Many children in low-income countries such as here in Nepal have insufficient vitamin B12 intakes in infancy. This appears to weaken their social and theoretical learning capacities later in life. Previous research has shown many Norwegian babies to also have too low an intake of this vitamin, which is important in brain development. (Illustrative photo: Colourbox)

Pregnant women who eat fewer eggs and meat can have kids with late brain development

Norwegian researchers have found that five-year-olds who received little vitamin B12 as infants tend to have greater problems solving various language and numerical problems as well as understanding other children's emotions.

Medical scientists have measured the vitamin status of infants and tested their social and theoretical skills five years later.

They discovered differences related to the quantities of vitamin B12 babies had received. Five-year-olds who had lower intakes in infancy trailed behind other kids their age in tests.

B12, also called cobalamin, is essential to the brain. Meat, milk and eggs are the major sources of the vitamin. In Norway another common source is mackerel, mainly sold in tins. 

The researchers collaborated with Nepalese and American colleagues on the study, which was implemented in Nepal. It was recently published in the American Journal of Clinical Nutrition.

Tested kids with puzzles

The research started in Nepal when blood samples were taken from 500 infants to measure their levels of vitamin B12.

Five years later, 320 of these children were contacted and underwent testing, including how long it took to solve various puzzles. 

The results showed a clear connection between early vitamin B12 status and various assessments of the children’s development.

“We found differences in how the children interpreted complex geometric figures and the degree in which they recognised other children’s emotions, dependent on the levels of vitamin B12 they had as infants,” says Clinical Psychologist and Researcher Ingrid Kvestad.

She works at Uni Research Health in Bergen and was first author of the work.

Can apply to other children

Researchers at Haukeland University Hospital in Bergen have previously shown that Norwegian infants can also get insufficient B12. In fact, two out of three babies under four months had low levels.

But this was a small selection of children – ones who had been referred by polyclinics because they were not developing sufficiently or they had eating problems.  

“The vitamin especially affects the nervous system in the first few months,” explained Dr Anne-Lise Bjørke-Monsen to Science Nordic’s Norwegian partner forskning.no in 2013.

New-borns have a little stored-up B12 they got from their mothers in utero. As infants they need to get enough B12 from breast milk, or for those who are bottle-fed, from milk supplements.

So it is important for pregnant women and mothers who breastfeed their babies to eat right. Vitamin B12 is mainly found naturally in meat, dairy products and eggs.

But after two or three months of breastfeeding a mother’s milk contains less B12.

So in 2013 the researchers Anne-Lise Bjørke-Monsen and Ingrid Torsvik recommended mothers who were feeding their babies nothing but breast milk at the age of six months to start giving them other food to ensure their child gets enough B12.

Vegans and vegetarians can get too little

Getting sufficient quantities of B12 without taking vitamin supplements can be particularly challenging for pregnant women who don’t eat meat.

“We didn’t measure this, but if one doesn’t want to eat meat and alternative can be mackerel,” says Kvestad.

The Norwegian study from 2013 also showed that a single injection with B12 did wonders for the kids.

It improved their motor skills development.

That study involved 100 infants who had been referred to the Children’s Clinic at Haukeland Hospital because they were lagging in motor skills development, had eating problems – or both.

These infants’ average age was four months and about half had been solely fed with breast milk. Blood samples showed that eight out of ten had low B12 levels.

Meat can give children a better start

However, Kvestad is more concerned about children in low-income countries.

“Huge numbers in South Asia eat little meat and insufficient vitamin B12 levels are widespread,” she says.

This seems to have an impact on children’s learning abilities and skills in interpreting others.

A sizeable number of children in low-income countries fail to develop to their full potential for their age group.

“Our results show that correcting vitamin B12 deficiencies early can be a way of ensuring these kids a better development,” says Kvestad.

She thinks that extra B12 in these regions can be an easy and cheap way of giving many children a better start in life.

A delay or a chronic problem?

Are children who received insufficient doses of B12 just behind schedule in maturing or does the deficiency cause permanent, irreversible damage to brain development?

“We don’t know. To find out we need to also test the children as they get older and see if the differences decrease, persist or expand,” says Kvestad.

She and her colleagues are investigating this question in a number of large interventional studies in Nepal and India.

This initiative involves cooperation among researchers from Uni Research Health, Innlandet Hospital Trust, Tribhuvan University in Nepal, the Center for Intervention Studies in Maternal and Child Health at the University of Bergen, Haukeland University Hospital and researchers in the USA, including from Johns Hopkins University.

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Read the Norwegian version of this article at forskning.no

Translated by: Glenn Ostling

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