Folate and vitamin B₁₂ in relation to lactation: a 9-month postpartum follow-up study

• Published in: European journal of clinical nutrition Vol. 60; no. 1; pp. 120 - 128
• Main Authors: Ramlau-Hansen, C.H, Møller, U.K, Henriksen, T.B, Nexø, E, Møller, J
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing 2006; Nature Publishing Group
• Subjects: Adult; Animal reproduction; Biological and medical sciences; Blood; breast feeding; Clinical nutrition; Dietary Supplements; Feeding; Female; folic acid; Folic Acid - administration & dosage; Folic Acid - blood; Folic Acid Deficiency - blood; Folic Acid Deficiency - epidemiology; homocysteine; Homocysteine - blood; human lactation; Humans; Lactation - metabolism; Lactation - physiology; Life Style; maternal nutrition; Medical sciences; Metabolic diseases; methylmalonic acid; Methylmalonic Acid - blood; Nutritional Requirements; Nutritional Status; postpartum period; Postpartum Period - blood; Qualitative research; Reagents; Time Factors; Vitamin B; Vitamin B 12 - administration & dosage; Vitamin B 12 - blood; Vitamin B 12 Deficiency - blood; Vitamin B 12 Deficiency - epidemiology; vitamin B12; vitamin deficiencies; vitamin supplements; Thiol; breast-feeding; Lactation; Nutrition; B-Vitamins; serum B12; Breast feeding; Cyanocobalamin; Folate; Blood plasma; Sulfur containing aminoacid; serum folate; Homocystein; Methylmalonic acid; Follow up study; plasma homocysteine; Serum; serum methylmalonic acid
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/sj.ejcn.1602275

Objective: To investigate the relation between lactation and markers of folate and vitamin B12 (B12) deficiency in women with and without vitamin supplementation. Design: A 9-month follow-up study. Subjects and methods: Blood samples from 91 women, who gave birth to a single healthy child, were collected 3 weeks, 4 and 9 months postpartum and analysed for circulating level of homocysteine (tHcy), methylmalonic acid (MMA), folate and B12. The participants were categorized as exclusively, partly or not breast-feeding dependent on the degree of lactation 4 months postpartum. During follow-up, lifestyle factors were recorded by structured interviews. Results: Among 72 exclusively breast-feeding women, the median (10-90% percentile) tHcy was 5.8 (3.1-8.3) micromol/l 3 weeks postpartum, 6.1 (4.1-10.3) micromol/l 4 months postpartum and 5.3 (3.6-8.7) micromol/l 9 months postpartum. At 9 months postpartum, none of the women breast-fed exclusively. No significant change occurred in the concentration of B12 and folate. Exclusively breast-feeding women without vitamin supplementation had higher median tHcy than supplemented exclusively breast-feeding women 4 and 9 months postpartum (7.0 vs 5.4 micromol/l (P<0.001) and 5.8 vs 4.5 micromol/l (P=0.003), respectively). Six women had increased (>15 micromol/l) tHcy; four of these were unsupplemented and exclusively breast-feeding. Conclusion: We found no overall indication of depletion of the folate and B12 stores during the lactation period in this population. However, folate-supplemented women had lower tHcy and higher folate levels, suggesting a beneficial effect of supplementation with folate throughout lactation. Sponsorship: The Biomedical Laboratory Scientist Education and Research Fund and LEO Pharma Research Foundation supported this study. DPC Scandinavia, Denmark donated reagents for the folate and tHcy analysis.