title: Thiamine diphosphate in whole blood, thiamine and thiamine monophosphate in breast-milk in a refugee population.
abstract: BACKGROUND
  The provision of high doses of thiamine may prevent thiamine deficiency in the post-partum period of displaced persons.
  
  
  RESULTS
  The study aimed to evaluate a supplementation regimen of thiamine mononitrate (100 mg daily) at the antenatal clinics in Maela refugee camp. Women were enrolled during antenatal care and followed after delivery. Samples were collected at 12 weeks post partum. Thiamine diphosphate (TDP) in whole blood and thiamine in breast-milk of 636 lactating women were measured. Thiamine in breast-milk consisted of thiamine monophosphate (TMP) in addition to thiamine, with a mean TMP to total thiamine ratio of 63%. Mean whole blood TDP (130 nmol/L) and total thiamine in breast-milk (755 nmol/L) were within the upper range reported for well-nourished women. The prevalence of women with low whole blood TDP (<65 nmol/L) was 5% and with deficient breast-milk total thiamine (<300 nmol/L) was 4%. Whole blood TDP predicted both breast-milk thiamine and TMP (R(2) = 0.36 and 0.10, p<0.001). A ratio of TMP to total thiamine ≥63% was associated with a 7.5 and 4-fold higher risk of low whole blood TDP and deficient total breast-milk thiamine, respectively. Routine provision of daily 100 mg of thiamine mononitrate post-partum compared to the previous weekly 10 mg of thiamine hydrochloride resulted in significantly higher total thiamine in breast-milk.
  
  
  CONCLUSIONS
  Thiamine supplementation for lactating women in Maela refugee camp is effective and should be continued. TMP and its ratio to total thiamine in breast-milk, reported for the first time in this study, provided useful information on thiamine status and should be included in future studies of breast-milk thiamine.
authors: Institute of Nutrition, Friedrich-Schiller-University, Jena, Germany. wolfgang.stuetz@uni-jena.de
authors: Wolfgang
authors: W
authors: Stuetz
authors: Verena Ilona
authors: VI
authors: Carrara
authors: Rose
authors: R
authors: McGready
authors: Sue Jean
authors: SJ
authors: Lee
authors: Hans Konrad
authors: HK
authors: Biesalski
authors: François Henry
authors: FH
authors: Nosten
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D016014:Linear Models; D008895:Milk, Human / Q000378:metabolism*; D015999:Multivariate Analysis; D012036:Refugees; D012307:Risk Factors; D013785:Thailand; D013832:Thiamine Deficiency / Q000097:blood; D013833:Thiamine Monophosphate / Q000378:metabolism*; D013835:Thiamine Pyrophosphate / Q000097:blood*; D055815:Young Adult
chemical_list: D013833:Thiamine Monophosphate; D013835:Thiamine Pyrophosphate