title: Vitamin A concentration in human milk and its relationship with liver reserve formation and compliance with the recommended daily intake of vitamin A in pre-term and term infants in exclusive breastfeeding.
abstract: OBJECTIVE
  To evaluate vitamin A concentration in mature breast milk of nursing mothers aiming to meet the daily needs and the formation of liver reserve in pre-term (PT) and term infants (T) in comparison with the recommended intake for this nutrient in this group.
  
  
  METHODS
  We analyzed the retinol concentration in the milk of 120 nursing mothers (40 of PT infants and 80 of T infants) by collecting 10 mL of mature breast milk, held by a hand spray of one of the breasts 2 h after the last feeding in the morning. The cutoff points adopted for identification of vitamin A deficiency (VAD) and the liver reserve were <1.05 and >2.3 μmol/L, respectively.
  
  
  RESULTS
  The concentrations of retinol in the human milk of T infants were superior to concentrations in the milk of PT infants (1.87 + 0.81 > 1.38 + 0.67 μmol/L, p < 0.0001). They were higher in T compared to PT (352.64 + 152.72 > 217.65 + 105.65 μg, p < 0.0001), but both were below the recommendation. VAD was 20.0 % (T) and 27.5 % (PT). Only 40.0 % (T) and 22.5 % (PT) of the mothers had retinol concentrations in milk above 2.3 mmol/L.
  
  
  CONCLUSIONS
  The milk of the nursing mothers studied did not have enough retinol to meet the daily needs and to form liver reserve in both groups, especially in PT newborns. This finding reinforces the idea that supplementation with massive doses of vitamin A in the immediate postpartum period can be used as a protective device of the infant against VAD.
authors.affiliation: Faculty of Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Gisele
authors.initials: G
authors.lastname: Souza
authors.forename: Manoela
authors.initials: M
authors.lastname: Dolinsky
authors.forename: Andréa
authors.initials: A
authors.lastname: Matos
authors.forename: Cristiane
authors.initials: C
authors.lastname: Chagas
authors.forename: Andréa
authors.initials: A
authors.lastname: Ramalho
mesh_terms: D000328:Adult; D001942:Breast Feeding; D019587:Dietary Supplements; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008099:Liver / Q000737:chemistry; D008297:Male; D008895:Milk, Human / Q000737:chemistry*; D009035:Mothers; D049590:Postpartum Period; D064167:Recommended Dietary Allowances; D047929:Term Birth; D014801:Vitamin A / Q000032:analysis*; D014802:Vitamin A Deficiency / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D014801:Vitamin A