cobalamin insufficiency in need of intramuscular treatment with hydroxycobalamin, followed by introduction of animal food after 4 months of age.
Plain language titleVitamin B12 Is Important for Normal Development in Young ChildrenPlain language summaryVitamin B12, also called cobalamin, is found only in animal-sourced food. As low-meat, vegetarian, and vegan diets are increasingly popular in Western countries, vitamin B12 deficiency has become common, also in pregnant women and babies. Vitamin B12 status is essential for normal development and adequate levels of this vitamin is particularly important during pregnancy and the first years of life. In pregnancy, vitamin B12 is transferred from the mother to the fetus, so the baby has a store of this vitamin at birth. However, if the mother has vitamin B12 deficiency or the baby is born premature or with a low birth weight, the vitamin store may be insufficient and the baby may develop vitamin B12 deficiency. Maternal vitamin B12 status is important as long as the baby is exclusively breastfed. Breast milk contains vitamin B12, but the concentration decreases after 4 to 6 weeks and may be too low to support the baby until animal-sourced foods are introduced. The vitamin B12 content in formula milk is higher than in breast milk, and vitamin B12 deficiency is more common in exclusively breastfed babies. Vitamin B12 deficiency is associated with diffuse symptoms in small babies and may be difficult to detect, and the diagnosis have a mean delay of 4 months in this age-group. Typical symptoms are regurgitations or spitting up, constipation, problems with feeding and swallowing, and delayed psychomotor development. Suspicion of vitamin B12 insufficiency in babies should prompt immediate biochemical testing. Plasma total homocysteine is a metabolic marker of vitamin B12 status and can be measured in a blood sample from the baby. A level >5.0 µmol/L indicates probable vitamin B12 insufficiency and the baby should receive vitamin B12 supplementation, followed by introduction of animal-sourced foods at 3 to 4 months of age.
摘要：
■最佳的钴胺素状态是正常神经发育所必需的。
■为了描述流行病学，与新生儿和婴儿钴胺不足有关的病理生理学和诊断挑战，以防止其发生。
■在新生儿和小婴儿中钴胺状态不足很普遍，由于产妇钴胺缺乏症的患病率很高，纯母乳喂养的延长期限和后期引入的动物性食品。钴胺不足与神经发育延迟和微妙的临床症状如进食困难有关，婴儿的反流和便秘。钴胺受损状态的早期诊断和治疗对于预防神经系统损害很重要。
■临床怀疑婴儿钴胺不足应推断立即进行生化检测，血浆总同型半胱氨酸>5.0µmol/L表明需要用羟钴胺进行肌内治疗的钴胺不足，然后在4个月大之后引入动物性食物。
简单的语言标题维生素B12对儿童的正常发育很重要仅在动物来源的食物中发现。作为低肉，素食主义者,素食在西方国家越来越受欢迎，维生素B12缺乏已成为常见的，孕妇和婴儿也是如此。维生素B12状态对于正常发育至关重要，在怀孕和生命的最初几年中，这种维生素的适当水平尤为重要。在怀孕期间,维生素B12从母亲转移到胎儿，所以婴儿在出生时就有这种维生素的储存。然而,如果母亲缺乏维生素B12或婴儿早产或低出生体重，维生素储存可能不足，婴儿可能会出现维生素B12缺乏症。只要婴儿完全母乳喂养，母亲的维生素B12状况就很重要。母乳含有维生素B12，但浓度在4至6周后降低，并且可能太低而无法支持婴儿，直到引入动物来源的食物。配方乳中的维生素B12含量高于母乳，维生素B12缺乏在纯母乳喂养的婴儿中更为常见。维生素B12缺乏与小婴儿的弥漫性症状有关，可能很难发现，在这个年龄段，诊断平均延迟4个月。典型的症状是反流或吐痰，便秘,进食和吞咽问题，精神运动发育延迟。怀疑婴儿维生素B12不足应立即进行生化检测。血浆总同型半胱氨酸是维生素B12状态的代谢标志物，可以在婴儿的血液样本中进行测量。水平>5.0µmol/L表示可能的维生素B12不足，婴儿应补充维生素B12，然后在3至4个月大时引入动物来源的食物。
■为了描述流行病学，与新生儿和婴儿钴胺不足有关的病理生理学和诊断挑战，以防止其发生。
■在新生儿和小婴儿中钴胺状态不足很普遍，由于产妇钴胺缺乏症的患病率很高，纯母乳喂养的延长期限和后期引入的动物性食品。钴胺不足与神经发育延迟和微妙的临床症状如进食困难有关，婴儿的反流和便秘。钴胺受损状态的早期诊断和治疗对于预防神经系统损害很重要。
■临床怀疑婴儿钴胺不足应推断立即进行生化检测，血浆总同型半胱氨酸>5.0µmol/L表明需要用羟钴胺进行肌内治疗的钴胺不足，然后在4个月大之后引入动物性食物。
简单的语言标题维生素B12对儿童的正常发育很重要仅在动物来源的食物中发现。作为低肉，素食主义者,素食在西方国家越来越受欢迎，维生素B12缺乏已成为常见的，孕妇和婴儿也是如此。维生素B12状态对于正常发育至关重要，在怀孕和生命的最初几年中，这种维生素的适当水平尤为重要。在怀孕期间,维生素B12从母亲转移到胎儿，所以婴儿在出生时就有这种维生素的储存。然而,如果母亲缺乏维生素B12或婴儿早产或低出生体重，维生素储存可能不足，婴儿可能会出现维生素B12缺乏症。只要婴儿完全母乳喂养，母亲的维生素B12状况就很重要。母乳含有维生素B12，但浓度在4至6周后降低，并且可能太低而无法支持婴儿，直到引入动物来源的食物。配方乳中的维生素B12含量高于母乳，维生素B12缺乏在纯母乳喂养的婴儿中更为常见。维生素B12缺乏与小婴儿的弥漫性症状有关，可能很难发现，在这个年龄段，诊断平均延迟4个月。典型的症状是反流或吐痰，便秘,进食和吞咽问题，精神运动发育延迟。怀疑婴儿维生素B12不足应立即进行生化检测。血浆总同型半胱氨酸是维生素B12状态的代谢标志物，可以在婴儿的血液样本中进行测量。水平>5.0µmol/L表示可能的维生素B12不足，婴儿应补充维生素B12，然后在3至4个月大时引入动物来源的食物。
