Folate and cobalamin status in relation to breastfeeding and weaning in healthy infants

  • Hay G
  • Johnston C
  • Whitelaw A
 et al. 
  • 42


    Mendeley users who have this article in their library.
  • 44


    Citations of this article.


BACKGROUND Folate and cobalamin status changes markedly during infancy. OBJECTIVE We aimed to examine the influence of breastfeeding on folate and cobalamin status in healthy infants. DESIGN In a longitudinal study, we measured serum folate, cobalamin, holotranscobalamin, holohaptocorrin, methylmalonic acid, and homocysteine at birth and at ages 6, 12, and 24 mo (n = 361, 262, 244, and 224, respectively). Breastfeeding status and nutrient intake were assessed by using questionnaires and 7-d weighed-food records (at 12 mo). RESULTS All indexes changed significantly from birth to age 24 mo (P < 0.001). Folate was high until age 6 mo and then declined. At age 6 mo, folate was positively correlated with duration of exclusive breastfeeding (rho = 0.29; P < 0.001). Cobalamin status declined after birth in breastfed but increased in nonbreastfed infants. Thus, holotranscobalamin (pmol/L) was lower in breastfed than in nonbreastfed children at age 6 mo [geometric mean: 37 (95% CI: 33, 40) and 74 (64, 86), respectively], at 12 mo [51 (46, 56) and 76 (70, 82), respectively], and at 24 mo [65 (50, 83) and 90 (85, 97), respectively; P < 0.05 for all]. Complementary feeding did not increase (6 mo) or modestly increased (12 mo) cobalamin status in breastfed children. At 12 mo, cobalamin intake (microg/d), excluding breast milk cobalamin, was lower in breastfed than in nonbreastfed infants [geometric mean: 1.4 (1.3, 1.6) and 2.4 (2.1, 2.6), respectively; P < 0.001]. However, after adjustment for total cobalamin intake, cobalamin status (ie, holotranscobalamin) remained significantly lower in breastfed than in nonbreastfed infants [54 (49, 59) and 70 (64, 78), respectively; P < 0.001]. CONCLUSIONS Low cobalamin status is a characteristic finding in breastfed children. Reference limits according to age and breastfeeding status should be considered in early childhood.

Get free article suggestions today

Mendeley saves you time finding and organizing research

Sign up here
Already have an account ?Sign in

Find this document


  • Gry Hay

  • Carole Johnston

  • Andrew Whitelaw

  • Kerstin Trygg

  • Helga Refsum

Cite this document

Choose a citation style from the tabs below

Save time finding and organizing research with Mendeley

Sign up for free