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Author Notes:

Address correspondence to AMW (e-mail: anne.williams@emory.edu)

The authors’ responsibilities were as follows—AMW: managed the data, carried out the data analysis and interpretation, and drafted the manuscript; CPS, LHA, and CJC: aided AMW in conceptualization of the research; SS-F and DH: conducted the laboratory assessment of the vitamin B-12 biomarkers and contributed to data analysis and interpretation; MK, BA, AL, and CAN: assisted in conducting the field research as part of the parent study; and all authors: reviewed, read, and approved the final manuscript.

Author disclosures: AMW, CPS, SS-F, DH, MK, BA, AL, CAN, LHA, and CJC, no conflicts of interest.


Research Funding:

Funding for this research was provided by Grant OPPGD759 from the Bill & Melinda Gates Foundation to the University of California, Berkeley; a Henry A Jastro Graduate Research Award at the University of California, Davis (AW); USDA, ARS #2032-51000-004-00; and an Academic Senate Faculty Research Grant at the University of California Davis School of Medicine (CC).


  • vitamin B-12
  • human milk
  • micronutrient deficiency
  • infant feeding
  • breastfeeding
  • lactation
  • Kenya

Infant Serum and Maternal Milk Vitamin B-12 Are Positively Correlated in Kenyan Infant-Mother Dyads at 1–6 Months Postpartum, Irrespective of Infant Feeding Practice1–3


Journal Title:

Journal of Nutrition and Food Sciences


Volume 148, Number 1


, Pages 86-93

Type of Work:

Article | Final Publisher PDF


Background Vitamin B-12 is an essential nutrient required for many functions including DNA synthesis, erythropoiesis, and brain development. If maternal milk vitamin B-12 concentrations are low, infants may face elevated risks of deficiency when exclusively breastfed. Objective We evaluated cross-sectional associations between infant serum vitamin B-12 concentrations and maternal milk vitamin B-12 concentrations at 1–6 mo postpartum among an unsupplemented population in rural western Kenya, and assessed biological demographic, and dietary characteristics associated with adequate infant serum vitamin B-12. Methods We modeled 1) infant serum vitamin B-12 using maternal milk vitamin B-12 concentration with linear regression; and 2) adequate (>220 pmol/L) infant serum vitamin B-12 using hypothesized biological, demographic, and dietary predictors with logistic regression. In both models, we used generalized estimating equations to account for correlated observations at the cluster-level. Results The median (quartile 1, quartile 3) infant serum vitamin B-12 concentration was 276 pmol/L (193, 399 pmol/L) and approximately one-third of infants had serum vitamin B-12 ≤220 pmol/L, indicating that they were vitamin B-12 depleted or deficient. There was a positive correlation between maternal milk and infant serum vitamin B-12 (r = 0.36, P < 0.001) and in multivariable analyses, maternal milk vitamin B-12 concentration was significantly associated with infant serum vitamin B-12 adequacy (P-trend = 0.03). Conclusions Despite a high prevalence (90%) of maternal milk vitamin B-12 concentrations below the level used to establish the Adequate Intake (<310 pmol/L), there was a low prevalence of infant vitamin B-12 deficiency. We found few factors that were associated with infant vitamin B-12 adequacy in this population, including infant feeding practices, although maternal vitamin B-12 status was not measured. The contribution of maternal milk to infant vitamin B-12 status remains important to quantify across populations, given that maternal milk vitamin B-12 concentration is modifiable with supplementation. This trial was registered at clinicaltrials.gov as NCT01704105.

Copyright information:

© The Author(s) 2018. Published by Oxford University Press on behalf of the American Society for Nutrition.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
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