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Open AccessArticle

Vitamin B12 is Low in Milk of Early Postpartum Women in Urban Tanzania, and was not Significantly Increased by High dose Supplementation

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Ifakara Health Institute, Bagamoyo Research and Training Center, P.O. Box 74 Bagamoyo, Tanzania
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Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Muhimbili University of Health and Allied Sciences, P.O. Box 65001 Dar-es-Salaam, Tanzania
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USDA ARS Western Human Nutrition Research Centre, University of California Davis, CA 95616, USA
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Program in International and Community Nutrition, Department of Nutrition, University of California, Davis, CA 95616, USA
*
Author to whom correspondence should be addressed.
Nutrients 2020, 12(4), 963; https://doi.org/10.3390/nu12040963
Received: 3 March 2020 / Revised: 23 March 2020 / Accepted: 28 March 2020 / Published: 31 March 2020
(This article belongs to the Section Micronutrients and Human Health)
The effect of maternal multivitamin supplementation on breast milk vitamin B12 concentrations has not been examined in Tanzania, where the prevalence of maternal plasma B12 insufficiency is 25.6%. Multivitamins (containing 50 µg vitamin B12) or placebo were provided during pregnancy and in the postpartum period. Breast milk samples were collected at or around six weeks postpartum from 491 participants in a trial of multivitamins (NCT00197548). Linear and logistic regression models were used to examine the effect of supplements on vitamin B12 concentration in milk and its associations with other variables including potential confounders. Median vitamin B12 concentration in breast milk was 206 pmol/L and 70% of women had levels indicating inadequacy (<310 pmol/L). Multivitamin supplements did not significantly reduce the odds of inadequate vitamin B12 in breast milk, suggesting suboptimal absorption. A single unit increase in maternal hemoglobin at six weeks was associated with 18% lower odds of inadequate vitamin B12 in breast milk. Participants with higher BMI at baseline had double the odds of having inadequate vitamin B12 than the reference group (<22 kg/m2). Trials to determine the optimal dose, route, and duration of supplementation to improve maternal B12 status in Sub-Saharan Africa are of utmost importance. View Full-Text
Keywords: vitamin B12; postpartum; breast milk; supplementation; Urban Tanzania vitamin B12; postpartum; breast milk; supplementation; Urban Tanzania
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Lweno, O.N.; Sudfeld, C.R.; Hertzmark, E.; Manji, K.P.; Aboud, S.; Noor, R.A.; Masanja, H.; Salim, N.; Shahab-Ferdows, S.; Allen, L.H.; Fawzi, W.W. Vitamin B12 is Low in Milk of Early Postpartum Women in Urban Tanzania, and was not Significantly Increased by High dose Supplementation. Nutrients 2020, 12, 963.

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