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In several studies of women and children, we have demonstrated that poor vitamin B 12 status is common in South Asia.35 There is also compelling evidence that vitamin B 12 deficiency occurs frequently during pregnancy,2 6 7 and case studies have demonstrated harmful effects of severe vitamin B 12 deficiency on the developing infant brain.8 9 The consequences of mild or subclinical vitamin B 12 deficiency are less clear but it has been shown to be associated with decreased cognitive performance in both the elderly and children.1013 Three randomised controlled trials (RCT) have measured the effect of vitamin B 12 supplementation on neurodevelopment in children: In a Norwegian trial, an intramuscular injection of B 12 substantially improved the motor development in 6-week-old infants after 1 month,14 another intervention study in low birthweight children recently confirmed these findings.15 The infants in these studies had evidence of suboptimal vitamin B 12 status, but none was severely deficient

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The defect is very large or unacceptable to parents because of how it makes their child look

Detailed discussions on the topic can be found in the literature (Yuan et al