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Articles

Weekly Vitamin A and Iron Supplementation during Pregnancy Increases Vitamin A Concentration of Breast Milk but Not Iron Status in Indonesian Lactating Women¹

Siti Muslimatun^*,, Marjanka K. Schmidt^*,, Clive E. West^,**2, Werner Schultink, Joseph G. A. J. Hautvast and Darwin Karyadi^*

^* SEAMEO TROPMED Regional Center for Community Nutrition, University of Indonesia, Jakarta, Indonesia; Division of Human Nutrition and Epidemiology, Wageningen University, the Netherlands; ^** Department of Gastroenterology, University Medical Centre Nijmegen, the Netherlands; and Nutrition Section, UNICEF, New York, NY.

²To whom correspondence should be addressed. E-mail: Clive.West{at}staff.nutepi.wau.nl.

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.

KEY WORDS: • iron • vitamin A • pregnant women • weekly supplementation • breast milk

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