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J Nutr. 2016 May;146(5):1125-31. doi: 10.3945/jn.115.228189. Epub 2016 Apr 13.

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.

Author information

1
Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA;
2
Department of Population Medicine and Diagnostic Sciences, Program in International Nutrition, Cornell University, Ithaca, NY;
3
Innovations for Poverty Action, Nairobi, Kenya, and New Haven, CT;
4
Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA; USDA Agricultural Research Service Western Human Nutrition Research Center, Davis, CA;
5
Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, CA; and.
6
Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA; Innovations for Poverty Action, Nairobi, Kenya, and New Haven, CT;
7
Innovations for Poverty Action, Nairobi, Kenya, and New Haven, CT; Mathematica Policy Research, Washington, DC.
8
USDA Agricultural Research Service Western Human Nutrition Research Center, Davis, CA;
9
Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, Davis, CA; cpstewart@ucdavis.edu.

Abstract

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.

KEYWORDS:

Africa; Kenya; animal-source foods; breast milk; food security; hunger; lactation; vitamin B-12

PMID:
27075905
PMCID:
PMC4841927
DOI:
10.3945/jn.115.228189
[Indexed for MEDLINE]
Free PMC Article

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