To investigate the relation between lactation and markers of folate and vitamin B12 (B12) deficiency in women with and without vitamin supplementation.
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.
Among 72 exclusively breast-feeding women, the median (10–90% percentile) tHcy was 5.8 (3.1–8.3) μmol/l 3 weeks postpartum, 6.1 (4.1–10.3) μmol/l 4 months postpartum and 5.3 (3.6–8.7) μmol/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 μmol/l (P<0.001) and 5.8 vs 4.5 μmol/l (P=0.003), respectively). Six women had increased (>15 μmol/l) tHcy; four of these were unsupplemented and exclusively breast-feeding.
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.
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.
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We thank the women who participated in the study, the staff at The Osteoporosis Clinic, Aarhus University Hospital, Denmark for collecting the blood samples, Lene Damm Christensen and the other staff at Department of Clinical Biochemistry, Aarhus University Hospital, Skejby, Denmark for analysing the blood samples, the secretaries at Department of Obstetrics and Gynaecology, Aarhus University Hospital, Skejby, Denmark for assisting during the identification of eligible women, Gurli Tanderup and DPC Scandinavia for providing reagents for the tHcy and folate analyses and finally The Biomedical Laboratory Scientist Education and Research Fund and LEO Pharma Research Foundation for their financial support.
Guarantor: CH Ramlau-Hansen.
Contributors: CHR, JM, UKM and TBH designed the study. CHR and UKM collected the samples. JM and EN were responsible for the biochemical analyses; CHR performed the statistical analyses, wrote the original manuscript and edited all subsequent versions. JM, EN and TBH contributed to the interpretation of data and commented on the manuscript. All authors approved the final version of the manuscript.
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Ramlau-Hansen, C., Møller, U., Henriksen, T. et al. Folate and vitamin B12 in relation to lactation: a 9-month postpartum follow-up study. Eur J Clin Nutr 60, 120–128 (2006). https://doi.org/10.1038/sj.ejcn.1602275
- serum folate
- serum B12
- plasma homocysteine
- serum methylmalonic acid
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