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[2] Treatment Initial treatment Infants breastfeeding from an individual with vitamin B 12 deficiency: IM cyanocobalamin followed by either PO cyanocobalamin OR vitamin B 12 -enriched food or formula [1] [2] Children Asymptomatic children with mild deficiency and no concern for malabsorption or nonadherence: high-dose PO cyanocobalamin once daily [1] [4] [13] [17] All others: IM cyanocobalamin [1] Adolescents: Treatment is similar to treatment of vitamin B 12 deficiency in adults