Browse > Article

Folate Content of Human Milk During Extended Lactation and Folate Nutritional Status of Lactating Women in Korea  

Jeong, Da-Woon (Department of Food & Nutrition, Chonnam National University)
Lim, Hyeon-Soo (Human Ecology Research Institute, Chonnam National University)
Publication Information
Journal of Nutrition and Health / v.41, no.6, 2008 , pp. 518-529 More about this Journal
Abstract
Lactating women have an increased need of folate in the breastfeeding period and, as a consequence, may be in risk of folate deficiency. Folate content of breast milk, furthermore, is important for infants to support exponential growth. However, little is known about the folate content of breast milk from Korean lactating women and their folate nutritional status. In this study, therefore, we investigated the folate status of Korean lactating women and the folate content of their breast milk during extended lactation. A total of 10 subjects who delivered full-term infants participated this study voluntarily. Dietary folate intakes were measured and blood and breast milk were collected at 1, 2, 3, and 6 months postpartum. The women who did not take folic acid supplements failed to meet the recommended intake(RI) of folate for lactating women during all the study periods but those who did met the RI. The unsupplemented women showed lower plasma folate concentrations compared to the supplemented women and all the women were in suboptimal folate status determined by plasma folate concentration throughout the study periods. But the supplemented women showed lower prevalence of suboptimal folate status only at 3 or 6 months postpartum. Plasma folate concentrations of both groups decreased with the progression of lactation. Erythrocyte folate concentrations were not different between the two groups, however, that of the unsupplemented reduced further as time progressed. Plasma homocysteine levels were not different between the two groups. Concentrations of erythrocyte folate and plasma homocysteine were not changed throughout the study periods. Folate contents of their breast milk through the study periods were not different between the two groups and it decreased as lactation progressed in both groups. The results of this study suggest that the folate nutritional status of Korean lactating women might be deteriorated with the progression of lactation without folic acid supplements.
Keywords
folate; human milk; lactating women; folate supplementation;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Smith AM, Picciano MF, Deering RH. Folate intake and concentrations in term infants. Am J Clin Nutr 1988; 41(3): 590-598
2 Milunsky A, Jick H, Jick SS, Bruell CL, Maclaughld DS, Rothman KJ, Willett W. Multivitamin folic acid supplementation in early pregnancy reduces the prevalence of neural tube defects. JAMA 1989; 24: 262(20): 2847-2852
3 Aiso K, Tamura T. Trienzyme treatment for food folate analysis: optimal pH and incubation time for alpha-amylase and protease treatment. J Nutr Sci Vitaminol (Tokyo) 1998; 44(3): 361-70   DOI
4 Ingram CF, Fleming AF, Patel M, Galpin JS. Pregnancy- and lactation-related folate deficiency in South Africa-a case for folate food fortification. S Afr Med J 1999; 89(12): 1279-1284
5 Udipi SA, Kirksey A, Roepke JLB. Diurnal variation in folacin levels of human milk: use of a single sample to represent folacin concentration in milk during a 24-h period. Am J Clin Nutr 1987; 45(4): 770-779   DOI
6 O'Connor DL, Tamura T, Picciano MF. Pteroylpolyglutamates in human milk. Am J Clin Nutr 1991; 53(4): 930-934   DOI
7 EK J. Plasma, red cell, and breast milk folacin concentrations in lactation women. Am J Clin Nutr 1983; 38(6): 929-935   DOI
8 FAO. Requirement of vitamin A, iron, folate and vitamin B12. Report of a joint FAO/WHO export consultation. FAO food and nutrition series No 23. Rome; 1988
9 Imamura A. Iron, folate and vitamin B12 in maternal blood and breast milk. Acta Obstet Gynaecol Jpn 1981; 33(7): 1053-1061
10 Min HS. Folate status and plasma homocysteine concentration of Korean adults. Korean J Nutr 2001; 34(4): 393-400
11 Lee JA, Lee JI, Lim HS. Maternal folate status and its influencing factors in early pregnancy. J Korean Soc Food Sci Nutr 2004; 33(2): 331-338   DOI
12 Houghton LA, Sherwood KL, O'Connor DL. How well do blood folate concentrations predict dietary folate intakes in a sample of Canadian lactating women expressed to high levels of folate? An observational study. BMC Pregnant Childbirth 2007; 7: 25   DOI
13 Glorimar R, Pereira SE, Trugo NM. Longitudinal change in plasma total homocysteine during pregnancy and postpartum in Brazilian women and its relation with folate status and other factors. Int J Vitam Nutr Res 2004; 74(2): 95-101   DOI
14 Bruinse HW, van den Berg H, Haspels AA. Maternal serum folacin levels during and after normal pregnancy. Eur J Obstet Gynecol Reprod Biol 1985; 20(4): 153-158   DOI   ScienceOn
15 Tamura T. Microbiological assay of folate. In: Folate in Health and Disease. Picciano MF, Gregory JF, Stokstad ELR (eds). p.121-137, New York: Marcel Dekker Inc; 1995
16 Bank MR, Kirksey A. Effect of storage time and temperature on folacin and vitamin C levels in term and preterm human milk. Am J Clin Nutr 1985; 41(2): 235-242   DOI
17 Keizer SE, Gibson RS, O'Connor DL. Postpartum folic acid supplementation of adolescents: Impact on maternal folate and zinc status and milk composition. Am J Clin Nutr 1995; 62(2): 377-384   DOI
18 Butte NF, Calloway DH. Evaluation of nutritional performance of Navajo women. Am J Clin Nutr 1981; 34(10): 2216-2228   DOI
19 Sauberlich HE. Evaluation of folate nutrition in population groups. In: Folic Acid Metabolism in Health and Disease Picciano MF, Stokstad ELR and Gregory JF (eds). p.211, New York: Wiley-Liss; 1990
20 Quist J, Abdulla M, Jagerstad M, Svensson S. Iron, zinc, and folate status during pregnancy and two months after delivery. Acta Obstet Gynecol Scand 1986; 65(1): 15-22
21 Mudd SH, Havlik R, Levy HL, McKusick VA, Feinleib M. Cardiovascular lisk in heterozygotes homocystinuria. Am J Hum Genet 1983; 34(6): 1018-21
22 Sneed SM, Zane C, Thomas MR. The effects of ascorbic acid, vitamin B6, vitamin B12, and folic acid supplementation on the breast milk and maternal nutritional status of low socioeconomic lactating women. Am J Clin Nutr 1981; 34(7): 1338-1346   DOI
23 Milan N, Byg KE, Hvas AM, Bergholt T, Eriksen L. Erythrocyte folate, plasma folate and plasma homocysteine during normal pregnancy and postpartum: a longitudinal study comparing 404 Danish women. Haematology 2006; 76(3): 200-205
24 Tamura T, Picciano MD. Folate determination in human milk. J Nutr Sci Vitaminol 2006; 52(2): 161   DOI
25 Mackey AD, Picciano MF. Maternal folate status during extended lactation and the effect of supplemental folic acid. Am J Clin Nutr 1999; 69(2): 285-292   DOI
26 Hibbard BM. Folate and fetal development. Br J Gynaecol 1993; 100(4): 307-309   DOI
27 Bates CJ, Fuller NJ, Prentice Am. Folate status during pregnancy and lactation in a west African rural community. Hum Nutr Clin Nutr 1986; 40(1): 3-13
28 Nelson MM, Evans HM. The effect of succinylsulfathiazole on pteroylglutamic acid deficiency during lactation in the rat. Arch Biochem 1948; 18(1): 153-159
29 The Korean Nutrition Society. Dietary Reference Intakes for Koreans (KDRIs). Gukjin Publishing Co., Seoul; 2005
30 O'Connor DL, Green T, Piccano MF. Maternal folate status and lactation. J Mamary Gland Biol Neoplasia 1997; 2(3): 279-289   DOI   ScienceOn
31 Tamura T, Yoshimura Y, Arakawa T. Human milk folate and folate status in lactating mothers and their infants. Am J Clin Nutr 1980; 33(2): 193-197   DOI
32 Lim HS. Folate status in pregnant and lactating women. J Korean Soc Food Sci Nutr 1997; 26(5): 983-992
33 Ubbink JB, Vermaak WJH, Bennett JM, Becker PJ, van Staden DA, Bissbort S. The prevalence of homocysteine and hypercholesterolemia in angiographically defined coronary heart disease. Klin Wochenschr 1991; 69(12): 527-534   DOI   ScienceOn
34 Thomas MR, Sneed SM, Wei C, Nail PA, Wilson M, Sprinkle EE 3rd. The effects of vitamin C, vitamin $B_6$, vitamin $B_{12}$, folic acke, riboflavin, and thiamin on the breast milk and maternal status of well-nourished women at 6 months postpartum. Am J Clin Nutr 1980; 33(10): 2151-2156   DOI
35 Ramlau-Hansen CH, Moller UK, Henriksen TB, Nexo E, Moller J. Folate and vitamin $B_{12}$ in relation to lactation: a 9-month postpartum follow-up study. Eur J Clin Nutr 2006; 60(2): 120-128   DOI   ScienceOn
36 Lee JI. Lim HS. A longitudinal study on maternal iron and folate status during and after pregnancy in Korean women. Korean J Community Nutrition 2001; 6(2): 182-191
37 Araki A, Sako Y, Ito H. Plasma homocysteine concentration in Japanese patients with non-insulin dependent diabetes mellitus; effect of parenteral methylcobalamin treatment. Atherosclerosis 1993; 103(2): 149-157   DOI   ScienceOn
38 Refsum H, Ueland PM, Svardal AM. Fully automated fluorescence assay for determining total homocysteine in plasma. Clin Chem 1989; 35(9): 1921-1927
39 Lindenbaum J, Allen RH. Clinical spectrum and diagnosis of folate deficiency. In: Folate in Health and Disease. LB Bailey (ed). p.43-74. New York: Marcel Dekker Inc; 1995
40 Metz J, Zalusky R, Herbert V. Folic acid binding by serum and milk. Am J Clin Nutr 1968; 21(4): 289-297   DOI
41 Cooperman JM, Dweck HS, Newman LJ, Garbarino C, Lopez R. The folate in human milk. Am J Clin Nutr 1982; 36(4): 576-580   DOI
42 Smith AM, Picciano MF, Deering RH. Folate supplementation during lactation: maternal folate status, human milk folate content, and their relationship to infant folate status. J Pediatric Gastroenterol Nutr 1983; 2(4): 622-628   DOI
43 Chang NS, Kang MH, Paik HY, Kim IH, Cho YW, Park SC, Shin YW. Serum folate and iron levels of pregnant, lactating, and non-pregnant, non-lactating women. Korean J Nutr 1993; 26(1): 67-75
44 Tamura T, Picciano MD. Folate and human reproduction. Am J Clin Nutr 2006; 83(5): 993-1016   DOI
45 Ramlau-Hansen CH, Moller UK, Maller J, Thulstrup AM. Lactation-a risk factor for elevated plasma homocysteine? Ugeskr_Laeger 2003; 165(28): 2819-2823
46 Lim HS, Mackey AD, Tamura T, Wong SC, Picciano MF. Measurable human milk folate is increased by treatment with $\alpha$- amylase and protease in addition to folate conjugase. Food Chem 1998; 63(3): 401-407   DOI   ScienceOn
47 Lim HS, Heo YR. Plasma total homocysteine, folate, and vitamin $B_{12}$ status in Korean adults. J Nutr Sci Vitaminol (Tokyo) 2002; 48(4): 290-297   DOI
48 Lee SO, Lee YK, Kim EA, Jang NS, Kim YJ. The Comparison of pregnant and nan-pregnant women for homocysteine, vitamin $B_{12}$ levels and the study of factors effecting on homocysteine, vitamin $B_{12}$. Korean J Obstet and Gynaecol 2003; 46(8): 1550-1555
49 Metz J. Folate deficiency conditioned by lactation. Am J Clin Nutr 1970; 23(6): 843-847   DOI