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Lack of response may indicate incorrect diagnosis, concurrent deficiencies, or inadequate treatment frequency

Hempill-Bryant explains that babies born to B12 deficient mothers will also be deficient in B12, especially if they are then exclusively breastfed. A study in the Journal of Child Neurology found that the most severe cases of B12 deficiency can lead to weakness, failure to thrive, afebrile seizure, developmental delay, nystagmus, tremors, and involuntary movement among young babies

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While all studies adequately ascertained exposure and ensured comparability between outcome groups by controlling for confounders, 42% (n = 5) did not provide adequate sample representativeness and size, and 17% (n = 2) did not report the non-response rate