2003 baby formula tragedy shows researchers importance of B1 to infant development, proves baby formula needs to be regulated.

Thirteen years after the 2003 "Remedia tragedy," Israeli scientists are investigating the role of vitamin B1 in child development.

The Remedia tragedy occurred when babies were nourished solely by a vegetarian formula which lacked B1 (thiamine). Twenty of the affected infants were left with severe learning disabilities, and three of them died.

The formula in question was commissioned by an Israeli company and imported from Germany. It was sold between July and November 2003.

In February 2013, Remedia’s chief food technologist was sentenced to 30 months in prison for negligent manslaughter in the case. Health Ministry officials who failed to supervise and examine imports were also convicted and punished, as were people from the German manufacturer.

Thirty-nine surviving affected children were studied over a period of nine years, from the age of 5 or 6.

Scientists compared the affected children to a sample group of 30 healthy children of the same age, and found thiamine deficiency in the first year of life leads to severe issues in motor function and balance skills later on.

The study was published in Maternal and Child Nutrition, and conducted by Sourasky Hospital Pediatric Neurology Director Professor Aviva Fattal-Valevski and MA student Yael Harel.

Fattal-Valevski said, "At first it was a mystery. It was like an epidemic. But after the mothers discussed the situation in the waiting room, it became clear that the infants, all under a year old, had consumed the same formula.

"After a food technician from the ministry confirmed the total lack of vitamin B1 in the formula, we immediately provided the infants with supplements.

"The body’s capacity for storing Vitamin B1 is limited. Unlike Vitamin B12, Vitamin B1 is only stored in the body for three weeks. It needs to be frequently replenished. It is critical to be aware of how important this vitamin is for child development.

"Even healthy babies might be at risk from B1 deficiency. If your infant is suffering from virus after virus, you must intervene with extra vitamins. But it’s a vicious cycle, because one of the first symptoms of lack of B1 in the system is an absence of appetite.

"We’ve proven that B1 deficiency in infancy has long-term implications on gross and fine motor function and balance skills in childhood.

"Our study emphasizes the importance of proper infant feeding and regulatory control of breast milk substitutes."

The research team is now focusing on the link between B1 deficiency in infancy and lifelong learning disabilities.