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In the alkaline environment of the small intestine, R-proteins are degraded by pancreatic enzymes, freeing vitamin B 12 to bind to intrinsic factor (IF), a protein secreted by specialized cells in the stomach (parietal cells)

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This preparation is used in adults for the long-term treatment of anemia caused by vitamin B12 deficiency (pernicious anemia) after blood values have been stabilized by injections

Unfortunately with small children, the tenting effect that occurs not only brings with it subcutaneous fatty tissue but also a ribbon of muscle that is just as likely, if not more likely to receive the medication that is thought to be being administered into the subcutaneous tissue