Researchers in a specialist blood clinic followed nearly 500 children over ten years and discovered that B12 deficiency was more common than many parents realise—affecting about 1 in 10 children referred for blood testing. The study, published in Frontiers in Pediatrics, tracked which children showed deficiency and what symptoms they experienced, ranging from infants to teenagers.
B12 is a nutrient found only in animal products like meat, dairy, and eggs. Without it, children's bodies cannot make healthy red blood cells or maintain a healthy nervous system. The study showed that some children had no symptoms at all, while others experienced serious complications that could cause lasting damage if left untreated.
Two age groups are at highest risk: babies and teenagers
The study found a striking pattern: babies and toddlers under 3 accounted for 35% of B12 deficiency cases, while teenagers aged 13 and up made up 53% of cases. This "two-peak" pattern means you should stay alert at both ends of childhood. Younger children are vulnerable during the transition from breastfeeding to solid foods, while teenagers may not get enough B12 if their diet shifts away from animal products.
Symptoms can range from tiredness to nerve damage
Over half the children presented with anaemia—appearing pale and tired. Others had unexplained blood cell problems, and about 1 in 6 showed signs that their nervous systems were affected, such as difficulty concentrating or developmental delays. Children with severely low B12 (below 100 pg/mL) were significantly more likely to have blood abnormalities and nervous system symptoms. This matters because some neurological damage can become permanent if left untreated.
Plant-based diets and digestive issues increase risk
Families following vegetarian or vegan diets, babies transitioning from breastfeeding, and children with digestive problems face higher risk. While Singapore's multicultural food culture and accessible healthcare offer some protection, these specific groups need extra attention. The encouraging news: B12 deficiency is highly treatable once detected through a simple blood test.
Protect your child with early detection and the right diet
- Watch for persistent tiredness, paleness, poor appetite, slow growth, or difficulty concentrating—raise these with your paediatrician promptly for potential B12 screening.
- If your family is vegetarian or vegan, ensure your child receives fortified plant-based milk, fortified cereals, nutritional yeast, or a doctor-prescribed B12 supplement.
- Ask your paediatrician about B12 screening if your child has digestive issues or if you're exclusively breastfeeding while following a plant-based diet yourself.