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This study aims to inform pediatricians and neonatologists on the existence of important nutritional deficits with clinical and subclinical manifestations in the child undergoing ileal resection in the neonatal period, which customarily arrive in outpatient pediatric neurologic services. Necrotizing enterocolitis (NEC) is a serious disorder affecting 1% to 5% of infants admitted to newborn intensive care nurseries. Surgical intervention to remove necrotic bowel is frequently required, and has particular significance because of the unique absorptive capacity of the ileum for fats, bile salts, and vitamin B12. The long-term effects of neonatal ileal resection on vitamin B12 absorption in later life are unknown. Vitamin B12 deficiency in children may potentially lead to anemia, neurologic abnormalities, and developmental delay. However, these signs may not manifest themselves for several years. The central nervous system manifestations may not be easily recognized in these former high-risk infants, and we thought that identification of a treatable condition, which could affect development, was important. There is a paucity of follow-up information on children who have undergone extensive ileal resection in the new- born period as a consequence of NEC. We emphasize the mandatory follow-up monitoring and evaluation for vitamin Bt2 deficiency of all patients who have undergone ileal resection for NEC. Further investigation into the use of serum homocysteine and methylmalonic acid as markers of asymptomatic vitamin B12 deficiency in children is warranted.

Enterocolitis, Necrotizing; Ileostomy; Vitamin B 12 Deficiency