Breast Milk Vitamin Research Articles

Cohort profile of an early life observational cohort in China: Bone and MicroBiOme onset (BAMBOO) study

PurposeThe Bone And MicroBiOme Onset (BAMBOO) study is an ongoing prospective observational cohort study conducted in Tianjin, China, aiming to determine age-appropriate trajectories for microbiome maturation and bone development and...

Vitamin A Nutritional Status of Urban Lactating Chinese Women and Its Associated Factors.

We aimed to investigate dietary vitamin A (DVA) intake, serum vitamin A (SVA) concentrations, and breast milk vitamin A (BMVA) concentrations of urban lactating Chinese women and explore the associated factors. We recruited 326 lactating women from ten cities in China and collected their dietary information, blood samples, and breast milk samples. SVA and BMVA were assessed with high-performance liquid chromatography. Mann–Whitney U tests, Kruskal–Wallis H tests, Chi-square tests, Spearman correlation tests, and multiple regression analyses were conducted. The median (25th, 75th) of DVA, SVA and BMVA were 372.36 (209.12, 619.78) μg RAE/day, 1.99 (1.71, 2.35) μmol/L, and 1.67 (1.13, 2.15) μmol/L, respectively. Only 3.1% of lactating women met the recommended nutrient intake of Vitamin A (VA), and 20.6% had a BMVA level below 1.05 μmol/L. Compared to underweight or normal weight women, overweight or obese lactating women had lower DVA and BMVA but higher SVA (p = 0.022; p = 0.030; p = 0.003). Multiparous women had a higher risk of inadequate BMVA (p = 0.023) than primiparous women. SVA and BMVA were positively associated with DVA, especially for lactating women not using VA supplements (β = 0.174, 95%CI = 0.025, 0.324, p = 0.022; β = 0.501, 95%CI = 0.208, 0.795, p = 0.001). There was no association between SVA and BMVA (β = 0.165, 95%CI = −0.037, 0.366, p = 0.109). In conclusion, VA nutritional status among Chinese urban lactating women needs more attention, especially for those who are obese, overweight, or higher parity. Increased DVA may contribute to increased BMVA.

Dietary share of ultra-processed foods and its association with vitamin E biomarkers in Brazilian lactating women.

Despite evidence showing that the intake of ultra-processed food has a negative impact on health, diet quality and dietary vitamin E, its impact on vitamin E nutritional status and breast milk remains unknown. This study aimed to assess the influence of the consumption of ultra-processed foods on vitamin E biomarkers of lactating women. A cross-sectional study was performed with 294 lactating women. Food consumption was obtained by 24-h dietary recall, and foods were grouped according to the NOVA classification. Levels of α-tocopherol were analysed by HPLC. Breast milk vitamin E (BMVE) adequacy was based on the quantity of the vitamin in the estimated intake volume. The Kruskal–Wallis test was used to compare the tertiles and linear regression to association between ultra-processed food consumption and biomarkers. Ultra-processed foods accounted for 16 % of energy intake and vitamin E intakes by all women were considered low. Serum α-tocopherol was 26·55 (sd 7·98) µmol/l, 5 % (n 11) showed inadequate vitamin E (< 12 µmol/l) and 78 % had an inadequate BMVE content (< 4 mg/780 ml). The regression showed that a higher dietary share of ultra-processed foods was associated with lower concentrations of serum α-tocopherol (β = –0·168, 95 % CI –0·047, 0·010, P = 0·003) and inadequate BMVE content (β = –0·144, 95 % CI = –0·505, 0·063, P = 0·012) (adjustment for income and maternal age). Thus, higher dietary shares of ultra-processed foods had an impact on vitamin E biomarkers, suggesting that inadequate dietary intake practices during lactation may reduce the supply of vitamin E to women and breast milk.

Vitamin D concentration in serum and milk of breastfeeding women

Background The hormonally active form of vitamin D generates a number of extraskeletal biological responses, which significantly influences body's homeostasis. The evaluation of vitamin D concentration and supplementing deficiency for breastfeeding women are crucial to maintain good health. The purpose of the study was to measure vitamin D concentration in serum and milk of breastfeeding women, including the influence of supplementation. Hypothesis: Most of breastfeeding women are deficient in vitamin D. Material and methods Blood and breast milk samples were collected consecutively from 46 healthy, non-obese, Caucasian, breastfeeding women at different stages of lactation. The LC-MS/MS method was applied for the measurements of vitamin D. Serum and breast milk vitamin D concentrations in the form of 25(OH)D₂, 25(OH)D₃ and total 25(OH)D were measured in Polish breastfeeding women. Results Serum total 25(OH)D concentrations ranged from 50.2 to 115.7 nmol/L (mean value 75.8±15.5 nmol/L), while breast milk 25(OH)D₃ concentrations ranged between 0.03-1.78 nmol/L (0.64±0.42 nmol/L). More than a half of the examined women (52%) supplement vitamin D using different medications and half of the women showed insufficient (50-75 nmol/L) serum levels of total 25(OH)D. There were no correlations between maternal serum total 25(OH)D concentration and 25(OH)D₃ in breast milk concentration (R=0.27 p=0.07). Breast milk 25(OH)D₃ concentrations were correlated to the duration of breastfeeding (R=0.54 p=0.0002). The median milk 25(OH)D₃ concentration in mothers breastfeeding for more than 9 months was significantly higher (p<0.0005) when compared to women who were breastfeeding for less than 9 months (0.78 vs 0.33 nmol/L). Conclusions Exactly half of the examined women in the reproductive period have deficiency of vitamin D. It seems that vitamin D supplementation is an important element in maintaining the optimal concentration of this vitamin in the body. Prolonged breastfeeding (more than 9 months) affects the concentrations of 25(OH)D₃ in human milk.

Effectiveness of a Food-Based Intervention to Increase Breast Milk Vitamin A Content at One Month of Infancy

Abstract Objectives Vitamin A requirements in early infancy are met only by breast milk intake. It is critical to ensure adequate breast milk vitamin A levels which also helps develop liver stores. The objective of the study was to evaluate the effect of a maternal food-based intervention on breast milk vitamin A content Methods Pregnant women (n = 50; 24 ± 1 week of gestation) were recruited for the randomized study. A 10 g of a green leafy vegetable powder (mint/coriander/curry) providing about 3200 μg β-carotene/day, for a period of 4 months up to 1 month of lactation were provided for intervention arm. Breast milk (BM) retinol concentration and BM volume were assessed. BM retinol and beta-carotene were assayed by HPLC and BM fat by creamatocrit method. BM retinol: fat ratio was calculated. The dose-to-mother deuterium dilution technique was used to estimate BM volume through enrichment of saliva measured by Fourier Transform Infrared Spectroscopy. Total BM retinol content was calculated from BM volume and the BM retinol (including beta-carotene:1 vitamin A RAE = 12 μg β-carotene). Inadequacy of intake was defined as proportion of infants with intake below a requirement of 400 μg RAE/day. Analysis of co-variance was performed after adjusting for age of mother, change in maternal blood retinol from baseline and BM fat, to compare outcomes between intervention and control arm. Results Maternal age, gestational age, socio-demographic characteristics and baseline vitamin A intake were comparable in both arms. Mean BM volume was similar in the 2 arms (676 ± 102 in intervention vs 630 ± 100 ml/day in control). BM retinol content (0.72 ± 0.12 vs 0.64 ± 0.11 μg/mL; P = 0.029) and BM retinol: fat ratio [0.41 (0.31, 0.47) vs 0.29 (0.21, 0.41), P = 0.011] were significantly higher in the intervention arm. The mean total BM retinol content was significantly higher in the intervention (482.2 ± 100.7 vs 406.5 ± 89.2 μg/day; P = 0.015; Cohen's effect size 0.80). Inadequacy of infant vitamin A intake was 14.3% in the intervention arm as against 39.1% in the control arm (P = 0.065). Conclusions The food-based intervention was effective in increasing vitamin A content in breast milk and thereby vitamin A intake in infants. Funding Sources International Atomic Energy Agency.

Vitamin B12 is Low in Milk of Early Postpartum Women in Urban Tanzania, and was not Significantly Increased by High dose Supplementation.

The effect of maternal multivitamin supplementation on breast milk vitamin B12 concentrations has not been examined in Tanzania, where the prevalence of maternal plasma B12 insufficiency is 25.6%. Multivitamins (containing 50 µg vitamin B12) or placebo were provided during pregnancy and in the postpartum period. Breast milk samples were collected at or around six weeks postpartum from 491 participants in a trial of multivitamins (NCT00197548). Linear and logistic regression models were used to examine the effect of supplements on vitamin B12 concentration in milk and its associations with other variables including potential confounders. Median vitamin B12 concentration in breast milk was 206 pmol/L and 70% of women had levels indicating inadequacy (<310 pmol/L). Multivitamin supplements did not significantly reduce the odds of inadequate vitamin B12 in breast milk, suggesting suboptimal absorption. A single unit increase in maternal hemoglobin at six weeks was associated with 18% lower odds of inadequate vitamin B12 in breast milk. Participants with higher BMI at baseline had double the odds of having inadequate vitamin B12 than the reference group (<22 kg/m2). Trials to determine the optimal dose, route, and duration of supplementation to improve maternal B12 status in Sub-Saharan Africa are of utmost importance.

The Effect of High-Dose Postpartum Maternal Vitamin D Supplementation Alone Compared with Maternal Plus Infant Vitamin D Supplementation in Breastfeeding Infants in a High-Risk Population. A Randomized Controlled Trial.

In view of continuing reports of high prevalence of severe vitamin D deficiency and low rate of infant vitamin D supplementation, an alternative strategy for prevention of vitamin D deficiency in infants warrants further study. The aim of this randomized controlled trial among 95 exclusively breastfeeding mother–infant pairs with high prevalence of vitamin D deficiency was to compare the effect of six-month post-partum vitamin D3 maternal supplementation of 6000 IU/day alone with maternal supplementation of 600 IU/day plus infant supplementation of 400 IU/day on the vitamin D status of breastfeeding infants in Doha, Qatar. Serum calcium, parathyroid hormone, maternal urine calcium/creatinine ratio and breast milk vitamin D content were measured. At baseline, the mean serum 25-hydroxyvitamin D (25(OH)D) of mothers on 6000 IU and 600 IU (35.1 vs. 35.7 nmol/L) and in their infants (31.9 vs. 29.6) respectively were low but similar. At the end of the six month supplementation, mothers on 6000 IU achieved higher serum 25(OH)D mean ± SD of 98 ± 35 nmol/L than 52 ± 20 nmol/L in mothers on 600 IU (p < 0.0001). Of mothers on 6000 IU, 96% achieved adequate serum 25(OH)D (≥50 nmol/L) compared with 52%in mothers on 600 IU (p < 0.0001). Infants of mothers on 600 IU and also supplemented with 400 IU vitamin D3 had slightly higher serum 25(OH)D than infants of mothers on 6000 IU alone (109 vs. 92 nmol/L, p = 0.03); however, similar percentage of infants in both groups achieved adequate serum 25(OH)D ≥50 nmol/L (91% vs. 89%, p = 0.75). Mothers on 6000 IU vitamin D3/day also had higher human milk vitamin D content. Safety measurements, including serum calcium and urine calcium/creatinine ratios in the mother and serum calcium levels in the infants were similar in both groups. Maternal 6000 IU/day vitamin D3 supplementation alone safely optimizes maternal vitamin D status, improves milk vitamin D to maintain adequate infant serum 25(OH)D. It thus provides an alternative option to prevent the burden of vitamin D deficiency in exclusively breastfeeding infants in high-risk populations and warrants further study of the effective dose.

Fatty Acids and Fat-Soluble Vitamins in Breast Milk: Physiological Significance and Factors Affecting Their Concentrations.

Fatty acids (FAs) and fat-soluble vitamins are vital components of the human milk lipid fraction. About two-thirds of the human milk FA fraction consist of oleic, linoleic, and palmitic FAs, but the precise composition depends on maternal geography, diet, and genetics. Mothers with high fish consumption have more docosahexaenoic acid (DHA) and other ω-3 FAs in their milk, while mothers with high dairy consumption have more branched-chain FAs in their milk. Vitamins A and E are the most common fat-soluble vitamins, but milk concentrations vary, depending on maternal diet and body stores. Vitamin D is typically low or undetectable in mother's milk and typically fails to meet the infant needs. However, trial data indicate that high maternal supplementation (6,400 IU/day) safely provides nutritionally adequate amounts of vitamin D in her milk. FA and fat-soluble vitamin levels in mother's milk can significantly influence infant health; for example, in preterm infants, low endogenous stores of DHA paired with low levels in maternal milk may influence the risk of chronic lung disease and other inflammatory conditions. Greater attention is warranted to the variation in FA and fat-soluble vitamin content of human milk in relation to infant health.

Vitamin A Supplementation during Pregnancy Enhances Pandemic H1N1 Vaccine Response in Mothers, but Enhancement of Transplacental Antibody Transfer May Depend on When Mothers Are Vaccinated during Pregnancy

In the growing embryo, the vitamin A requirement is tightly regulated. Maternal vitamin A deficiency during pregnancy may alter maternal immune function to accommodate the fetus. Our primary objective was to determine the effect of oral vitamin A supplementation (VAS) during pregnancy and until 6 mo postpartum on pandemic H1N1-vaccine responses in mothers and their infants at 6 mo of age. In this randomized controlled clinical trial, pregnant women (n=112) during the second trimester (mean ± SD:14±1wk) were assigned to receive either an oral dose of 10,000 IU vitamin A or placebo weekly until 6 mo postpartum. During the third trimester, mothers received a single dose of inactivated pandemic H1N1-influenza vaccine. Hemagglutination-inhibition (HAI) titer was measured in cord, infant, and maternal blood samples. Multivariate regressions with adjustments were used for data analysis. Seventy-six percent of women had low plasma retinol concentrations (<1.05 μmol/L) in their second trimester. VAS of mothers increased vitamin A concentrations in cord blood by 21.4% and in colostrum by 40.7%. At 6 mo postpartum, women in the vitamin A group had 38.7% higher HAI titers and a higher proportion of HAI titer of ≥1:40 of the cutoff compared with the placebo group. A total of 54.5% of infants had an HAI titer ≥1:40 at 6 mo of age, but there was no difference in HAI titer in infants between groups. Overall, HAI in cord blood did not differ between groups, but in the placebo group, cord blood HAI was negatively associated with maternal "vaccination-to-delivery intervals" (rs=-0.401; P = 0.5), and maternal VAS increased cord blood HAI 6-fold if antenatal immunization was administered ≥10 wk before delivery. In a community with low vitamin A status, weekly maternal VAS during pregnancy and postpartum increases the breast-milk vitamin A concentration and enhances prenatal H1N1-vaccine responses in mothers, but the benefits of maternal VAS in transplacental antibody transfer may depend on the time of gestation when mothers were vaccinated. This trial was registered at clinicaltrials.gov as NCT00817661.

Low breastmilk vitamin A concentration is prevalent in rural Ethiopia.

There is scant information on the breastmilk vitamin A (BMVA) concentration of lactating women in developing countries, partly due to lack of methods applicable in-field. To assess BMVA concentrations of samples collected from lactating women of children aged 6-23 months, in Mecha district, Ethiopia. Data on socio-demographic and anthropometric characteristics were collected from randomly selected lactating women (n = 104). Breast milk samples were collected and vitamin A concentrations were analyzed using HPLC and iCheck FLUORO then the two measurements were compared. The prevalence of underweight (BMI < 18.5 kg/m2) among lactating women was 17%. Seventy six percent of the BMVA values were <1.05 µmol/l and 81% were <8 µg/g fat. The mean BMVA concentration accounted to 41% of the estimated average value for mothers in developing countries. The BMVA values from HPLC and iCheck were correlated (r = 0.59, p = < 0.001), but it was not strong. The result indicates the low vitamin A status of the lactating women and their children. It further indicates that intake assessments should not use average BMVA composition. The possibility of using iCheck for monitoring interventions designed to improve vitamin A status of lactating women with low BMVA requires further investigation.

Vitamin B-12 content in breast milk of vegan, vegetarian, and nonvegetarian lactating women in the United States

The nutritional profile of human milk varies significantly between women, and the impact of maternal diet on these variations is not well understood. We analyzed breast-milk vitamin B-12 concentration and vitamin B-12 supplement use pattern among women who adhered to different dietary patterns: vegan, vegetarian, and nonvegetarian. A total of 74 milk samples, 26 from vegan, 22 from vegetarian, and 26 from nonvegetarian breastfeeding mothers, were analyzed. The prevalences of low vitamin B-12 (<310 pmol/L) were 19.2% for vegans, 18.2% for vegetarians, and 15.4% for nonvegetarians, which was not significant by diet group (P=1.00). The median (quartile 1, quartile 3) vitamin B-12 values were 558 pmol/L (331, 759 pmol/L) for vegans, 509 pmol/L (368, 765 pmol/L) for vegetarians, and 444 pmol/L (355, 777 pmol/L) for nonvegetarians (P=0.890). The use of individual vitamin B-12 supplements was higher in vegans (46.2%) than in vegetarians (27.3%) and nonvegetarians (3.9%) (P=0.001). In linear regression analysis, the use of individual vitamin B-12 supplements was a significant positive predictor of milk vitamin B-12 concentration (β ± SE: 172.9 ± 75.2; standardized β=0.263; P=0.024; R2=0.069), the use of a multivitamin had a significant negative relation with milk vitamin B-12 concentrations (β ± SE -222.0 ± 98.7; standardized β=-0.258; P=0.028, R2=0.067;), whereas the use of a B-complex vitamin and prenatal vitamin were not predictive of vitamin B-12 milk concentration (P>0.05). Almost 20% of our study participants were classified as having low breast-milk vitamin B-12 concentrations (<310 pmol/L), independent of maternal diet pattern. Approximately 85% of participants categorized as having low vitamin B-12 were taking vitamin B-12 supplements at doses in excess of the Recommended Dietary Allowance, which suggests that more research is needed to determine breast-milk adequacy values.

The effects of zinc supplementation on zinc, retinol and carotene levels in lactating Amazonian women

The effects of zinc supplementation on levels of zinc, retinol and carotene in serum and breast milk were investigated in a double blind controlled prospective study amongst 66 poor urban Amazonian mothers in 1981. The mothers predominantly breast-fed their infants for the first five months of life and took supplements from soon after birth. Milk retinol levels were already significantly higher in zinc supplemented (ZS) than non-zinc supplemented (NZS) mothers by one month post-partum, and by four months had risen significantly in the ZS mothers but fallen in NZS mothers. At four months post-partum, milk retinol levels of ZS mothers were near normal and double those of NZS mothers. The effect of zinc supplementation on these retinol levels was possibly associated with an increased absorption and utilization of dietary carotene, since milk carotene levels also increased in ZS mothers to levels three times those of NZS mothers at four months post-partum. This impact of zinc supplementation on maternal and breast milk vitamin A levels has not been shown previously and is of potential relevance where zinc and vitamin A deficiency are common.

Comparison of the effect of daily versus bolus dose maternal vitamin D3 supplementation on the 24,25-dihydroxyvitamin D3 to 25-hydroxyvitamin D3 ratio.

Supplementing lactating mothers with high doses of vitamin D3 can adequately meet vitamin D requirements of the breastfed infant. We compared the effect of bolus versus daily vitamin D3 dosing in lactating mothers on vitamin D3 catabolism. We hypothesized that catabolism of 25(OH)D3 to 24,25(OH)2D3 would be greater in the bolus than in the daily dose group. Randomized controlled trial (clinicaltrials.govNCT01240265) in 40 lactating women. Subjects were randomized to receive vitamin D3 orally, either a single dose of 150,000IU or 5000IU daily for 28days. Vitamin D metabolites were measured in serum and breast milk at baseline, 1, 3, 7, 14 and 28days. Temporal changes in the serum 24,25(OH)2D3/25(OH)D3 ratio. The concentration of serum 24,25(OH)2D3 was directly related to that of 25(OH)D in both groups (r2=0.63; p<0.001). The mean (±SD) 24,25(OH)2D3/25(OH)D3 ratio remained lower at all time points than baseline values in the daily dose group (0.093±0.024, 0.084±0.025, 0.083±0.024, 0.080±0.020, 0.081±0.023, 0.083±0.018 at baseline, 1, 3, 7, 14, and 28days, respectively). In the single dose group, the increase in 24,25(OH)2D3 lagged behind that of 25(OH)D, but the 24,25(OH)2D3/25(OH)D3 values (0.098±0.032, 0.067±0.019, 0.081±0.017, 0.092±0.024, 0.103±0.020, 0.106±0.024, respectively) exceeded baseline values at 14 and 28days and were greater than the daily dose group at 14 and 28days (p=0.003). The 24,25(OH)2D3/25(OH)D3 ratio remained in the normal range with both dosing regimens. Greater breast milk vitamin D3 values in the single dose group were inversely associated with the 24,25(OH)2D3/25(OH)D3 ratio (r2=0.14, p<0.001), but not with daily dosing. After a 14-day lag, a single high dose of vitamin D led to greater production of 24,25(OH)2D3, presumably via induction of the 24-hydroxylase enzyme (CYP24A1), relative to the 25(OH)D3 value than did daily vitamin D supplementation, and this effect persisted for at least 28days after vitamin D administration. A daily dose of vitamin D may have more lasting effectiveness in increasing 25(OH)D3 with lesser diversion of 25(OH)D3 to 24,25(OH)2D3 than does larger bolus dosing.

日本人の食事摂取基準(2010年版)決定の基礎とした母乳中の水溶性ビタミン含量

日本人の食事摂取基準(2010年版)決定の基礎とした母乳中の水溶性ビタミン含量

Iron, Zinc, Folate, and Vitamin B-12 Status Increased among Women and Children in Yaoundé and Douala, Cameroon, 1 Year after Introducing Fortified Wheat Flour

Background: Few data are available on the effectiveness of large-scale food fortification programs.Objective: We assessed the impact of mandatory wheat flour fortification on micronutrient status in Yaoundé and Douala, Cameroon.Methods: We conducted representative surveys 2 y before and 1 y after the introduction of fortified wheat flour. In each survey, 10 households were selected within each of the same 30 clusters (n = ∼300 households). Indicators of inflammation, malaria, anemia, and micronutrient status [plasma ferritin, soluble transferrin receptor (sTfR), zinc, folate, and vitamin B-12] were assessed among women aged 15–49 y and children 12–59 mo of age.Results: Wheat flour was consumed in the past 7 d by ≥90% of participants. Postfortification, mean total iron and zinc concentrations of flour samples were 46.2 and 73.6 mg/kg (target added amounts were 60 and 95 mg/kg, respectively). Maternal anemia prevalence was significantly lower postfortification (46.7% compared with 39.1%; adjusted P = 0.01), but mean hemoglobin concentrations and child anemia prevalence did not differ. For both women and children postfortification, mean plasma concentrations were greater for ferritin and lower for sTfR after adjustments for potential confounders. Mean plasma zinc concentrations were greater postfortification and the prevalence of low plasma zinc concentration in women after fortification (21%) was lower than before fortification (39%, P < 0.001); likewise in children, the prevalence postfortification (28%) was lower than prefortification (47%, P < 0.001). Mean plasma total folate concentrations were ∼250% greater postfortification among women (47 compared with 15 nmol/L) and children (56 compared with 20 nmol/L), and the prevalence of low plasma folate values was <1% after fortification in both population subgroups. In a nonrepresentative subset of plasma samples, folic acid was detected in 77% of women (73% of those fasting) and 93% of children. Mean plasma and breast-milk vitamin B-12 concentrations were >50% greater postfortification.Conclusion: Although the pre-post survey design limits causal inference, iron, zinc, folate, and vitamin B-12 status increased among women and children in urban Cameroon after mandatory wheat flour fortification.

A Novel Methodology for the Quantification of B-Vitamers in Breast Milk

With this report we present development, validation and application of an analytical methodology for the quantification of 18 water soluble vitamers and secreted or biological forms in breast milk. On a relatively low amount of breast milk (200 µL), we applied isotope dilution-based sample preparation based on a combination of enzymatic treatment and protein precipitation using acidic methanol enriched with stable isotope labelled internal standards. Compounds separation was achieved by reversed-phase liquid chromatography and detection performed by tandem mass spectrometry in positive electrospray ionization mode. To perform the quantification of 18 water soluble vitamers, procured pooled breast milk was used to build matrixmatched calibration curves, as labelled internal standards were not available for each vitamer. The analytical approach has been validated according to the EMA guidelines. The overall performance of the method was considered adequate, with 0.3- 28.3% and 0.9-32.6% intra and inter-day precision respectively and averaged accuracy reaching 92.2-107.5%. In addition, performed freeze/thaw stability studies showed the potential degradation of some vitamers. We therefore recommend particular attention in sample collection with rather having dedicated aliquots with small volumes. The feasibility of this analytical approach has been evaluated by quantifying various breast milk samples that were procured from an external supplier. The main forms found in breast milk were thiamine monophosphate for B1, flavin adenine nucleotide for B2, nicotinamide for B3, pyridoxal for B6 and 5-methyl tetrahydrofolic acid for B9. In addition, we newly reported nudifloramide as B3 form present in breast milk. With this analytical approach, it will give more confidence to provide a comprehensive assessment of the presence of water soluble vitamins in breast milk. This will enable the accurate evaluation of the nutritional requirements of infants.

Vitamin B-12 Concentrations in Breast Milk Are Low and Are Not Associated with Reported Household Hunger, Recent Animal-Source Food, or Vitamin B-12 Intake in Women in Rural Kenya

Background: Breast milk vitamin B-12 concentration may be inadequate in regions in which animal-source food consumption is low or infrequent. Vitamin B-12 deficiency causes megaloblastic anemia and impairs growth and development in children.Objective: We measured vitamin B-12 in breast milk and examined its associations with household hunger, recent animal-source food consumption, and vitamin B-12 intake.Methods: In a cross-sectional substudy nested within a cluster-randomized trial assessing water, sanitation, hygiene, and nutrition interventions in Kenya, we sampled 286 women 1–6 mo postpartum. Mothers hand-expressed breast milk 1 min into a feeding after 90 min observed nonbreastfeeding. The Household Hunger Scale was used to measure hunger, food intake in the previous week was measured with the use of a food-frequency questionnaire (FFQ), and vitamin B-12 intake was estimated by using 24-h dietary recall. An animal-source food score was based on 10 items from the FFQ (range: 0–70). Breast milk vitamin B-12 concentration was measured with the use of a solid-phase competitive chemiluminescent enzyme immunoassay and was modeled with linear regression. Generalized estimating equations were used to account for correlated observations at the cluster level.Results: Median (IQR) vitamin B-12 intake was 1.5 μg/d (0.3, 9.7 μg/d), and 60% of women consumed <2.4 μg/d, the estimated average requirement during lactation. Median (IQR) breast milk vitamin B-12 concentration was 113 pmol/L (61, 199 pmol/L); 89% had concentrations <310 pmol/L, the estimated adequate concentration. Moderate or severe hunger prevalence was 27%; the animal-source food score ranged from 0 to 30 item-d/wk. Hunger and recent animal-source food and vitamin B-12 intake were not associated with breast milk vitamin B-12 concentrations. Maternal age was negatively associated with breast milk vitamin B-12 concentrations.Conclusion: Most lactating Kenyan women consumed less than the estimated average requirement of vitamin B-12 and had low breast milk vitamin B-12 concentrations. We recommend interventions that improve vitamin B-12 intake in lactating Kenyan women to foster maternal health and child development. The main trial was registered at clinicaltrials.gov as NCT01704105.

Vitamin-fortified complementary foods for infant nutrition

The diet of modern nursing women consisting of natural foods is adequate for the consumption of energy and sometimes excessively caloric can not to provide the organism with the necessary amounts of vitamins. The content of vitamins in breast milk of insufficiently supplied women is less than in nursing mothers, adequate supply of vitamins. The needs of the growing breast-fed child by women with multivitamin deficiency can not to satisfied by means breast milk. Based on the analysis of the vitamin status of pregnant and lactating women, as well as the content of vitamins in breast milk of mothers with various vitamins sufficiency conclusion for inclusion in the diet of infants enriched with vitamins and minerals weaning cereal-based products (cereals) had been made. Vitamin and mineral supplements or vitamin enriched foods must be included in the diet to maintain the vitamin status of lactating women.

Regional, Socioeconomic, and Dietary Risk Factors for Vitamin B-12 Deficiency Differ from Those for Folate Deficiency in Cameroonian Women and Children ,

Background: Representative data on folate and vitamin B-12 dietary intake and status in low-income countries are rare, despite the widespread adoption of folic acid fortification.Objective: The purpose of this study was to evaluate folate and vitamin B-12 intake, status, and risk factors for deficiency before implementation of a national fortification program in Cameroon.Methods: A nationally representative cross-sectional cluster survey was conducted in 3 ecologic zones of Cameroon (South, North, and the 2 largest cities, Yaoundé/Douala), and information on dietary intake was collected from 10 households in each of 30 randomly selected clusters per zone. In a subset of women and their 12- to 59-mo-old children (n = 396 pairs), plasma folate and vitamin B-12, as well as breast milk vitamin B-12, were analyzed.Results: Vitamin B-12 and folate dietary intake patterns and plasma concentrations were similar for women and children. In the subsample, 18% and 29% of women and 8% and 30% of children were vitamin B-12 (≤221 pmol/L) and folate (<10 nmol/L) deficient, respectively. Mean dietary folate ranged from 351 μg dietary folate equivalents/d in the North to 246 μg dietary folate equivalents/d in Yaoundé/Douala; plasma folate was negatively associated with socioeconomic status (P = 0.001). Plasma vitamin B-12 deficiency was similar in the South and North, 29% and 40%, respectively, but was only 11% in Yaoundé/Douala, and was positively associated with socioeconomic status. Mean breast milk vitamin B-12 was statistically significantly lower in the North (101 pmol/L) than in the South (296 pmol/L) or Yaoundé/Douala (349 pmol/L).Conclusions: Folate intake and status are inadequate among women and young children in Yaoundé/Douala, whereas low vitamin B-12 intake and status are more common in poor and rural areas, especially in the North. Different strategies may be needed to control deficiency of these nutrients in different regions of Cameroon.

Effect of Small‐Quantity Lipid‐Based Nutrient Supplement (SQ‐LNS) on Breast Milk Vitamin A Concentration among Ghanaian Women

BackgroundVitamin A deficiency remains a global public health problem.DesignWomen 蠄 20 weeks of gestation (N=1,320) were randomly assigned to receive either a multiple micronutrient supplement (MMN) providing 18 micronutrients including 800 µg RE vitamin A or SQ‐LNS with the same nutrients as the MMN group, plus four minerals and macronutrients contributing 118 kcal daily until 6 months postpartum; a control group received iron and folic acid only (IFA) during pregnancy and a placebo during the first 6 months postpartum. Breast milk samples collected at 6 months postpartum were analyzed for retinol and fat concentrations in a subsample of 756 women.ResultsAverage ± SD breast milk retinol concentration, per gram of fat, was 56.3 ± 2.1 nmol/g; there were no significant differences between groups [IFA (n=243) 59.1 ± 2.8, MMN (n=260) 55.4 ± 2.5, LNS (n=253) 54.7 ± 2.5 nmol/g fat; p=0.45], regardless of whether the woman had or had not received a high‐dose vitamin A supplement (200, 000 IU) soon after childbirth.About 17% of participants had low milk retinol (蠄 28 nmol/g fat), whereas we estimated that 36% of infants were potentially receiving vitamin A at levels above the Tolerable Upper Level (UL, 600 µg RAE/day).ConclusionDaily low dose vitamin A supplementation did not increase breast milk vitamin A levels in this sample of Ghanaian women. Women in this population may have had adequate dietary vitamin A intake.