Vitamin B-12 content in breast milk of vegan, vegetarian, and nonvegetarian lactating women in the United States

• Published in: The American journal of clinical nutrition Vol. 108; no. 3; pp. 525 - 531
• Main Authors: Pawlak, Roman, Vos, Paul, Shahab-Ferdows, Setareh, Hampel, Daniela, Allen, Lindsay H, Perrin, Maryanne Tigchelaar
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2018; Oxford University Press; American Society for Clinical Nutrition, Inc
• Subjects: Adequacy; Adolescent; Adult; Breast; Breast Feeding; Breast milk; Cross-Sectional Studies; Diet; Dietary Supplements; eating habits; Female; Humans; lactating women; Lactation; maternal nutrition; Middle Aged; Milk; Milk, Human - chemistry; mothers; nutrient content; Regression analysis; supplements; United States; United States - epidemiology; Vegan; vegan diet; Vegans; vegetarian; Vegetarianism; Vegetarians; Vitamin B; Vitamin B 12 - administration & dosage; Vitamin B 12 - analysis; Vitamin B 12 Deficiency - epidemiology; vitamin B-12; vitamin B12; Women; Young Adult; United States; United States > US; MMA; supplements; BSQ; vitamin B-12; vegetarian; breast milk; vegan; Hcy
• ISSN: 0002-9165; 1938-3207; 1938-3207
• DOI: 10.1093/ajcn/nqy104

The nutritional profile of human milk varies significantly between women, and the impact of maternal diet on these variations is not well understood. We analyzed breast-milk vitamin B-12 concentration and vitamin B-12 supplement use pattern among women who adhered to different dietary patterns: vegan, vegetarian, and nonvegetarian. A total of 74 milk samples, 29 from vegan, 19 from vegetarian, and 26 from nonvegetarian breastfeeding mothers, were analyzed. The prevalences of low vitamin B-12 (<310 pmol/L) were 19.2% for vegans, 18.2% for vegetarians, and 15.4% for nonvegetarians, which was not significant by diet group (P = 1.00). The median (quartile 1, quartile 3) vitamin B-12 values were 558 pmol/L (331, 759 pmol/L) for vegans, 509 pmol/L (368, 765 pmol/L) for vegetarians, and 444 pmol/L (355, 777 pmol/L) for nonvegetarians (P = 0.890). The use of individual vitamin B-12 supplements was higher in vegans (46.2%) than in vegetarians (27.3%) and nonvegetarians (3.9%) (P = 0.001). In linear regression analysis, the use of individual vitamin B-12 supplements was a significant positive predictor of milk vitamin B-12 concentration (β ± SE: 172.9 ± 75.2; standardized β = 0.263; P = 0.024; R2 = 0.069), the use of a multivitamin had a significant negative relation with milk vitamin B-12 concentrations (β ± SE −222.0 ± 98.7; standardized β = −0.258; P = 0.028, R2 = 0.067;), whereas the use of a B-complex vitamin and prenatal vitamin were not predictive of vitamin B-12 milk concentration (P > 0.05). Almost 20% of our study participants were classified as having low breast-milk vitamin B-12 concentrations (<310 pmol/L), independent of maternal diet pattern. Approximately 85% of participants categorized as having low vitamin B-12 were taking vitamin B-12 supplements at doses in excess of the Recommended Dietary Allowance, which suggests that more research is needed to determine breast-milk adequacy values.