Increased urinary methylmalonic acid excretion in breast-fed infants of vegetarian mothers and identification of an acceptable dietary source of vitamin B-12.
Increased urinary methylmalonic acid (UMMA) concentrations might indicate vitamin B-12 deficiency. Our study tested the hypothesis that elevated UMMA in breast-fed infants is associated with decreased maternal serum B-12 concentrations. UMMA concentrations were measured in 17 vegetarian mothers and their infants and in six infants of nonvegetarian mothers. Serum vitamin B-12 concentrations were determined in all mothers. Range of UMMA for vegetarian infants (3-924 mcg/mg [2.6-790.9 mumol/mmol] creatinine) was much broader than that for omnivorous infants (2-25 mcg/mg [1.7-21.4 mumol/mmol] creatinine). Maternal UMMA and serum vitamin B-12 were negatively correlated (r = -0.700, p = 0.003). Infant UMMA concentrations correlated positively with maternal UMMA concentrations (r = 0.686, p = 0.003) and inversely with maternal serum vitamin B-12 concentrations (r = -0.681, p less than 0.001). In three infants with high UMMA concentrations, vitamin B-12 treatment (oral B-12, vitamin B-12 injection, or a modification of maternal diet within the vegetarian philosophy) led to an abrupt decrease of UMMA.
Specker
B L
BL
Department of Pediatrics, University of Cincinnati Medical Center, OH 45267-0541.
Miller
D
D
Norman
E J
EJ
Greene
H
H
Hayes
K C
KC
D000328:Adult; D001942:Breast Feeding; D003404:Creatinine / Q000652:urine; D014676:Diet, Vegetarian; D005260:Female; D005504:Food Analysis; D006801:Humans; D007223:Infant; D008314:Malonates / Q000652:urine*; D008764:Methylmalonic Acid / Q000652:urine*; D014805:Vitamin B 12 / Q000008:administration & dosage* / Q000032:analysis
D008314:Malonates; D008764:Methylmalonic Acid; D003404:Creatinine; D014805:Vitamin B 12