Factors associated with longitudinal changes in B-vitamin and choline concentrations of human milk

Abstract

ABSTRACT Background Little is known regarding the associations between maternal factors and B-vitamin and choline concentrations in early milk and the trajectories of these vitamins during lactation. Objectives In this hypothesis-generating study, we modeled the association between maternal and offspring factors and longitudinal changes in milk B-vitamin and choline concentrations throughout lactation. Methods A hundred women were studied in a prospective birth cohort and milk samples from 52 women were collected at 2–8 d, 76 women at 28–50 d, and 42 women at 88–119 d postpartum. Maternal dietary intake during pregnancy and lactation was assessed by an FFQ. Linear mixed-effects models with interaction terms were used to evaluate changes in milk B-vitamin and choline concentrations over time based on maternal factors and the early postpartum concentrations of these micronutrients. Results The women with higher early postpartum milk concentrations of niacin (βinteraction = −0.02; SE = 0.00; P < 0.001), pantothenic acid (βinteraction = −0.10; SE = 2.56; P < 0.001), vitamin B-12 (βinteraction= −0.10; SE = 0.03; P < 0.001), and choline (βinteraction= −0.90; SE = 0.18; P < 0.001) exhibited a decrease in their concentrations throughout lactation. The participants with overweight and obesity prepregnancy experienced an increase in milk vitamin B-12 concentrations over time (βinteraction = 0.04; SE = 0.02; P = 0.06). In contrast, a decrease in vitamin B-12 concentration was observed among women with vitamin B-12 intake below the RDA during pregnancy (βinteraction= −0.08; SE = 0.05; P = 0.07). The women with niacin intake below the RDA during lactation experienced an increase in milk concentrations over time (βinteraction = 0.01; SE = 0.01; P = 0.03). A gestational age at birth >40 wk was associated with an increase in milk choline concentration throughout lactation (βinteraction = 0.54; SE = 0.16; P< 0.01). Conclusions Changes in B-vitamin and choline concentrations in human milk over time may be associated with the early concentrations of these micronutrients in milk, maternal prepregnancy BMI, dietary intake, and gestational age at delivery.