title: Serum and breast-milk vitamin A in women during lactation in rural Chiang Mai, Thailand.
abstract: Vitamin A deficiency can occur during lactation and breast-milk vitamin A has been recommended for monitoring the vitamin A status of lactating women and their infants. This study aimed to investigate the vitamin A status of lactating women in relation to race, age, parity, duration of lactation and anthropometric status. A cross-sectional study was conducted among 262 lactating women in rural Chiang Mai, Thailand. Blood and breast-milk samples were collected. Serum retinol, carotene and breast-milk retinol concentrations were analysed by high-performance liquid chromatography. The results show that mean serum retinol and breast-milk retinol in hill tribes were significantly lower than in Thais, 1.91 (0.59) and 0.79 (0.52) compared with 2.10 (0.51) and 1.04 (0.58) mumol/L, respectively. Mean serum retinol and breast-milk retinol were highest during the 1st 3 months of lactation. Maternal age, parity and anthropometric status (BMI) were not associated with serum or breast-milk retinol concentrations. There was a significant relationship between serum and breast-milk retinol values in women who breastfed for 6 months or longer (regression co-efficients 0.30; 95% CI 0.16, 0.43). Breast-milk retinol levels declined significantly from 4 to 12 months after delivery, which could increase the risk of vitamin A deficiency in children who were exclusively breastfed or receiving inappropriate complementary foods during this period. Weaning foods which commence at 6 months and have an adequate vitamin A content should ensure that the vitamin A status of the young child is maintained.
authors.affiliation: Department of Community Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand. rpanpani@mail.med.cmu.ac.th
authors.forename: Ratana
authors.initials: R
authors.lastname: Panpanich
authors.forename: Kannika
authors.initials: K
authors.lastname: Vitsupakorn
authors.forename: Gregory
authors.initials: G
authors.lastname: Harper
authors.forename: Bernard
authors.initials: B
authors.lastname: Brabin
mesh_terms: D000328:Adult; D015992:Body Mass Index; D001942:Breast Feeding / Q000208:ethnology; D002851:Chromatography, High Pressure Liquid; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007774:Lactation / Q000097:blood / Q000208:ethnology / Q000378:metabolism*; D008423:Maternal Age; D008895:Milk, Human / Q000737:chemistry*; D010298:Parity; D012044:Regression Analysis; D012423:Rural Health; D013785:Thailand / Q000453:epidemiology / Q000208:ethnology; D013997:Time Factors; D014801:Vitamin A / Q000032:analysis* / Q000097:blood; D014802:Vitamin A Deficiency / Q000453:epidemiology / Q000209:etiology*
chemical_list: D014801:Vitamin A