¹Deutsche Gesellschaft für Technische Zusammenarbeit (GTZ) GmbH, Eschborn

²Institute of Nutrition, University of Giessen, Giessen, Germany

³UNICEF, Jakarta

⁴Faculty of Medicine, Universitas Kristen, Jakarta, Indonesia

⁵Nestlé Research Center, Nestec Ltd, Lausanne, Switzerland

⁶SEAMEO-TROPMED Regional Center for Community Nutrition, University of Indonesia, Jakarta, Indonesia

Correspondence to: Dr R Gross, GTZ/SEAMEO, PO Box 3852, Jakarta 10038, Indonesia.

Objective: To gain information about the micronutrient status of urban, middle-income, breast-feeding mothers in relation to zinc and selected fat-soluble vitamins in plasma and breast milk and to assess possible interaction between the measured micronutrients.

Design: Cross-sectional study

Subjects: 91 mothers and their infants living in middle-income areas of Jakarta, Indonesia

Results: None of the measured anthropometric data of the mothers (e.g. BMI: 22.0±3.1 kg/m2) and their infants (birth weight: 3.2±0.5 kg) gave any indication of undernutrition. The mean concentrations in blood were 124±18 g/l for hemoglobin, 385±111 g/l for retinol, 34±23 g/l for -carotene, 104±72 g/l for -carotene, 7.7±3.3 mg/l for -tocopherol, 0.57±0.23 mg/l for -tocopherol, 855±242 g/l for zinc, and the median concentration of lycopene was 29 g/l. The median breast milk concentrations were 420 g/l for retinol, 7.8 g/l for -carotene, and 2.7 mg/l for zinc. With increased duration of lactation, vitamin A and zinc concentrations significantly decreased in breast milk whereas plasma zinc concentration increased. Plasma - and -carotene were positively correlated (P<0.0001) with each other and with plasma lycopene. Breast milk -carotene was positively correlated with breast milk retinol and with plasma -carotene (P<0.0001). There was no correlation between zinc and vitamin A in either breast milk or plasma. Forty per cent of the mothers were anemic, 29.1% had a low plasma zinc concentration, and 23.7% had a moderately low plasma vitamin A concentration. Breast milk from 70% of the women had a low concentration of vitamin A and that from 66% had a low concentration of zinc.

Conclusions: Multi-micronutrient intervention should be considered to provide a sufficient supply of zinc and vitamin A for growth of exclusively breast-fed infants.

breast milk; anemia; zinc; retinol; -carotene; -carotene; infants