Folate and cobalamin status in relation to breastfeeding and weaning in healthy infants

Abstract

Background: Folate and cobalamin status changes markedly during infancy. Objective: We aimed to examine the influence of breastfeeding on folate and cobalamin status in healthy infants. Design: In a longitudinal study, we measured serum folate, cobalamin, holotranscobalamin, holohaptocorrin, methylmalonic acid, and homocysteine at birth and at ages 6, 12, and 24 mo (n ҃ 361, 262, 244, and 224, respectively). Breastfeeding status and nutrient intake were assessed by using questionnaires and 7-d weighed-food records (at 12 mo). Results: All indexes changed significantly from birth to age 24 mo (P 0.001). Folate was high until age 6 mo and then declined. At age 6 mo, folate was positively correlated with duration of exclusive breastfeeding ( ҃ 0.29; P 0.001). Cobalamin status declined after birth in breastfed but increased in nonbreastfed infants. Thus, holotranscobalamin (pmol/L) was lower in breastfed than in nonbreastfed children at age 6 mo [geometric x : 37 (95% CI: 33, 40) and 74 (64, 86), respectively], at 12 mo [51 (46, 56) and 76 (70, 82), respectively], and at 24 mo [65 (50, 83) and 90 (85, 97), respectively; P 0.05 for all]. Complementary feeding did not increase (6 mo) or modestly increased (12 mo) cobalamin status in breastfed children. At 12 mo, cobalamin intake (g/d), excluding breast milk cobalamin, was lower in breastfed than in nonbreastfed infants [geometric x : 1.4 (1.3, 1.6) and 2.4 (2.1, 2.6), respectively; P 0.001]. However, after adjustment for total cobalamin intake, cobalamin status (ie, holotranscobalamin) remained significantly lower in breastfed than in nonbreastfed infants [54 (49, 59) and 70 (64, 78), respectively; P 0.001]. Conclusions: Low cobalamin status is a characteristic finding in breastfed children. Reference limits according to age and breastfeeding status should be considered in early childhood.

Scientific Opinion on nutrient requirements and dietary intakes of infants and young children in the European Union

“…(Hay et al, 2011). In the fifth study, serum folate concentrations reported as P5-P95 were 23 to 120 nmol/L in infants at the age of six months, 16 to 72 nmol/L in infants aged 12 months and 9 to 46 nmol/L in children at the age of two years (Hay et al, 2008). In a study in Turkish infants, mean serum folate concentration was 30 nmol/L (range 17 to 45 nmol/L) in breast-fed infants and 45 nmol/L (range 20 to 45 nmol/L) in formula-fed infants at six months (Karademir et al, 2007).…”

Association between vitamin B12intake and EURRECA's prioritized biomarkers of vitamin B12in young populations: a systematic review

“…The most repeated reason for risk of bias across the studies was an inadequate explanation about the drop-outs and an inadequate assessment of exposure (method to assess vitamin B 12 intakes). (31) ) or MMA (two studies (28,31) , while in one study (31) , associations were not found for MMA).…”

“…In that study, serum n 5219 references identified from database search n 16 relevant references for further analysis n 101 references excluded from further analysis n 0 references identified from reference lists of systematic reviews n 5815 references screened for inclusion based on title and abstract n 5 relevant references for children and adolescents n 6 relevant references for pregnant and lactating women n 596 references identified from update database search n 5 relevant references for infants n 5625 references excluded n 117 potentially relevant references for inclusion based on full text Fig. 2 Selection of studies for the current systematic review (31) , 239 (212-268) in 2nd month (39) and 178 (161-198) in 3rd month (38) , with P , 0?0001 adjusted for maternal age vitamin B 12 and MMA were also measured; however, no association with them was found. In the RCT by Gewa et al (36) , the targeted population group was children and the studied relationship was I-H.…”

Amount of folic acid in different types of nutrition used in the neonatal period

“…The case of breastfed infants independent of maternal folate status suggests that concentrations of folate positively correlate with the duration of exclusive breastfeeding. The serum folate was not higher in the formula-fed infants (19). The association between lactation and folate status was observed (20).…”