Rare Case of Scurvy in Infant Highlights Potential Dangers of Plant-Based Diet

— -- Parents often worry about making sure their child has a healthy diet, but a new report highlights how being too strict when it comes to diet can do more harm than good.

Doctors based in Spain were surprised to find an infant had developed scurvy after consuming a diet almost entirely of plant-based formula.

The case report was published today in the journal Pediatrics.

When the child experienced skin irritation at 2 months of age, a doctor recommended to the parents that they stop giving him baby formula and instead supplement their child’s diet with an almond-based formula. Unfortunately, the child refused to eat much of anything else.

By the time he was 11 months old, he had become tired and irritable and was no longer sitting up.

Medical tests revealed widespread bone degeneration, multiple fractures, low calcium and other problems. The doctors soon realized they were looking at something rarely seen in the developed world: scurvy.

Scurvy is caused by a deficiency in vitamin C, also known as ascorbic acid. It is rarely seen in infants, as breast milk contains enough vitamin C to avoid the condition.

Dr. Keith Ayoob, a registered dietician and associate professor of pediatrics at Albert Einstein College of Medicine in New York, said the case, while rare, highlights the importance of adhering to guidelines for good nutrition for babies.

“Really serious deficiencies can occur when typical recommendations are avoided,” Ayoob said. “For an infant in the first year of life, a diet deficient in calcium, vitamin D, and scurvy ... that’s very concerning.”

Ayoob added that in a sense the scurvy diagnosis was lucky, since the signs of calcium and vitamin D deficiencies often don’t show up until it is too late.

In this case, doctors immediately treated the infant with supplements of vitamins C and D, as well as a balanced diet of formula, cereals, meat, fruits and vegetables. In less than three months, his medical workup was back to normal, and he even started walking.

The authors of the article note that when almond beverages are processed, vitamin C loses its potency, and puts infants at risk -- something parents should take to heart.

“Pediatricians and parents should be aware that plant-based beverages are not a complete food and they may not replace breastfeeding or infant formula,” the authors wrote.

Ayoob said he hopes that this report provides a wake-up call to parents and pediatricians.

“Before you change [a] child’s diet, it needs to be changed to a nutritionally adequate diet. This is too critical a period," he said. “Bottom line, stick to breast milk or formula.”

Dr. Jake Rosenberg is a resident of psychiatry at Mount Sinai Hospital in New York City and a resident in the ABC News Medical Unit.