Vitamin Deficiencies in Children

Malnutrition in children significantly increases the risk of death and various diseases, while also hindering their physical growth and development. Key indicators of malnutrition include stunting, wasting, and abnormal weight gain or loss. According to the World Health Organization's 2018 statistics, 22% of children under five suffer from stunting, 17 million are affected by wasting, and 45% in Africa and 33% in Asia have experienced overweight issues since 2000. Therefore, improving children's diets through breastfeeding and proper nutrition is always recommended. It is important to note that malnutrition can result from deficiencies in micronutrients such as vitamins and minerals, with vitamin A, iron, iodine, zinc, selenium, and various B vitamins being the most critical. Long-term strategies like food fortification and focusing on the nutrition of pregnant mothers are essential to reduce or prevent these deficiencies.

Vitamin B Deficiencies in Children

Vitamin B deficiencies manifest in several ways among children, as outlined below:

Vitamin B1 (Thiamine) Deficiency

Thiamine deficiency is linked to three childhood disorders: Leigh syndrome, beriberi (which affects infants aged two to three months, causing symptoms like shortness of breath, cyanosis, loud crying, rapid and enlarged heartbeat, and vomiting), and Wernicke-Korsakoff syndrome, characterized by ataxia, eye muscle paralysis, involuntary pupil movement, and confusion.

Vitamin B2 (Riboflavin) Deficiency

Its deficiency causes several health issues such as seborrheic dermatitis, normocytic anemia, glossitis, oral mucosa inflammation, cheilitis, edema, hyperemia, and sore throat. Studies show that low milk consumption in children and adolescents contributes to this deficiency.

Vitamin B3 (Niacin) Deficiency

Niacin deficiency leads to pellagra, marked by photosensitive skin pigmentation and diarrhea, potentially fatal if untreated. Though rare, it occurs in regions relying heavily on corn and white maize, which lack tryptophan, the amino acid necessary for niacin synthesis. Notably, cases have not been diagnosed in otherwise healthy children.

Vitamin B6 (Pyridoxine) Deficiency

This deficiency results in elevated homocysteine levels, seizures, and anemia. Infants older than six months exclusively breastfed without complementary foods and pregnant adolescents with limited income are most vulnerable.

Vitamin B12 (Cobalamin) Deficiency

In infants, deficiency causes poor growth and movement disorders, often due to maternal deficiency from vegan diets, previous gastric bypass surgery, malabsorption, or pernicious anemia. In older children and adolescents, autoimmune diseases, chronic thyroiditis, Helicobacter pylori infection, small intestine bacterial overgrowth, Crohn’s disease, excessive antacid use, bariatric surgery, or pancreatic disorders can lead to deficiency.

Folate Deficiency

Dietary lack of folate causes deficiency, which necessitates fortifying foods such as grain products. Certain medications interfere with folate metabolism, leading to anemia developing over four to five months. Folate is heat-sensitive during cooking despite its abundance in green vegetables and liver.

Vitamin B7 (Biotin) Deficiency

Biotin deficiency in children is linked to biotinidase deficiency, a genetic disorder that prevents biotin recycling in the body. Symptoms include muscle hypotonia (floppy baby syndrome), hearing loss, and skin irritation. Regular consumption of raw eggs increases the risk of deficiency.

Vitamin C Deficiency

Vitamin C is vital for children’s health and immune function and aids iron absorption. Rich sources include kiwi, oranges, strawberries, bell peppers, and tomatoes. Vitamin C deficiency is rare in children eating fruits and vegetables but can occur in those with poor diets or exposed to secondhand smoke, which raises their requirement to repair cell damage caused by smoke.

Fat-Soluble Vitamin Deficiencies (A, D, E, K)

Vitamin E Deficiency

Common in premature newborns due to increased free radical production and low storage in fatty tissue, vitamin E deficiency can cause hemolytic anemia, ataxia, muscle weakness, vision problems, blindness, and irregular heartbeats.

Vitamin K Deficiency

Newborns not given vitamin K injections are prone to bleeding. In older children, deficiency results from chronic liver disease, fat malabsorption, or drug interactions, causing prolonged blood clotting times.

Vitamin A Deficiency

Most prevalent in developing countries due to malnutrition, and in developed countries due to fat malabsorption, vitamin A deficiency causes night blindness, excessive eye dryness, and may lead to permanent eye damage or blindness.

Vitamin D Deficiency

Vitamin D deficiency causes rickets in infants, leading to softened bones; hence, infants are supplemented with 400 IU daily. In older children and adolescents, deficiency increases the risk of bone fractures.