Infant Serum and Maternal Milk Vitamin B-12 Are Positively Correlated in Kenyan Infant-Mother Dyads at 1-6 Months Postpartum, Irrespective of Infant Feeding Practice.

Source:   J. Nutr. 2018 01 01 . 148 ( 1 ) : 86-93 . doi: 10.1093/jn/nxx009 .
PMID: 29378045
DOI: 10.1093/jn/nxx009

ABSTRACT

Background

Vitamin B-12 is an essential nutrient required for many functions including DNA synthesis, erythropoiesis, and brain development. If maternal milk vitamin B-12 concentrations are low, infants may face elevated risks of deficiency when exclusively breastfed.

Objective

We evaluated cross-sectional associations between infant serum vitamin B-12 concentrations and maternal milk vitamin B-12 concentrations at 1-6 mo postpartum among an unsupplemented population in rural western Kenya, and assessed biological demographic, and dietary characteristics associated with adequate infant serum vitamin B-12.

Methods

We modeled 1) infant serum vitamin B-12 using maternal milk vitamin B-12 concentration with linear regression; and 2) adequate (>220 pmol/L) infant serum vitamin B-12 using hypothesized biological, demographic, and dietary predictors with logistic regression. In both models, we used generalized estimating equations to account for correlated observations at the cluster-level.

Results

The median (quartile 1, quartile 3) infant serum vitamin B-12 concentration was 276 pmol/L (193, 399 pmol/L) and approximately one-third of infants had serum vitamin B-12 ≤220 pmol/L, indicating that they were vitamin B-12 depleted or deficient. There was a positive correlation between maternal milk and infant serum vitamin B-12 (r = 0.36, P < 0.001) and in multivariable analyses, maternal milk vitamin B-12 concentration was significantly associated with infant serum vitamin B-12 adequacy (P-trend = 0.03).

Conclusions

Despite a high prevalence (90%) of maternal milk vitamin B-12 concentrations below the level used to establish the Adequate Intake (<310 pmol/L), there was a low prevalence of infant vitamin B-12 deficiency. We found few factors that were associated with infant vitamin B-12 adequacy in this population, including infant feeding practices, although maternal vitamin B-12 status was not measured. The contribution of maternal milk to infant vitamin B-12 status remains important to quantify across populations, given that maternal milk vitamin B-12 concentration is modifiable with supplementation. This trial was registered at clinicaltrials.gov as NCT01704105.

Author information
  1. Hubert Department of Global Health, Emory University, Atlanta, GA.
  2. Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA.
  3. USDA, ARS Western Human Nutrition Research Center, Davis, CA.
  4. Innovations for Poverty Action, New Haven, CT, USA and Kisumu, Kenya.
  5. School of Public Health, University of California Berkeley, Berkeley, CA.
  6. Mathematica Policy Research, Washington DC.
  7. University of California Davis Medical Center, Sacramento, CA.
KEYWORDS:
Kenya , breastfeeding , human milk , infant feeding , lactation , micronutrient deficiency , vitamin B-12 .
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