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Maternal and pediatric nutrition

Vitamin B12 concentrations in milk from Norwegian women during the six first months of lactation

European Journal of Clinical Nutrition volume 74, pages 749–756 (2020)Cite this article

Subjects

Abstract

Background

Human milk vitamin B12 (B12) concentrations depend on maternal status and intake; only few data are available in high-income countries.

Objective

We assessed human milk B12 concentrations during the first 6 months postpartum in Norwegian women and its association with maternal dietary B12 intake and maternal urinary methylmalonic acid (MMA) concentration.

Methods

In this cross-sectional study, 175 mothers, exclusively (80%) or partially (20%) breastfeeding, were included. Milk B12 was measured by IMMULITE®/IMMULITE® 1000 B12 competitive protein binding assay and urinary MMA relative to creatinine (MMA/Cr) by liquid chromatography–tandem-mass spectrometry. Maternal habitual B12 intake and supplement use were estimated using a food frequency questionnaire.

Results

Mean human milk B12 concentration was 327 pmol/L (range 140–1089), with 402 pmol/L at 1 month (n = 21), 333 pmol/L at four months (n = 32), and 299 pmol/L at 6 months (n = 21). Maternal B12 intake was 5 µg/d, 89% met the Estimated Average Requirement, and supplement use did not affect milk B12 concentrations. MMA/Cr was low in all women compared with published data. In exclusively breastfeeding women, MMA/Cr (beta (95% CI) −42.5 (−82.5, −2.5) and time since birth (−4.9 (−9.6, −0.3)) were significant predictors of human milk B12 concentrations. There was no association between total B12 intake and milk B12 concentration or between total B12 intake and MMA/Cr.

Conclusions

Maternal B12 status and human milk B12 concentrations are likely sufficient, based on adequate maternal B12 dietary intake combined with low urinary MMA concentrations. Nevertheless, milk B12 concentration fell during 6 months postpartum while maternal B12 status did not change.

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Fig. 1: The graphs show associations among human milk B12, maternal B12 intake and urinary MMA, and infant age.

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Funding

Funded by Oslo Metropolitan University.

Author information

Authors and Affiliations

  1. Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, 0130, Oslo, Norway

    Sigrun Henjum

  2. Children’s Hospital Oakland Research Institute, Oakland, CA, 94609, USA

    Mari Manger

  3. USDA/ARS Western Human Nutrition Research Center, Davis, CA, 95616, USA

    Daniela Hampel, Setareh Shahab-Ferdows & Lindsay H. Allen

  4. Department of Nutrition, University of California, Davis, CA, 95616, USA

    Daniela Hampel & Lindsay H. Allen

  5. Division of Infection Control, Environment and Health, Norwegian Institute of Public Health, 0213, Oslo, Norway

    Anne Lise Brantsæter

  6. Department of Nutrition, Institute of Medical Biosciences, University of Oslo, 0317, Oslo, Norway

    Nasser E. Bastani & Helga Refsum

  7. Department of Research, Innlandet Hospital Trust, 2380, Brumunddal, Norway

    Tor A. Strand

  8. Centre for International Health, University of Bergen, 5020, Bergen, Norway

    Tor A. Strand

Authors
  1. Sigrun Henjum
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  2. Mari Manger
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  3. Daniela Hampel
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  4. Anne Lise Brantsæter
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  8. Helga Refsum
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  9. Lindsay H. Allen
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Contributions

SH, TAS, ALB, and LA designed the study. SH performed the statistical analysis, DH made Fig. 1 and MM made Table 5 and wrote parts of the discussion. ALB was in charge of the dietary assessment. DH, SS-F and NEB analyzed vitamin B12 in milk and MMA in urine. LHA and HR provided detailed feedback on the paper. All authors read and approved the final paper.

Corresponding author

Correspondence to Sigrun Henjum.

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The authors declare that they have no conflict of interest.

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Henjum, S., Manger, M., Hampel, D. et al. Vitamin B12 concentrations in milk from Norwegian women during the six first months of lactation. Eur J Clin Nutr 74, 749–756 (2020). https://doi.org/10.1038/s41430-020-0567-x

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