Submitted to: American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 1/1/2005
Publication Date: 5/1/2005
Citation: Allen, L.H. 2005. MULTIPLE MICRONUTRIENTS IN PREGNANCY AND LACTATION: AN OVERVIEW. American Journal of Clinical Nutrition. 81(suppl):1206S-12S, 2005.
Technical Abstract: This overview of multiple micronutrients during pregnancy and lactation emphasizes two relatively neglected issues. The first is that maternal micronutrient status in the peri-conceptional period, and throughout pregnancy and lactation, should be viewed as a continuum; too often these three stages are treated and discussed separately from both a scientific and a public health perspective. Iron and vitamin B-12 are included as examples to stress how status at conception affects maternal, fetal and infant status and health until the child is weaned. The second issue is that while most attention has been focused on a few micronutrients, for example iron and folate as discussed elsewhere in this Supplement, multiple micronutrient deficiencies occur simultaneously when diets are poor. Some of these deserve more attention as causes of poor pregnancy outcome, including other B vitamin deficiencies that result in homocysteinemia, antioxidants, vitamin D, and iodine. In lactation, maternal status or intake of the B vitamins (except folate), vitamin A, selenium and iodine strongly affect the amount of these nutrients secreted in breast milk. This can result in the infant consuming substantially less than the recommended amounts and further depleting stores that were low at birth. While the optimal mode of meeting recommended micronutrient intakes is an adequate diet, in some situations supplementation is also important. Unfortunately information is lacking on the optimal formulation of micronutrient supplements for pregnant women, and the need to continue these supplements during lactation is not recognized in many situations where maternal and infant health could benefit.