(LB03-26-26) The Effects of Prenatal Multiple-RDA Multiple Micronutrient Supplementation on B Vitamins in Human Milk and Maternal and Infant Plasma: A Randomized, Double-Blind, Placebo-Controlled Trial

Objectives: Maternal and infant B-vitamin status plays critical roles in maternal health and infant growth. T The most widely used antenatal multiple micronutrient supplementation (MMS) formulation provides one recommended dietary allowance (RDA) of each micronutrient, but whether multiple-RDA doses are needed to restore B-vitamin status and improve human milk adequacy remains unclear.


Objective: This research assessed the effects of prenatal MMS providing multiple RDAs of B vitamins on B-vitamin concentrations in human milk and maternal and infant plasma.

Methods: HIV-uninfected pregnant women of 12 to 27 weeks of gestation in Dar es Salaam, Tanzania, were enrolled and randomly assigned to receive a daily MMS tablet or placebo through 6 weeks after delivery. All participants were provided with daily doses of elemental iron (60 mg) and folic acid (0.25 mg) during pregnancy and continued through 6 weeks postpartum. The MMS included vitamin B-1, B-2, B-3, B-6, and B-12 at 6 to 19 times the RDAs. The concentrations of B vitamins in human milk at 6 weeks postpartum (n = 434), maternal plasma at 6 weeks postpartum (n = 452), and infant plasma during 6 to 12 months of age (n = 428) were analyzed.br/>

Results: MMS increased maternal plasma concentrations of vitamins B-1 by 41% (95% CI: 8%, 85%), B-6 by 53% (95% CI: 33%, 75%), and B-12 by 13% (95% CI: 2%, 25%) at 6 weeks postpartum, compared with placebo. MMS increased milk concentrations of vitamins B-1 by 40% (95% CI: 24%, 57%), B-2 by 92% (95% CI: 60%, 130%), B-3 by 44% (95% CI: 16%, 80%), B-6 by 41% (95% CI: 23%, 61%), and B-12 by 28% (95% CI: 10%, 50%) at 6 weeks postpartum. During 6 to 12 months of age, MMS increased infant plasma vitamin B-12 by 14% (95% CI: 4%, 26%) and had no significant effects on other B vitamins in infant plasma.

Conclusions: These findings support further research comparing multiple-RDA MMS formulations with the current one-RDA formulation to examine optimal formulations and doses of prenatal MMS supplements.