Weekly vitamin A and iron supplementation during pregnancy increases vitamin A concentration of breast milk but not iron status in indonesian lactating women

Abstract

Studies on the effect of vitamin A and iron supplementation during pregnancy on maternal iron and vitamin A status postpartum are scarce. We investigated whether retinol and iron variables in breast milk and in serum postpartum were enhanced more with weekly vitamin A and iron supplementation during pregnancy than with weekly iron supplementation. During pregnancy, subjects were randomly allocated to two groups and received either (n=88) a weekly supplement of iron (120 mg Fe as FeSO4) and folic acid (500 μg) or (n=82) the same amount of iron and folic acid plus vitamin A [4800 retinol equivalents (RE)]. Transitional milk (4-7 d postpartum) had higher (P<0.001) concentrations of retinol and iron than mature milk (3 mo postpartum). Compared with the weekly iron group, the weekly vitamin A and iron group had a greater (P<0.05) concentration of retinol in transitional milk (as μmol/L) and in mature milk (as μmol/g fat). Although serum retinol concentrations ∼4 mo postpartum did not differ significantly, the weekly vitamin A and iron group had significantly fewer (P<0.01) subjects with serum retinol concentrations ≤0.70 μmol/L than the weekly iron group. Iron status and concentrations of iron in transitional and mature milk did not differ between groups. We have shown that weekly vitamin A and iron supplementation during pregnancy enhanced concentrations of retinol in breast milk although not in serum by ∼4 mo postpartum. However, no positive effects were observed on iron status and iron concentration in breast milk.