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ARS Home » Pacific West Area » Davis, California » Western Human Nutrition Research Center » Obesity and Metabolism Research » Research » Publications at this Location » Publication #353815
Title: Vitamin B12 content in breast milk of vegan, vegetarian and non-vegetarian lactating women in the United States

Author
item Allen, Lindsay - A
item PAWLAK, ROMAN - East Carolina University
item VOS, PAUL - East Carolina University
item Shahab-Ferdows, Setti
item Hampel, Daniela
item PERRIN, MARYANNE - University Of North Carolina Greensboro

Submitted to: The American Journal of Clinical Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 4/23/2018
Publication Date: 6/21/2018
Citation: Allen, L.H., Pawlak, R., Vos, P., Shahab-Ferdows, S., Hampel, D., Perrin, M.T. 2018. Vitamin B12 content in breast milk of vegan, vegetarian and non-vegetarian lactating women in the United States. American Journal of Clinical Nutrition. https://doi.org/10.1093/ajcn/nqy104.
DOI: https://doi.org/10.1093/ajcn/nqy104

Interpretive Summary: Although we know in general that the amounts of nutrients in human milk vary among mothers and are affected by their diet, there is a sparse amount of information on this topic. In this study we analyzed the amount of vitamin B12 in milk from women who consume vegan, vegetarian or non vegetarian diets, some of whom took B12 supplements. A total of 74 milk samples, 29 from vegan, 19 from vegetarian, and 26 from non vegetarian breastfeeding mothers, were analyzed. Prevalence of low B12 concentrations (<310 pmol/L) in milk was 19.2% for vegans, 18.2% for vegetarians, and 15.4% for non-vegetarians, which was not significantly different by diet group. The median (quartile 1, quartile 3) B12 values in milk were 558 pmol/L (331, 759) for vegans, 509 pmol/L (368, 765) for vegetarians, and 444 pmol/L (355, 777) for non-vegetarians (p = 0.890). Use of vitamin B12-supplements was higher in vegans (46.2%) than in vegetarians (27.3%) and non-vegetarians (3.9%) (p = 0.001). Taking a supplement of B12 alone predicted a higher milk B12 concentration, taking B12 in a multivitamin was associated with lower B12 in milk, and taking a B-complex vitamin or prenatal vitamin was not related to milk B12 concentration. Almost 20% of our study participants were classified as having low breast milk B12, independent of their diet pattern. Approximately 85% of participants categorized as having low milk B12 were taking B12 supplements at doses higher than the RDA, suggesting more research is needed to define low B12 concentrations in milk.

Technical Abstract: Background: The nutritional profile of human milk varies significantly among women and the impact of maternal diet on these variations is not well understood. Objective: We analyzed breast milk vitamin B12 concentration and vitamin B12 supplement use pattern among women who adhered to different diet patterns: vegan, vegetarian and non vegetarian. Design: A total of 74 milk samples, 29 from vegan, 19 from vegetarian, and 26 from non vegetarian breastfeeding mothers, were analyzed. Results: Prevalence of low B12 (<310 pmol/L) was 19.2% for vegans, 18.2% for vegetarians, and 15.4% for non-vegetarians, which was not statistically significant by diet group (p = 1.00). The median (quartile 1, quartile 3) B12 values were 558 pmol/L (331, 759) for vegan, 509 pmol/L (368, 765) for vegetarians, and 444 pmol/L (355, 777) for non-vegetarian (p = 0.890). Use of individual B12-supplements was higher in vegans (46.2%) than in vegetarians (27.3%) and non-vegetarians (3.9%) (p = 0.001). In a linear regression analysis, the use of individual B12 supplements was a significant positive predictor of milk B12 concentration (ß = 172.9; SE = 75.2; standardized ß = 0.263; p = 0.024; R2 = 0.069), the use of a multivitamin had a significant negative relationship with milk B12 concentrations (ß = -222.0; SE = 98.7; standardized ß = -0.258; p = 0.028, R2 = 0.067;), while the use of a B-complex vitamin and prenatal vitamin were not predictive of B12 milk concentration (p > 0.05). Conclusions: Almost 20% of our study participants were classified as having low breast milk B12 concentration (<310 pmol/L), independent of maternal diet pattern. Approximately 85% of participants categorized as having low B12 were taking B12 supplements at doses in excess of the RDA, suggesting more research is needed to determine breast milk adequacy values.