Raise Vegan August 2018 - Page 43

How much does my child need? The fantastic table below is from VeganHealth.org, outlining the rec- ommended dietary allowances for all ages and how to best supplement them (amounts extrapolated from recommendations for adults) (6): Breastfeeding mothers need to pay special attention to B12. A 2018 study showed that nearly 20% of the nursing infants studied were deficient, regardless of whether the mother was vegan and taking more than the recommended amount of B12 (7). Note that most infant formula is for- tified with B12, and weaned toddlers can start taking a multivitamin or B12 supplement in chewable or liquid form. Research has shown that the body only absorbs around 10 µg of a 500 µg B12 supplement (8). Though higher doses of B12 have not shown to be toxic, many health professionals recommend finding the smallest dose offered and taking it regularly, perhaps daily or a few times per week, versus a megadose less often (9). There is no strong evidence to show that one form of B12 supplement is superior in terms of absorption or bioavailability (10). What can affect absorption? Even when B12 intake is adequate, the following can inhibit your child’s absorption: • • • Taking an antacid which reduces hydrochloric acid in the stomach Pernicious anemia, which decreases the stomach cells that make in- trinsic factor needed for B12 absorption (in which case a very high oral dose or other form may be prescribed by your physician) A digestive disorder, like Celiac or Crohn’s disease How do I know if my child is getting enough? Your child’s pediatrician can order a simple blood test to evaluate B12 status every few years, but you may need to request this. One of the most accurate is the methylmalonic acid (MMA) test. Making sure the whole family is getting enough vitamin B12 doesn’t have to be overwhelming or scary. By paying attention to the points above, in- corporating B12-fortified foods and age-appropriate supplementation, and monitoring your child’s B12 status, you can rest assured that your family will be at low risk for deficiency. Resources 1. Strand TA, Ulak M, Kvestad I, Henjum S, Ulvik A, Shrestha M, Thorne-Lyman AL, Ueland PM, Shrestha PS, & Chandyo RK. Maternal and infant vitamin B12 status during infancy predict linear growth at 5 years. Pediatr Res. 2018 June. doi: 10.1038/s41390-018-0072-2. [Epub ahead of print]. 2. Venkatramanan S, Armata IE, Strupp BJ, & Finkelstein JL. Vitamin B12 and Cognition in Children. Advances in Nutrition Sept 2016; 7(5): 879-888. 3. Uni Research. “Children with poor vitamin B12 status early in life struggle more with tasks, recognition and interpreting feelings.” ScienceDaily. ScienceDaily, 27 March 2017. 4. Bickel NB. Low iron, vitamin B12 reserves linked to be- havior concerns Vr&2GG3Ww2V֖6VGRr֗&fF֖#"&W6W'fW2ƖVBF&Vf"6Ц6W&2֖זVr&2V&Ɨ6VB&#2#66W76V@Vǒr#Rv"fF֖#"fVvWF&FWG2fVvWF&WG&FFWFWF2&7F6Rw&WbFR6FVגbRЧG&FBFWFWF72GG3fGr&rF72&B&W6W&6W2#"$BFbWFFVB#'6&2fvƖ66W76VBVǐ2#bFǒVVG2fVvVF&rGG3fVvVF&rFǒVVG266W76VBVǒ"#rv"f26"fW&Fw22VBVĂbW'&BfF֖#"6FVB'&V7B֖Ʋ`fVvfVvWF&BfVvWF&7FFrvVFRVFVB7FFW26ƖWG"#( 3rࣂ6&V"rG&VB6&֖fF֖#"FVfЦ6V7&B6WB#"b##B#࣒6&VB"VW7F27vW&VB&Vv&FrfFЦ֖#"GG3WG&F7GVFW2&r"VW7F2Ч7vW&VB&Vv&FrfF֖#"V&Ɨ6VBfV"b#R66W76VBVǒB#6rrGFR6vR6VFW"FRЦ&R&ƖFVB&F֗VB6G&VB7GVGFWfVFRFP&VFfRVff67b7V&ƖwVB&fF֖"6WF֖7G&F&VGV6rFF6W'V77FVPWfV2FW&6VVBVB#bc"R$4UdTt4Х&6RfVvC