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Community and International Nutrition

Breast Milk Retinol Concentrations Are Not Associated with Systemic Inflammation among Breast-Feeding Women in Malawi¹

Barbara Dancheck², Veronique Nussenblatt, Michelle O. Ricks, Newton Kumwenda^*, Margaret C. Neville, Dana T. Moncrief, Taha E. Taha^** and Richard D. Semba

Department of Ophthalmology, Johns Hopkins School of Medicine, Baltimore, MD; ^* College of Medicine, University of Malawi, Blantyre, Malawi; Department of Physiology, University of Colorado School of Medicine, Denver, CO; and ^** Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD

²To whom correspondence should be addressed. E-mail: bdanche1{at}jhmi.edu.

The acute phase response and inflammation are associated with lower plasma retinol concentrations, but their effect on breast milk retinol concentrations is unclear. We measured plasma retinol concentrations, acute phase proteins, and breast milk retinol concentrations in 237 breast-feeding women at 2 wk postpartum in Blantyre, Malawi; 16.5% of the women had plasma retinol < 0.70 µmol/L and 14.8% had breast milk retinol < 1.05 µmol/L. Among women with and without inflammation [₁-acid glycoprotein (AGP) > 1 g/L and/or C-reactive protein (CRP) > 5 mg/L], geometric mean (95% CI) plasma retinol was 0.89 (0.84, 0.94) and 1.05 (1.01, 1.17) µmol/L, respectively (P < 0.0001). Among women with and without inflammation, geometric mean (95% CI) breast milk retinol was 2.12 (1.89, 2.36) and 2.05 (1.75, 2.39) µmol/L, respectively (P = 0.74). In multiple linear regression models adjusting for age, parity, education, BMI, and days postpartum, plasma retinol concentrations were associated with plasma AGP and CRP concentrations (P < 0.0001 and P = 0.01, respectively), whereas breast milk retinol concentrations were unaffected by plasma AGP and CRP concentrations (P = 0.22 and P = 0.86, respectively). These findings suggest that breast milk retinol concentrations are not affected by systemic inflammation.

KEY WORDS: • acute phase response • inflammation • milk • retinol • vitamin A deficiency

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