(P07-021-25) Multiple Micronutrient-Fortified Bouillon Increases Milk Vitamin B12 but Not Vitamin A Levels Among Lactating Women in Northern Ghana – A Randomized, Controlled Trial

Objectives: We assessed the effect of multiple micronutrient (MN)-fortified bouillon on breast milk concentrations of vitamins B12 (VB12) and A (VA) among non-pregnant, lactating women in northern Ghana.

Methods: Households with non-pregnant, lactating women 15-49 y of age who were breastfeeding an infant 4-18 mo of age (n=645) were randomized to receive either multiple MN-fortified bouillon cubes containing VA and VB12, folate, iron, zinc and iodine, or control bouillon cubes containing iodine only, for 12 wk. MN-fortified cubes were designed to provide ~3 µg/d of VB12 and ~500 µg/d of VA; however, due to a premix error, cubes provided an estimated 50% of the intended VA dose. At baseline, and after 11 and 12 wks of intervention, milk fat was measured by crematocrit, and milk VB12 and VA concentrations were measured by immunoassay and HPLC, respectively. Milk VB12 and VA concentrations were compared by intervention group with repeated measures ANCOVA controlling for baseline values.

Results: Median milk VB12 concentrations were higher in the intervention group (n=281) than in the control group (n=312) at 11 and 12 wk (235.7 [173, 320] pmol/L vs. 189.5 [144, 270] pmol/L (wk 11); and 214.5 [163, 296] pmol/L vs. 188.9 [142, 262] pmol/L (wk 12) respectively, P< 0.001); the prevalence of values < 310 pmol/L was 74.4% vs. 81.3% (wk 11); and 76.6% vs. 82.1% (wk 12), P=0.014. Median [Q1, Q3] milk VA concentration at baseline was 56.0 [36.9, 77.1] nmol/g fat; 13.4% had concentrations < 28 nmol/g fat.
Median milk VA concentrations declined in the intervention and control groups, and did not differ at 11 and 12 wk (40.1 [27.3, 58.9] nmol/g fat vs. 40.2 [26.4, 56.1] nmol/g fat (wk 11), and 37.4 [25.5, 50.1] nmol/g fat vs. 36.2 [23.6, 51.6] nmol/g fat (wk 12), respectively, P=0.140); the prevalence of values < 28 nmol/g fat increased (26.2% vs. 27.9% (wk 11), and 31.2% vs. 35.8% (wk 12), P=0.135).

Conclusions: Multiple MN-fortified bouillon increased milk VB12 concentrations but the prevalence of low values remained high; the intervention had no effect on milk VA, possibly because women received ~50% of the intended daily VA dose.

Funding Sources: Helen Keller International through the Bill & Melinda Gates Foundation