MINERAL AND VITAMIN INTERVENTIONS FOR AT-RISK POPULATIONS
Location: Obesity and Metabolism Research Unit
Title: Breast milk vitamin B-12 concentrations of Guatemalan women are correlated with maternal but not infant vitamin B–12 status at 12 months postpartum
| Deegan, Kathleen - |
| Jones, Katherine - |
| Zuleta, Clara - |
| Ramirez-Zea, Manuel - |
| Lilliballe, Dorte - |
| Nexo, Ebba - |
Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: October 22, 2011
Publication Date: N/A
Interpretive Summary: Vitamin B-12 deficiency is emerging as a public health concern in many developing countries. In our previous studies in Guatemala, one third of lactating women, infants and children had deficient or marginal vitamin B-12 status. The goal of this study was to determine the relationship between maternal B-12 status, the concentration of the vitamin in her breast milk, and how breast milk B-12 related to infant B-12 status. Participants were 183 pairs of lactating women and their breastfeeding infants at 12 months postpartum; breastfeeding occurred 12 times a day on average. Information was collected on maternal and infant anthropometry, serum vitamin B-12 and dietary B-12 intake. Breast milk vitamin B-12 was measured after removal of haptocorrin, a strong binder of the vitamin which in the past has invalidated most assays used to measure B-12 in human milk. Vitamin B-12 deficiency (serum B-12 <150 pmol/L) was found in 35% of mothers and 27% of infants, and marginal status (15-220 pmol/L) in 35% of mothers and 17% of infants. In a multiple regression analysis, breast milk vitamin B-12 was significantly correlated with maternal intake of the vitamin (r=0.26) and maternal serum B-12 (r=0.30). Infant serum B-12 was correlated with maternal serum B-12 (r=0.31) implicating a long-term influence of maternal status on the infant. However infant status was not related to breast milk B-12 because the infants’ intake of the vitamin from complementary food was higher than they obtained from breast milk, which was very low in the vitamin.
In our previous studies one third of lactating Guatemalan women, infants and children had deficient or marginal serum vitamin B-12 concentrations. Relationships among maternal and infant status and breast milk vitamin B-12, however, have not been investigated in such populations. Our purpose was to measure breast milk vitamin B-12 in Guatemalan women with a range of serum vitamin B-12 concentrations, and to explore associations between milk vitamin B-12 concentrations and maternal and infant vitamin B-12 intake and status. Participants were 183 mother-infant pairs, breastfeeding at 12 mo postpartum. Exclusion criteria included mother <17 y, infant <11.5 or >12.5 mo, multiple birth, reported health problems in mother or infant, and mother pregnant >3 mo. Data collected on mothers and infants included anthropometry, serum and breast milk vitamin B-12, and dietary vitamin B–12. Serum vitamin B-12 concentrations indicated deficiency (<150 pmol/L) in 35% of mothers and 27% of infants, and marginal status (150 to 220 pmol/L) in 35% of mothers and 17% of infants. In a multiple regression analysis, breast milk vitamin B-12 concentration was correlated (P<0.05) with both maternal vitamin B-12 intake (r=0.26) and maternal serum vitamin B-12 (r=0.30). Controlling for number of breastfeeds/d and vitamin B-12 intake from complementary foods, infant serum vitamin B-12 was correlated with maternal serum vitamin B-12 (r=0.31, P<0.001) but not breast milk vitamin B-12, implicating a long-term effect of pregnancy status on infant vitamin B-12 status at 12 mo postpartum.