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

Abstract

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) mmol/l 3 weeks postpartum, 6.1 (4.1-10.3) mmol/l 4 months postpartum and 5.3 (3.6-8.7) mmol/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 mmol/l (Po0.001) and 5.8 vs 4.5 mmol/l (P ¼ 0.003), respectively). Six women had increased (415 mmol/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.

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

“…The serum folate was not higher in the formula-fed infants (19). The association between lactation and folate status was observed (20). From this study the results of RBC folate concentration levels were similar in the fi rst two months of life in comparison with our previous fi ndings related to Slovakian newborns (21).…”

Nutrient Intake Values for Folate during Pregnancy and Lactation Vary Widely around the World

“…It has been suggested that folate status of the lactating mother in these study populations often declines merely due to the discontinuation of prenatal folic acid supplements [154]. A number of studies have been carried out on maintenance of blood folate status during lactation [76,152,155,156,157]; however, these studies have also been conducted in groups of women who had consumed high-dose folic acid supplements throughout pregnancy.…”

Vitamin B-12 Status Differs among Pregnant, Lactating, and Control Women with Equivalent Nutrient Intakes

“…Infantile vitamin B-12 deficiency can lead to neurologic impairments including irritability, apathy, and developmental regression (16)(17)(18). Although a few studies have examined longitudinal changes in maternal vitamin B-12 biomarkers during lactation (14,(19)(20)(21), less is known about the impact of this reproductive state (compared to the nonlactating state) on vitamin B-12 status and requirement.…”