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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 #355823
Title: 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

Author
item WILLIAMS, ANNE - University Of California, Davis
item STEWART, CHRISTINE - University Of California, Davis
item Shahab-Ferdows, Setti
item Hampel, Daniela
item KIPROTICH, MARION - Innovations For Poverty Action
item ACHANDO, BERYL - Innovations For Poverty Action
item LIN, AUDRIE - University Of California
item NULL, CLAIR - Innovations For Poverty Action
item Allen, Lindsay - A
item CHANTRY, CAROLINE - University Of California, Davis

Submitted to: Journal of Nutrition
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 10/13/2017
Publication Date: 1/25/2018
Citation: Williams, A.M., Stewart, C.P., Shahab-Ferdows, S., Hampel, D., Kiprotich, M., Achando, B., Lin, A., Null, C., Allen, L.H., Chantry, C.J. 2018. 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. Journal of Nutrition. 148:86-93. https://doi.org/10.1093/jn/nxx009.
DOI: https://doi.org/10.1093/jn/nxx009

Interpretive Summary: Vitamin B-12 is an essential nutrient required for many functions including DNA synthesis, blood cell synthesis, and brain development. If maternal breast milk vitamin B-12 concentrations are low, infants may face elevated risks of deficiency when exclusively breastfed. 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. We modeled infant serum vitamin B-12 using maternal milk vitamin B-12 concentration with linear regression; and adequate (>220 pmol/L) infant serum vitamin B-12 using hypothesized biological, demographic, and dietary predictors with logistic regression. 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). Despite a high prevalence (90%) of maternal milk vitamin B-12 concentrations below the level used to establish the recommended 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. However 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.

Technical 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