追加：第 20 节第 14 条，怀孕、喂奶时在吃素就每天补维生素 B12，孩子辅食要有动物性食物

2026-10-08 同日改标题：原标题「妈妈吃素的，……」会被读成「让妈妈吃素」，用户指出后改成「怀孕、喂奶时在吃素，就……」。

2026-10-08。用户在网上看到「孕期吃素、孩子生下来也只吃素和米油、发育不良」的帖子，问要不要收。按「没有必要的不加」四问评估后只收了这一件：读者会碰上、多数人不知道 B12 几乎只在动物性食物里、动作是新的、有原始来源。帖子本身是网络转述，不当来源，条目里不复述这个案例。

同一个帖子里的另外两件没收：

  • 医生说只能打生长激素、家长怕激素走掉：「拒绝正规治疗」第 16 节第 4 条（别为了试偏方停掉正规治疗）已覆盖，新条目备注里指过去。照帖子写成「医生让打生长激素就打」反而会推错方向，营养不良导致的长不高先要补营养。
  • 自学中医给孩子扎针「提智商」：普通读者几乎碰不上；非法行医罪管的是给别人看病，家长给自家孩子扎针写不出法律红线。

和已有条目的分工

  • 第 20 节第 4 条（6 个月起加辅食）：只写了卫健委 2024 年指南「每天的辅食必须包含含铁丰富的动物性食物」，没写全家吃素的情形。两边互相指路。
  • 第 27 节第 1 条（每天补 0.4 毫克叶酸）：备注末尾加一句指路，孕期这部分不在第 27 节另开条目。
  • 全书 grep「素食」「纯素」「B12」此前零命中，不是重复条目。

1. 美国疾控中心 MMWR 2003

  • URL：https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5204a1.htm（node fetch 带代理直取，200）
  • 原文（病例 1）：「During August 2001, a girl aged 15 months was hospitalized for lethargy and failure to thrive.」「Her mother reported following a vegan diet during the preceding 7 years」「The pediatrician diagnosed failure to thrive, developmental delay, and severe macrocytic anemia.」「A brain MRI indicated global cerebral atrophy.」「At age 32 months, she had made developmental progress but continued to have developmental delays, especially in speech and language.」
  • 原文（病例 2）：「The mother reported following a vegetarian diet during the preceding 20 years, with negligible amounts of meat, fish, and dairy products.」
  • 原文（编者按）：「The most common cause of cobalamin deficiency in infants and young children is maternal dietary deficiency ( 2 ), which generally manifests in breastfed infants at age 4--8 months」「In some cases, irreversible neurologic damage results from prolonged cobalamin deficiency, but the extent and degree of disability depends on the deficiency severity and duration」「Macrocytic anemia and other hematologic indices are not appropriate screening tools」「The only reliable unfortified sources are animal products, including meat, dairy products, and eggs. Most naturally occurring plant sources of cobalamin are not bioavailable; however, plant foods fortified with cobalamin, such as some cereals, meat analogs, soy or rice beverages, and nutritional yeast ( 7 ), can be reliable and regular sources.」「Vegetarians, particularly women during pregnancy and lactation, should be knowledgeable about the cobalamin content of their food or seek nutritional advice.」
  • 「After treatment for cobalamin deficiency, both children showed marked improvement」——收益栏「补上 B12 之后孩子有进步」据此。

2. ESPGHAN 2017 辅食立场文件

  • 题录与摘要：Europe PMC，PMID 28027215，DOI 10.1097/mpg.0000000000001454。
  • 原文：「All infants should receive iron-rich CF including meat products and/or iron-fortified foods.」「Vegan diets should only be used under appropriate medical or dietetic supervision and parents should understand the serious consequences of failing to follow advice regarding supplementation of the diet.」

3. 国家卫健委 2020 婴幼儿喂养健康教育核心信息

4. 反方：美国营养与饮食学会 2016 立场

  • Europe PMC，PMID 27886704，DOI 10.1016/j.jand.2016.09.025。2015 年那版（PMID 25911342）已被撤回（PMID 26430705），不引。
  • 原文：「These diets are appropriate for all stages of the life cycle, including pregnancy, lactation, infancy, childhood, adolescence, older adulthood, and for athletes.」「Vegans need reliable sources of vitamin B-12, such as fortified foods or supplements.」

没取到、没用的

  • 《中国居民膳食指南（2022）》素食人群部分、《中国孕妇、乳母膳食指南（2022）》核心信息：dg.cnsoc.org 的核心信息页正文是图片，无头 Chrome 也只拿到标题，无法逐字核对，没引。
  • 德国营养学会（DGE）2016 年全素立场：Crossref 没检到题录，没引。
  • Dror & Allen 2008（Nutrition Reviews 66(5):250）有婴儿 B12 缺乏病例的汇总分析，但摘要里没有数字、全文不开放，没引。

定级

  • 证据等级 B：只有病例报告和学会立场，这件事没法做分组试验。美国营养与饮食学会认为全素适合婴儿，标「争议」。
  • 收益量级「中」凭判断：没有相对降幅数字可套。发生率低，但后果是可能不可逆的神经发育损伤，而预防成本只是一瓶几十元的补充剂，所以没定「小」；又没有人群层面的效应量，所以不定「大」。