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Table 2 Summary effect of nutritional vitamins supplements on status of vitamin B human milk composition

From: Nutritional supplements and mother’s milk composition: a systematic review of interventional studies

First author surname, citation number

Type of Supplement

Characteristics of Participants

Type of study

Aim

Type of Nutrients Evaluated in Milk

Main findings

Jadad scale points and WHO divisions

Bates [44]

60 mothers living in two Gambian villages were given either 2 mg riboflavin or a placebo daily on a double-blind basis for 12 wk. Their riboflavin intake from dietary sources was about 0.5 mg/day

60 lactating mothers (mean age was 28.0 yr; their mean parity, 4. 1,)

Randomized double-blinded clinical trial

To evaluate the effect of a moderate increase in riboflavin intake on breast milk riboflavin level.

Riboflavin

Clinical signs associated with riboflavin deficiency improved more rapidly in the supplemented group; their breast milk riboflavin levels increased, and their infants’ activation coefficients (AC) were reduced, compared with those of the placebo group. After withdrawal of the supplement, the maternal and infants’ AC’s rose toward those of the placebo group.

4/5

Africa (AFRO)

Chang [45]

Mothers received pyridoxine (PN) supplements of 2.5, 4.0, 7.5, or 10.0 mg/d, respectively

Forty-seven infants born to healthy women were divided into four groups.

Randomized clinical trial

To assess maternal vitamin B6 intake and breast milk concentration of vitamin B6.

Vitamin B6

Mean vitamin B6 concentrations in breast milk were significantly lower for women supplemented with 2.5 mg PN.ehcl/d than for those supplemented with 4.0, 7.5, or 10.0 mg/d.

1/5

Americas (AMRO)

Duggan [46]

Daily oral dose of vitamin B-12 (50 mg) or a placebo identical in appearance.

One hundred eighty-three women were randomly assigned to receive vitamin B-12 and 183 to receive placebo.

A randomized, double-blind, placebo-controlled trial

To evaluate the effect of maternal supplementation of vitamin B-12 during pregnancy and lactation on maternal and infant biomarkers of vitamin B-12 status.

Milk vitamin B-12

At 6 wk. postpartum, median breast milk vitamin B-12 concentration was increased in vitamin B-12–supplemented women than placebo group (P < 0.0005). Oral supplementation of urban Indian women with vitamin B-12 throughout pregnancy and early lactation significantly increases vitamin B-12 status of mothers and infants.

5/5

South East Asia (SEARO)

Hampel [47]

Lipid-based nutrient supplements (LNS)

(n = 258) or 6 (n = 104), and 24 weeks (n = 362) from HIV infected Malawian mothers.

Randomized clinical trial

To investigate the contribution of each thiamin and riboflavin vitamer and the effect of lipid-based nutrient supplements (LNS) on the vitamer distribution at early and later stages of lactation.

Thiamin vitamers,

Riboflavin and FAD,

Thiamin-pyrophosphate

(TPP),

Lipid-based nutrient significantly increased Thiamin-monophosphate and free thiamin only at 2 weeks compared to the control. Free riboflavin was consistently and significantly increased with LNS versus control.

1/5

Africa (AFRO)

Hampel [48]

Thiamin, riboflavin, niacin, and vitamins B-6, B-12, A, and E.

18 healthy women (aged 18–26 years)

Randomized clinical trial

To evaluate the effects of sample collection protocols, variations in circadian rhythms, subject variability, and acute maternal micronutrient supplementation on milk vitamin concentrations.

Thiamin, riboflavin, niacin, and vitamins B-6, B-12, A, and E and fat were measured in each sample

No significant differences were observed for thiamin and vitamins B-12, A, E, and A. Vitamin B-6 concentrations increased linearly after supplements were consumed, whereas milk concentrations of riboflavin increased on day 3 and 4 compared with day 1.

1/5

South East Asia (SEARO)

Siddiqua [49]

250 μg/day B12 or a placebo throughout pregnancy and 3-month postpartum along with 60 mg iron + 400 μg folate.

68 women age 18–35 years.

Randomized clinical trial

To assess the effect of B12 supplementation in pregnancy and lactation on alleviation of anemia, and improvement of B12 status and vaccine-specific immunity in mothers and infants.

Vitamin B12

Supplementation increased B12 in plasma, colostrums and breast milk (p < 0.05) and lowered methylmalonic acid in neonates, mothers and infants at 3 months (p < 0.05).

Supplementation with 250 mg/day B12 during pregnancy and lactation substantially improved maternal, infant and breast milk B12 status.

4/5

South East Asia (SEARO)

Styslinger [50]

Pyridoxine HCI

Twenty-four healthy, lactating women with full-term, healthy infants and their ages ranged from 20 to 36 years.

Randomised-controlled trial

To examine the effects of such changes on the breastfed infants’ intake of vitamin B-6.

Vitamin b6

A significant (p < 0.001) positive correlation (r = 0.80) was found between maternal intake and the level of the vitamin in milk. The mean vitamin 8–6 content in milk of subjects supplemented with 20.0 mg vitamin 8–6/day was significantly higher (p < 0.05) than that for any other group.

1/5

Americas (AMRO)

Thomas [51]

Vitamin A, Vitamin D, Vitamin E, Vitamin C, Folic acid, Thiamin, Riboflavin, Niacin, Vitamin B6, Vitamin B12, Calcium, Iodine, Iron, Magnesium.

17 mothers at the end of gestation (18 to 35 years of age)

Randomised-controlled trial

To study the effects of vitamin supplements and/or diet on the levels of vitamin C, vitamin B6, and vitamin B12 in milk and blood of lactating women.

Vitamin B6, B12 and C

The vitamin B6 level in breast milk of the unsupplemented group of mothers was significantly lowers (P < 0.05) than the supplemented group of women at 5 to 7 days postpartum. Vitamin B12 concentration in milk of nonsupplemented mothers at 43 to 45 days postpartum was significantly lowers (P < 0.05) than the supplemented group of women at 43 to 45 days postpartum.

1/5

Americas (AMRO)