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

Anne M. Williams, Caroline J Chantry, Sera L. Young, Beryl S. Achando, Lindsay H. Allen, Benjamin F. Arnold, John M. Colford, Holly N. Dentz, Daniela Hampel, Marion C. Kiprotich, Audrie Lin, Clair A. Null, Geoffrey M. Nyambane, Setti Shahab-Ferdows, Christine P. Stewart

Research output: Contribution to journalArticlepeer-review

16 Scopus citations

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 animalsource 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 mg/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.

Original languageEnglish (US)
Pages (from-to)1125-1131
Number of pages7
JournalJournal of Nutrition
Volume146
Issue number5
DOIs
StatePublished - May 1 2016

Keywords

  • Africa
  • Animal-source foods
  • Breast milk
  • Food security
  • Hunger
  • Kenya
  • Lactation
  • Vitamin B-12

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics

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