The effect of thiamin and riboflavin supplementation on the level of those vitamins in human breast milk and urine

Nail, P A; Thomas, Mark; Eakin, Robert E.

doi:10.1093/ajcn/33.2.198

Cited by 62 publications

(43 citation statements)

References 9 publications

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“…TMP contributed to a higher extent to total thiamine (63%) than did free thiamine. Previous studies failed to report breast-milk TMP because thiamine was analysed as total thiamine by a microbiological assay [14] or in hydrolysed samples following manual [15], [16], [17] or HPLC-coupled [2], [18] fluorometric detection of thiochrome. The pre-treatment with enzymes to hydrolyse thiamine phosphate esters before derivatization to fluorescent thiochrome reveal the information only on total thiamine as a sum of ‘free’ thiamine content.…”

Section: Discussionmentioning

confidence: 99%

Thiamine Diphosphate in Whole Blood, Thiamine and Thiamine Monophosphate in Breast-Milk in a Refugee Population

et al. 2012

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Background The provision of high doses of thiamine may prevent thiamine deficiency in the post-partum period of displaced persons. Methodology/Principal Findings The study aimed to evaluate a supplementation regimen of thiamine mononitrate (100 mg daily) at the antenatal clinics in Maela refugee camp. Women were enrolled during antenatal care and followed after delivery. Samples were collected at 12 weeks post partum. Thiamine diphosphate (TDP) in whole blood and thiamine in breast-milk of 636 lactating women were measured. Thiamine in breast-milk consisted of thiamine monophosphate (TMP) in addition to thiamine, with a mean TMP to total thiamine ratio of 63%. Mean whole blood TDP (130 nmol/L) and total thiamine in breast-milk (755 nmol/L) were within the upper range reported for well-nourished women. The prevalence of women with low whole blood TDP (<65 nmol/L) was 5% and with deficient breast-milk total thiamine (<300 nmol/L) was 4%. Whole blood TDP predicted both breast-milk thiamine and TMP (R 2 = 0.36 and 0.10, p<0.001). A ratio of TMP to total thiamine ≥63% was associated with a 7.5 and 4-fold higher risk of low whole blood TDP and deficient total breast-milk thiamine, respectively. Routine provision of daily 100 mg of thiamine mononitrate post-partum compared to the previous weekly 10 mg of thiamine hydrochloride resulted in significantly higher total thiamine in breast-milk. Conclusions/Significance Thiamine supplementation for lactating women in Maela refugee camp is effective and should be continued. TMP and its ratio to total thiamine in breast-milk, reported for the first time in this study, provided useful information on thiamine status and should be included in future studies of breast-milk thiamine.

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Section: Discussionmentioning

confidence: 99%

Thiamine Diphosphate in Whole Blood, Thiamine and Thiamine Monophosphate in Breast-Milk in a Refugee Population

et al. 2012

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“…Procedures for collecting milk samples vary greatly among studies (e.g., opportunistic sample collection, samples collected after a period of no-breastfeeding or at some time during a feeding), samples may be with or without maternal supplementation, and they often are not accompanied by maternal dietary status data (15, 16, 19, 22–32). To what extent these variations influence the micronutrient concentration of milk has not been assessed.…”

Section: Introductionmentioning

confidence: 99%

Vitamin Concentrations in Human Milk Vary with Time within Feed, Circadian Rhythm, and Single-Dose Supplementation

Hampel

Shahab‐Ferdows

Islam

et al. 2017

The Journal of Nutrition

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Background: Human milk is the subject of many studies, but procedures for representative sample collection have not been established. Our improved methods for milk micronutrient analysis now enable systematic study of factors that affect its concentrations.Objective: We evaluated the effects of sample collection protocols, variations in circadian rhythms, subject variability, and acute maternal micronutrient supplementation on milk vitamin concentrations.Methods: In the BMQ (Breast-Milk-Quality) study, we recruited 18 healthy women (aged 18–26 y) in Dhaka, Bangladesh, at 2–4 mo of lactation for a 3-d supplementation study. On day 1, no supplements were given; on days 2 and 3, participants consumed ∼1 time and 2 times, respectively, the US-Canadian Recommended Dietary Allowances for vitamins at breakfast (0800–0859). Milk was collected during every feeding from the same breast over 24 h. Milk expressed in the first 2 min (aliquot I) was collected separately from the remainder (aliquot II); a third aliquot (aliquot III) was saved by combining aliquots I and II. Thiamin, riboflavin, niacin, and vitamins B-6, B-12, A, and E and fat were measured in each sample.Results: Significant but small differences (14–18%) between aliquots were found for all vitamins except for vitamins B-6 and B-12. Circadian variance was significant except for fat-adjusted vitamins A and E, with a higher contribution to total variance with supplementation. Between-subject variability accounted for most of the total variance. Afternoon and evening samples best reflected daily vitamin concentrations for all study days. Acute supplementation effects were found for thiamin, riboflavin, and vitamins B-6 and A at 2–4 h postdosing, with 0.1–6.17% passing into milk. Supplementation was reflected in fasting, 24-h postdose samples for riboflavin and vitamin B-6. Maximum amounts of dose-responding vitamins in 1 feeding ranged from 4.7% to 21.8% (day 2) and 8.2% to 35.0% (day 3) of Adequate Intake.Conclusions: In the milk of Bangladeshi mothers, differences in vitamin concentrations between aliquots within feedings and by circadian variance were significant but small. Afternoon and evening collection provided the most-representative samples. Supplementation acutely affects some breast-milk micronutrient concentrations. This trial was registered at clinicaltrials.gov as NCT02756026.

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“…Requirements for this vitamin are linked to the protein intake and because of this the concentration in human or formula milk is sometimes expressed relative to the protein content. Results from 5 studies show values for the ratio of vitamin B6 : protein in milk from mothers having different vitamin B6 intakes, between 7 and 30 pg/g protein, which would be expected to provide between about 68-300 pg/d (Thomas et al 1979(Thomas et al , 1980Sneed et al 1981;Styslinger & Kirksey, 1985;Borschel et al 1986). The mean value for pooled expressed mature human milk given in the DHSS report of 1977 is significantly lower, at 5 pg/g protein, providing only about 45 pgld.…”

Section: Vitamin Bcpyridoxinementioning

confidence: 99%

“…During prolonged lactation milk folate levels increase significantly, which is a pattern generally characteristic of the water-soluble vitamins (Halsted et al 1978;Ford et al 1983). Levels in breast milk seem to be relatively resistant to maternal supplements although the response is somewhat better if the mother is malnourished (Deodhar et al 1964;Thomas et al 1980;Sneed et al 1981). Neither clinical deficiency nor low values for biochemical indices of folate status have been reported for breast fed infants born at term (Ek & Magnus 1979;Salmenpera et al 1986).…”

Section: Folatementioning

confidence: 99%

“…Mean concentrations of 0.2-1.3 pg/l in mature breast milk of unsupplemented well nourished mothers are reported, but with a wide range for individuals and a higher concentration in colostrum (Macy, 1949;Kon & Mawson, 1950;Ford et al 1983). The response to maternal oral supplements is minimal, with levels reaching 1.88 pgA, lower than some values reported in the milk of unsupplemented women (Thomas et al 1980Styslinger & Kirksey, 1985. Clinical deficiency of vitamin BI2 has been reported in breast fed infants of strictly vegan mothers and of mothers with pernicious anaemia (Hoey et al 1982;Kuhne et al 1991).…”

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confidence: 96%

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Vitamin requirements for term infants: considerations for infant formulae

Powers

1997

Nutr. Res. Rev.

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Objective. To provide the informed health professional with an up to date evaluation of the current thinking regarding requirements for vitamins in infant feeds. Establishing criteria for adequacy. Vitamin adequacy in the neonate is currently defined in terms of circulating levels of a vitamin or of the activity of a vitamin dependent enzyme in the erythrocytes. Although these measurements have their value there is a need to develop biochemical, physiological or clinical markers of well defined specific function. For some vitamins there is a risk of deleterious effects of very high intakes: risk of toxicity needs to be taken into consideration when making recommendations for inclusion in infant formulae. Breast milk as the 'gold standard'. Breast milk concentrations of vitamins have been used as the criteria of adequate intake by neonates. This may not always be justified. Greater consideration needs to be given to differences in bioavailability of vitamins from breast milk compared with formula feeds, of the influence of season, and of stage of lactation, on the stated composition. Experimental approaches. Animal studies have provided limited information regarding effects of different levels of intakes on current status indices in the neonatal period. There are few reports of randomized controlled studies into the effects of different levels of vitamins and these rely heavily on biochemical criteria of adequacy. Recent developments. The inclusion of fl-carotene into formula feeds for premature babies is an issue of current interest. What is the justification for this? Are there potential benefits for the term infant? Riboflavin deficiency in the period around weaning may affect the normal structural and functional development of the gastrointestinal tract; some. of these effects may be permanent. Research to be done. A greater understanding of the absorption and metabolism of vitamins during infancy is required in order to help establish dietary requirements. The relative bioavailability of vitamins in human milk and formulae needs to be investigated. Criteria for vitamin adequacy should be extended to include measures of function. Information regarding the conversion factor from tryptophan to niacin in infancy would allow us to set niacin requirements with greater confidence. There is a particular lack of information about concentrations of biotin and pantothenic acid in breast milk and the relative biochemical status of infants receiving breast milk and formulae. Benefits of including fi-carotene into infant formulae need to be evaluated. The role of individual micronutrients in the structural and functional development of the gastrointestinal tract should be explored.

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The effect of thiamin and riboflavin supplementation on the level of those vitamins in human breast milk and urine

Cited by 62 publications

References 9 publications

Thiamine Diphosphate in Whole Blood, Thiamine and Thiamine Monophosphate in Breast-Milk in a Refugee Population

Thiamine Diphosphate in Whole Blood, Thiamine and Thiamine Monophosphate in Breast-Milk in a Refugee Population

Vitamin Concentrations in Human Milk Vary with Time within Feed, Circadian Rhythm, and Single-Dose Supplementation

Vitamin requirements for term infants: considerations for infant formulae

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