Skip to main content
SpringerLink
Log in

Maternal Vitamin A Nutriture and the Vitamin A Content of Human Milk

  • Published:
Journal of Mammary Gland Biology and Neoplasia Aims and scope Submit manuscript

Abstract

Because of the many functions of vitamin A inhuman physiology, deficiency or excess of the vitamin inlactating women or their infants can adversely affecttheir health. Infants are born with low body stores of vitamin A, and rely on vitamin A inmilk to meet their needs. The vitamin A content of milkis related to maternal vitamin A status and maternaldietary vitamin A intake during lactation. Low-income lactating women in non-industrialized countrieshave lower milk vitamin A concentrations than lactatingwomen in industrialized countries. Supplementation oflactating women in non-industrialized countries with vitamin A or beta-carotene has resulted inincreased milk vitamin A concentrations. However, theoptimal timing and dose for sustaining adequate levelsof vitamin A in milk throughout the lactation period has not been determined. Furtherresearch is needed to understand factors affecting thetransfer of vitamin A to milk, and to evaluate variousstrategies for improving the vitamin A status of mothers and infants.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

REFERENCES

  1. J. A. Olson (1996). Vitamin A. In E. Ziegler (ed.), Present Knowledge in Nutrition, ILSI Press, Washington, D.C. pp. 109–119.

    Google Scholar 

  2. World Health Organization (1995). Global Prevalence of Vitamin A Deficiency, World Health Organization, Geneva.

    Google Scholar 

  3. M. W. Bloem, M. Wedel, and R. J. Egger (1990). Mild vitamin A deficiency and risk of respiratory tract disease and diarrhea in preschool and school children in northeastern Thailand. Am. J. Epidemiol. 131:332–339.

    PubMed  Google Scholar 

  4. A. Sommer and K. West, Jr. (1996). Vitamin A deficiency. Health, Survival and Vision, Oxford University Press, Oxford.

    Google Scholar 

  5. A. Sommer, I. Tarwotjo, G. Hussaini, and D. Susanto (1983). Increased mortality in children with mild vitamin A deficiency. Lancet 2:585–588.

    PubMed  Google Scholar 

  6. A. Sommer, J. Katz, and I. Tarwotjo (1984). Increased risk of respiratory disease and diarrhea in children with preexisting mild vitamin A deficiency. Am. J. Clin. Nutr. 40:1090–1095.

    PubMed  Google Scholar 

  7. G. H. Beaton, R. Martorell, K. A., B. Edmonston, G. McCabe, A. C. Ross, and B. Harvey (1993). Effectiveness of vitamin A supplementation in the control of young child morbidity and mortality in developing countries. Nutrition Policy Discussion Paper No. 13 ACC/SCN.

  8. J. Katz, S. K. Khatry, K. P. West, Jr., J. H. Humphrey, S. C. LeClerq, E. Kimbrough, P. R. Pohkrel, and A. Sommer (1995). Nightblindness is prevalent during pregnancy and lactation in rural Nepal. J. Nutr. 125:2122–2127.

    PubMed  Google Scholar 

  9. S. de Pee, C. E. West, Muhilal, D. Karyadi, and J. G. A. J. Hautvast (1995). Lack of improvement in vitamin A status with increased consumption of dark-green leafy vegetables. Lancet 346:75–81.

    PubMed  Google Scholar 

  10. E. Starbuck (1993). Night blindness during pregnancy as a risk marker for early infant death in Jumla, Nepal. Ph.D. Thesis, Johns Hopkins University.

  11. P. Christian, K. P. West, Jr., S. K. Khatry, J. Katz, S. R. Shrestha, E. K. Pradhan, S. C. LeClerq, and R. P. Pokhrel (1998). Night blindness of pregnancy in rural Nepal—nutritional and health risks. Intl. J. Epid. 27:231–237.

    Google Scholar 

  12. K. J. West, S. Khatry, J. Katz, S. C. LeClerq, E. D. Pradhan, S. R. Shrestha, P. B. Connor, S. Dali, A. Adhikari, and R. P. Pokhrel (1997). Impact of weekly supplementation of women with vitamin A or beta-carotene on fetal, infant, and maternal mortality in Nepal. XVIII IVACG Meeting of the International Vitamin A Consultative Group, Cairo, Egypt. International Life Sciences Institute, Washington, D.C.

  13. Z. A. Leitner, T. Moore, and I. M. Sharman (1975). Fatal self-medication with retinol and carrot juice. Proc. Nutr. Sci. 34:44A-45A.

    Google Scholar 

  14. H. K. Biesalski (1989). Comparative assessment of the toxicology of vitamin A and retinoids in man. Toxicology 57:117–161.

    PubMed  Google Scholar 

  15. F. W. Rose (1986). Vitamin A congeners, Teratology 33:355.

    PubMed  Google Scholar 

  16. World Health Organization (1997). Safe vitamin A dosage during pregnancy and lactation, World Health Organization.

  17. J. Mills, J. Simpson, G. Cunningham, M. Conley, and G. Rhoads (1997). Vitamin A and birth defects. Am. J. Obstet. Gynecol., 177:31–36.

    PubMed  Google Scholar 

  18. K. Rothman, L. Moore, M. Singer, U. S. Nguyen, S. Manino, and A. Milunsky (1995). Teratogenicity of high vitamin A intake. N. Engl. J. Med., 333:1369–1373.

    PubMed  Google Scholar 

  19. Teratology Society Public Affairs Committee (1987). Teratology society position paper: Recommendations for vitamin A use during pregnancy Teratology 35:267–268.

    Google Scholar 

  20. A. Czeizel and M. Rockenbauer (1998). Prevention of congenital abnormalities by vitamin A. Int'l. J. Vit. Nutr. Res. 68:219–231.

    Google Scholar 

  21. S. de Pee, C. West, D. Permaesih, S. Martuti, Muhilal, and J. Hautvast (1998). Orange fruit is more effective than are dark-green, leafy vegetables in increasing serum concentrations of retinol and β-carotene in schoolchildren in Indonesia. Am. J. Clin. Nutr. 68:1058–1067.

    PubMed  Google Scholar 

  22. N. W. Solomons and J. Bulux (1993). Plant sources of provitamin A and human nutriture. Nutr. Rev. 51:199–204.

    PubMed  Google Scholar 

  23. K. M. Rigtrup, L. R. McEwen, H. M. Said, and D. E. Ong (1994). Retinyl ester hydrolytic activity is associated with human intestinal brush border membranes. Am. J. Clin. Nutr. 60:111–116.

    PubMed  Google Scholar 

  24. V. Reddy and B. Sivakumar (1972). Studies on vitamin A absorption in children. Indian Pediatrics 9:307–310.

    PubMed  Google Scholar 

  25. D. S. Goodman and W. S. Blaner (1984). Biosynthesis, absorption, and hepatic metabolism of retinol. In The Retinoids, Academic Press, Inc., New York, pp. 1–37.

    Google Scholar 

  26. J. A. Olson (1987). Recommended dietary intakes (RDI) of vitamin A in humans. Am. J. Clin. Nutr. 45:704–716.

    PubMed  Google Scholar 

  27. S. Pereira and A. Begum (1973). Retention of a single oral massive dose of vitamin A. Clin. Sci. Mol. Med. 45:233–237.

    Google Scholar 

  28. J. Kusin, V. Reddy and B. Sivakumar (1974). Vitamin E supplements and the absorption of a massive dose of vitamin A. Am. J. Clin Nutr. 27:774–776.

    PubMed  Google Scholar 

  29. H. E. Sauberlich, H. E. Hodges, D. L. Wallace, H. Kolder, J. E. Canham, J. Hood, N. Raica, Jr., L. K. Lowry (1974). Vitamin A metabolism and requirements in the human studied with the use of labeled retinol. Vit. Horm. 32:251–275.

    Google Scholar 

  30. J. W. Erdman, T. L. Bierer, and E. T. Gugger (1993). Absorption and transport of carotenoids. Ann. NY Acad. Sci. 691:76–85.

    PubMed  Google Scholar 

  31. J. Bauernfeind (1971). Carotenoid vitamin A precursors and analogs in foods and feeds. J. Agr. Food Chem. 20:456–473.

    Google Scholar 

  32. X. D. Wang (1994). Review: Absorption and metabolism of β-carotene. J. Am. Coll. Nutr. 13:314–325.

    PubMed  Google Scholar 

  33. T. van Vliet (1996). Absorption of β-carotene and other carotenoids in humans and animal models. Eur. J. Clin. Nutr. 50:S32–S37.

    Google Scholar 

  34. B. A. Underwood (1990). Methods for assessment of vitamin A status. J. Nutr. 120:1459–1463.

    PubMed  Google Scholar 

  35. S. Pilch (1987). Analysis of vitamin A data from the health and nutrition examination surveys. J. Nutr. 117:636–640.

    PubMed  Google Scholar 

  36. World Health Organization (1996). Indicators for assessing vitamin A deficiency and their application in monitoring and evaluating intervention programmes. WHO/UNICEF, Geneva.

    Google Scholar 

  37. Z. Ajans, A. Sarrif, and M. Husbands (1965). Influence of vitamin A on human colostrum and early milk. Am. J. Clin. Nutr. 17:139–142.

    PubMed  Google Scholar 

  38. J. C. Wallingford and B. A. Underwood (1986). Vitamin A deficiency in pregnancy, lactation, and the nursing child. In J. Bauernfeind (ed.), Vitamin A Deficiency and Its Control, Academic Press, New York, pp. 101–152.

    Google Scholar 

  39. A. Ross, M. Davila, and M. Cleary (1985). Fatty acids and retinyl esters of rat milk: Effects of diet and duration of lactation. J. Nutr. 115:1488–1497.

    PubMed  Google Scholar 

  40. J. Tomlinson, G. E. Mitchell, N. W. Bradley, R. E. Tucker, J. A. Boling, G. T. Shelling (1974). Transfer of vitamin A from bovine liver to milk. J. Anim. Sci. 39:813.

    PubMed  Google Scholar 

  41. S. Donoghue (1988). Vitamin A transport in plasma of ewes during late gestation and into milk during early lactation. J. Vit. Res. 58:3–11.

    Google Scholar 

  42. A. Vahlquist and S. Nilsson (1979). Mechanisms for vitamin A transfer from blood to milk in rhesus monkeys. J. Nutr. 109:1456–1463.

    PubMed  Google Scholar 

  43. A. Ross (1982). Retinol esterification by mammary gland microsomes from the lactating rat. J. Lipid Res. 23:133–144.

    PubMed  Google Scholar 

  44. M. Davila, L. Norris, M. Cleary, and A. Ross (1985). Vitamin A during lactation: Relationship of maternal diet to milk vitamin A content and to the vitamin A status of lactating rats and their pups. J. Nutr. 115:1033–1041.

    PubMed  Google Scholar 

  45. A. C. Ross and E. Garder (1994). The function of vitamin A in cellular growth and differentiation, and its roles during pregnancy and lactation. Adv. Exp. Med. Biol. 352:187–208.

    PubMed  Google Scholar 

  46. A. Pasatiempo and A. C. Ross (1990). Effects of food or nutrient restriction on milk vitamin A transfer and neonatal vitamin A stores in the rat. Brit. J. Nutr. 63:351–363.

    PubMed  Google Scholar 

  47. K. Rasmussen and N. Warman (1983). Effect of maternal malnutrition during the reproductive cycle on growth and nutritional status of suckling rat pups. Am. J. Clin. Nutr. 38:77–83.

    PubMed  Google Scholar 

  48. N. Warman and K. Rasmussen (1983). Effects of malnutrition during the reproductive cycle on nutritional status and lactational performance of rat dams. Nutr. Res. 3:527–545.

    Google Scholar 

  49. R. Stoltzfus and B. A. Underwood (1995). Breastmilk vitamin A as an indicator of the vitamin A status of women and infants. Bull World Health Org. 73:703–711.

    PubMed  Google Scholar 

  50. M. Gebre-Medhin, A. Vahlquist, Y. Hofvander, L. Upsali, and B. Vahlquist (1976). Breast milk composition in Ethiopian and Swedish mothers. I. Vitamin A and β-carotene. Am. J. Clin. Nutr. 29:441–451.

    PubMed  Google Scholar 

  51. B. Fredrikzon, O. Hernell, L. Blackburg, and T. Olivecrona (1978). Bile-salt stimulated lipase in human milk: Evidence of activity in vivo and of a role in the digestion of milk retinol esters. Pediatr. Res. 12:1048–1052.

    PubMed  Google Scholar 

  52. L. Canfield, A. Giuliano, and E. Graver (1995). Carotenoids, Retinoids, and Vitamin A in Human Milk. In R. Jensen, (ed.), Handbook of Milk Composition, Academic Press, San Diego, California.

    Google Scholar 

  53. L. Canfield, A. Giuliano, E. Neilson, B. Blashil, E. Graver, and H. Yap (1998). Kinetics of the response of milk and serum β-carotene to daily β-carotene supplementation in healthy, lactating women. Am. J. Clin. Nutr. 67:276–283.

    PubMed  Google Scholar 

  54. A. Rice, R. Stolzfus, A. de Francisco, J. Chakraborty, C. Kjolhede, and M. Wahed (1999). Maternal vitamin A or β-carotene supplementation in lactating Bangladeshi women benefits mothers and infants but does not prevent subclinical deficiency. J. Nutr. 129:356–365.

    PubMed  Google Scholar 

  55. V. Newman (1993). Vitamin A and Breastfeeding: A Comparison of Data from Developed and Developing Countries, Wellstart International, San Diego, California.

    Google Scholar 

  56. B. A. Underwood (1994). Maternal vitamin A status and its importance in infancy and early childhood. Am. J. Clin. Nutr. 59:517S-524S.

    PubMed  Google Scholar 

  57. R. Stoltzfus, M. Hakimi, K. W. Miller, K. M. Rasmussen, S. Dawiesah, J. P. Habicht, and M. J. Dibley (1993). High dose vitamin A supplementation of breast-feeding Indonesian mothers: Effects on the vitamin A status of mother and infant. J. Nutr. 123:666–675.

    PubMed  Google Scholar 

  58. S. Roy, A. Islam, A. Molla, S. Akramuzzaman, F. Jahan, and G. Fuchs (1997). Impact of a single megadose of vitamin A at delivery on breastmilk of mothers and morbidity of their infants. Eur. J. Clin. Nutr. 51:302–307.

    PubMed  Google Scholar 

  59. P. Venkatachalam, B. Belavady, and C. Gopalan (1962). Studies on vitamin A nutritional status of mothers and infants in poor communities in India. Trop. Pediatr. 61:262–268.

    Google Scholar 

  60. S. Kon and E. Mawson (1950). Human milk. Wartime studies of certain vitamins and constitutents. Med. Res. Council: Spec. Rep. Ser. No.269.

  61. A. Sobel, A. Rosenberg, and B. Kramer (1950). Enrichment of milk vitamin A in normal lactating women. Am. J. Dis. Child. 80:932–943.

    Google Scholar 

  62. M. Hrubetz, J. J. Deul, and B. Hanley (1945). Studies on carotenoid metabolism. V. The effects of a high vitamin A intake on the composition of human milk. J. Nutr. 29:245–254.

    Google Scholar 

  63. Muhilal, A. Murdiana, I. Azis, S. Saidin, A. Basuni Jahari, and D. Karyadi (1988). Vitamin A-fortified monosodium glutamate and vitamin A status: a controlled field trial. Am. J. Clin. Nutr. 48:1265–1270.

    PubMed  Google Scholar 

  64. G. Arroyave, J. R. Aguilar, M. Flores, and M. A. Guzman (1979). Evaluation of sugar fortification with vitamin A at the national level. Pan American Health Organization, Washington, D.C.

    Google Scholar 

  65. L. Villard and C. Bates (1987). Effect of vitamin A supplementation on plasma and breast milk vitamin A levels in poorly nourished Gambian women. Hum. Nut.: Clin. Nutr. 41C:47–58.

    Google Scholar 

  66. R. Tarjan, M. Kramer, K. Szoke, and K. Linder (1963). The effect of different factors on the composition of human milk and its variations. I. The effect of vitamin-rich foods on the composition of human milk. Nutr. Diet. 7:12–29.

    Google Scholar 

  67. S. Patton, L. Canfield, G. Huston, A. Ferris, and R. Jensen (1990). Carotenoids of human colostrum. Lipids 25:159–165.

    PubMed  Google Scholar 

  68. Y. Kim, C. English, P. Reich, L. Gerber, and K. Simpson (1990). Vitamin A and carotenoids in human milk. J. Agr. Food Chem. 38:1930–1933.

    Google Scholar 

  69. L. Canfield, A. Giuliano, E. Neilson, H. H. Yap, E. J. Graver, H. A. Cui, and B. M. Blashil (1997). β-Carotene in breast milk and serum is increased after a single β-carotene dose. Am. J. Clin. Nutr. 66:52–61.

    PubMed  Google Scholar 

  70. H. C. Furr, O. Amedee-Manesme, A. J. Clifford, R. H. Bergen III, A. D. Jones, D. P. Anderson, and J. A. Olson (1989). Vitamin A concentrations in liver determined by isotope dilution assay with tetradeuterated vitamin A and by biopsy in generally healthy adult humans. Am. J. Clin. Nutr. 49:713–716.

    PubMed  Google Scholar 

  71. M. J. Haskell, G. J. Handelman, J. M. Peerson, A. D. Jones, A. Rabbi, M. A. Awal, M. A. Wahed, D. Mahalanabis, and K. H. Brown (1997). Assessment of vitamin A status by the deuterated retinol dilution technique and comparison with hepatic retinol concentration in Bangladeshi surgical patients. Am. J. Clin. Nutr. 66:67–74.

    PubMed  Google Scholar 

  72. M. H. Green, J. B. Green, and K. C. Lewis (1987). Variation in retinol utilization rate with vitamin A status in the rat. J. Nutr. 117:694–703.

    PubMed  Google Scholar 

  73. M. Haskell, R. Mazumder, J. M. Peerson, A. D. Jones, M. A. Wahed, D. Mahalanabis, and K. H. Brown (1999). Use of the deuterated retinol dilution (DRD) technique to assess total body vitamin A stores of adult volunteers consuming different levels of vitamin A. Am. J. Clin. Nutr. (in press).

  74. S. Tanumihardjo, J. Cheng, D. Permaesih, Muherdiyantiningsih, E. Rustan, Muhilal, D. Karyadi, and J. A. Olson (1996). Refinement of the modified relative-dose response test as a method for assessing vitamin A status in a field setting: Experience with Indonesian children. Am. J. Clin. Nutr. 64:966–971.

    PubMed  Google Scholar 

Download references

Authors
  1. Marjorie J. Haskell
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Kenneth H. Brown
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Haskell, M.J., Brown, K.H. Maternal Vitamin A Nutriture and the Vitamin A Content of Human Milk. J Mammary Gland Biol Neoplasia 4, 243–257 (1999). https://doi.org/10.1023/A:1018745812512

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1023/A:1018745812512

Search

Navigation