[Severe nutritional deficiencies in young infants with inappropriate plant milk consumption]

Arch Pediatr. 2014 May;21(5):483-8. doi: 10.1016/j.arcped.2014.02.027. Epub 2014 Apr 13.
[Article in French]


Over the past few years, we have observed increasing consumption of inappropriate plant milks as an alternative to infant milk formula. Some families believe that foods labeled as natural are the most healthy and an appropriate nutritional choice. However, their composition does not respect European recommendations. They are always hypocaloric and protein, vitamin, and mineral concentrations are inadequate. The aim of this study was to report severe nutritional complications after inappropriate plant milk consumption. Between 2008 and 2011, we studied severe nutritional deficiencies caused by consumption of plant milks bought in health food stores or online shops. Infants were identified in our centers and examined through medical history, physical examination, and laboratory testing. Nine cases of infants aged from 4 to 14 months were observed. In all cases, these milks were used as an alternative to milk formulas for supposed cow's milk allergy. At diagnosis, four patients were aged 6 months or less. They had received plant milk exclusively for 1-3 months. The beverages consumed were rice, soya, almond and sweet chestnut milks. In three cases, infants presented severe protein-calorie malnutrition with substantial hypoalbuminemia (<20 g/L) and diffuse edema. In the other cases, the nutritional disorders were revealed by a refractory status epilepticus related to severe hypocalcemia (one case), growth arrest of both height and weight secondary to insufficient caloric intake (five cases), and severe cutaneous involvement (one case). Five children had severe iron deficiency anemia (<70 g/L), three children had a very low 25-hydroxy vitamin D level (nutritional rickets), and two had severe hyponatremia (<130 mmoL/L). Milk alternative beverages expose infants to severe nutritional deficiencies. Serious complications can occur. Early, exclusive, and extended use is riskier. These diseases are preventable, and parental education should be provided. Statutory measures forbidding their use in young infants should be organized to slow down the progress of this social trend.

Publication types

  • English Abstract

MeSH terms

  • Avitaminosis / blood
  • Avitaminosis / etiology*
  • Diet, Vegetarian / adverse effects*
  • Female
  • Food, Organic / adverse effects*
  • France
  • Humans
  • Infant
  • Infant Formula / chemistry*
  • Infant Nutrition Disorders / blood
  • Infant Nutrition Disorders / etiology*
  • Infant, Newborn
  • Male
  • Nutrition Surveys
  • Nutritional Requirements
  • Nutritive Value
  • Protein Hydrolysates / adverse effects*
  • Protein Hydrolysates / chemistry*
  • Protein-Energy Malnutrition / blood
  • Protein-Energy Malnutrition / etiology*
  • Retrospective Studies
  • Risk Factors
  • Soy Milk / chemistry*
  • Trace Elements / blood
  • Trace Elements / deficiency*


  • Protein Hydrolysates
  • Trace Elements