Maternal folate status during extended lactation and the effect of supplemental folic acid
Open accessAbstract
Background Folate requirements during lactation are not well established.Objective We assessed the effects of dietary and supplemental folate intakes during extended lactation.Design Lactating women (n = 42) were enrolled in a double-blind, randomized, longitudinal supplementation trial and received either 0 or 1 mg folic acid/d. At 3 and 6 mo postpartum, maternal folate status was assessed by measuring erythrocyte, plasma, milk, and dietary folate concentrations; plasma homocysteine; and hematologic indexes. Infant anthropometric measures of growth, milk intake, and folate intake were also assessed.Results In supplemented women, values at 6 mo for erythrocyte and milk folate concentrations and for plasma homocysteine were not significantly different from those at 3 mo. In supplemented women compared with unsupplemented women at 6 mo, values for erythrocyte folate (840 compared with 667 nmol/L; P < 0.05), hemoglobin (140 compared with 134 g/L; P < 0.02), and hematocrit (0.41 compared with 0.39; P < 0.02) were higher and values for reticulocytes were lower. In unsupplemented women, milk folate declined from 224 to 187 nmol/L (99 to 82 ng/mL), whereas plasma homocysteine increased from 6.7 to 7.4 micromol/L. Dietary folate intake was not significantly different between groups (380+/-19 microg/d) and at 6 mo was correlated with plasma homocysteine in unsupplemented women (r = -0.53, P < 0.01) and with plasma folate in supplemented women (r = 0.49, P < 0.02).Conclusions A dietary folate intake of approximately 380 microg/d may not be sufficient to prevent mobilization of maternal folate stores during lactation.
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The available data suggest that, even in industrialized countries, some infants who are breastfed may not be receiving optimal amounts of certain micronutrients, as the levels found in breastmilk, maternal serum or urine did not always reach recommended levels in all women.
“The available data suggest that, even in industrialized countries, some infants who are breastfed may not be receiving optimal amounts of certain micronutrients, as the levels found in breastmilk, maternal serum or urine did not always reach recommended levels in all women [73,85,86,87,88,89,90,91,92,93,94,95].”
From Immune function and micronutrient requirements change over the life course (2018) · cites this paper as [85]
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Recommended Dietary Allowances.
(1991) · Annals of Internal Medicine · doi:10.7326/0003-4819-114-9-822_3 · Cited by 3,926 · see citing works
Czeizel, A. E., & Dudás, I. (1992) · New England Journal of Medicine · doi:10.1056/nejm199212243272602 · Cited by 3,200 · see citing works
Institute of Medicine (1998) · National Academies Press eBooks · doi:10.17226/6015 · Cited by 2,464 · see citing works
Prevention of neural tube defects: Results of the Medical Research Council vitamin study
Wald, N., Sneddon, J., Densem, J. W., Frost, C. D., & Stone, R. (1992) · International Journal of Gynecology & Obstetrics · doi:10.1016/0020-7292(92)90076-u · Cited by 2,364 · see citing works
Plasma Homocysteine Levels and Mortality in Patients with Coronary Artery Disease
Nygard, O. K., Nordrehaug, J. E., Refsum, H., Ueland, P. M., Farstad, M., & Vollset, S. E. (1997) · New England Journal of Medicine · doi:10.1056/nejm199707243370403 · Cited by 1,746 · see citing works
Breastfeeding and the Use of Human Milk
Work Group on Breastfeeding (1997) · PEDIATRICS · doi:10.1542/peds.100.6.1035 · Cited by 1,255 · see citing works
Marasinghe, M. G., Freund, R. J., Littell, R. C., et al. (1988) · Technometrics · doi:10.2307/1270330 · Cited by 1,056 · see citing works
Araki, A., & Sako, Y. (1987) · Journal of Chromatography B Biomedical Sciences and Applications · doi:10.1016/0378-4347(87)80438-3 · Cited by 1,052 · see citing works
Total homocysteine in plasma or serum: methods and clinical applications
Ueland, P. M., Refsum, H., Stabler, S. P., Malinow, M. R., Andersson, A. D. R., & Allen, R. H. (1993) · Clinical Chemistry · doi:10.1093/clinchem/39.9.1764 · Cited by 984 · see citing works
Folate, I. P. O., & Vitamins, O. B. (1998) · Cited by 962 · see citing works
Bailey, L. B. (2009) · CRC Press eBooks · doi:10.1201/9781420071252 · Cited by 636 · see citing works
Ziegel, E. R., Littell, R. C., Freund, R. J., & Spector, P. (1992) · Technometrics · doi:10.2307/1268965 · Cited by 557 · see citing works
Selhub, J., & Jw, M. (1992) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/55.1.131 · Cited by 555 · see citing works
NCHS Growth Curves for Children Birth-18 Years
Hamill, P. V. V., Drizd, T. A., Johnson, C. L., Reed, R. B., & Roche, A. F. (1977) · Defense Technical Information Center (DTIC) · Cited by 532 · see citing works
Neville, M. C., Keller, R., Seacat, J. M., Lutes, V., Lutes, M., Casey, C. E., Allen, J., & Archer, P. (1988) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/48.6.1375 · Cited by 417 · see citing works
Manual for Scoring Socioeconomic Status for Research on Health Behavior
Green, L. W. (1970) · Public Health Reports (1896-1970) · doi:10.2307/4593972 · Cited by 396 · see citing works
Bowman, B. A. (1995) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/62.5.1029 · Cited by 308 · see citing works
Protein-bound homocyst(e)ine. A possible risk factor for coronary artery disease.
Kang, S. S., WONG, P. W. K., Cook, H. Y., Norušis, M. J., & Messer, J. V. (1986) · Journal of Clinical Investigation · doi:10.1172/jci112461 · Cited by 302 · see citing works
Epidemiology and Control of Neural Tube Defects
Elwood, M., Little, J., & Elwood, J. (1992) · doi:10.1093/oso/9780192618849.001.0001 · Cited by 300 · see citing works
Folate requirement and metabolism in nonpregnant women
Sauberlich, H. E., Kretsch, M. J., Skala, J. H., et al. (1987) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/46.6.1016 · Cited by 226 · see citing works
The natural history of vascular disease in homocystinuria and the effects of treatment
Wilcken, D. E. L., & Wilcken, B. M. (1997) · Journal of Inherited Metabolic Disease · doi:10.1023/a:1005373209964 · Cited by 225 · see citing works
Pfeiffer, C. M., Rogers, L. M., & Gregory, J. F. (1997) · Journal of Agricultural and Food Chemistry · doi:10.1021/jf960633q · Cited by 209 · see citing works
Pfeiffer, C. M., Rogers, L. M., & Gregory, J. F. (1997) · Journal of Agricultural and Food Chemistry · doi:10.1021/jf970374k · Cited by 180 · see citing works
Pfeiffer, C., Rogers, L. M., Bailey, L., et al. (1997) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/66.6.1388 · Cited by 157 · see citing works
Analysis of Folate Data from the Second National Health and Nutrition Examination Survey (NHANES II)
Senti, F. R., & Pilch, S. M. (1985) · Journal of Nutrition · doi:10.1093/jn/115.11.1398 · Cited by 146 · see citing works
Food Folate Assay with Protease, α-Amylase, and Folate Conjugase Treatments
Tamura, T., Mizuno, Y., Johnston, K. E., et al. (1997) · Journal of Agricultural and Food Chemistry · doi:10.1021/jf960497p · Cited by 122 · see citing works
Maternal serum folate and zinc concentrations and their relationships to pregnancy outcome
Tamura, T., Goldenberg, R., Freeberg, L., Cliver, S., Cutter, G., & Hoffman, H. (1992) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/56.2.365 · Cited by 119 · see citing works
Human Lactation. Milk Components and Methodologies
Finley, D. (1987) · Journal of Nutrition · doi:10.1093/jn/117.2.396 · Cited by 117 · see citing works
Controlled Dietary Folate Affects Folate Status in Nonpregnant Women
O'Keefe, C. A., Bailey, L. B., Thomas, E. A., Hofler, S. A., Davis, B. A., Cerda, J. J., & Gregory, J. F. (1995) · Journal of Nutrition · doi:10.1093/jn/125.10.2717 · Cited by 110 · see citing works
Folic Acid Binding by Serum and Milk
Metz, J., Zalusky, R., & Herbert, V. D. (1968) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/21.4.289 · Cited by 94 · see citing works
Assessment of homocysteine status
Refsum, H., Fiskerstrand, T., Guttormsen, A. B., et al. (1997) · Journal of Inherited Metabolic Disease · doi:10.1023/a:1005321225893 · Cited by 91 · see citing works
Application of a Tri-Enzyme Extraction for Total Folate Determination in Foods
Martin, J. I., Landen, W. O., Soliman, A.-G. M., et al. (1990) · Journal of AOAC INTERNATIONAL · doi:10.1093/jaoac/73.5.805 · Cited by 91 · see citing works
Human milk folate and folate status in lactating mothers and their infants
TAMURA, T., Yoshimura, Y., & Arakawa, T. (1980) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/33.2.193 · Cited by 90 · see citing works
Making sense of laboratory tests of folate status: Folate requirements to sustain normality
Herbert, V. D. (1987) · American Journal of Hematology · doi:10.1002/ajh.2830260211 · Cited by 87 · see citing works
Thomas, M. R., Sneed, S. M., Wei, C., et al. (1980) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/33.10.2151 · Cited by 75 · see citing works
Plasma Folate Adequacy as Determined by Homocysteine Level a
Lewis, C. A., PANCHARUNITI, N., & Sauberlich, H. E. (1992) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1992.tb17123.x · Cited by 69 · see citing works
Iron, Zinc and Folate Status During Pregnancy and Two Months After Delivery
Qvist, I., Abdulla, M., Jägerstad, M., et al. (1986) · Acta Obstetricia Et Gynecologica Scandinavica · doi:10.3109/00016348609158223 · Cited by 68 · see citing works
Folate Supplementation During Lactation
Smith, A. M. V., Picciano, M. F., & Deering, R. H. (1983) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/00005176-198311000-00009 · Cited by 56 · see citing works
Self-citationPteroylpolyglutamates in human milk
O’Connor, D. L., Tamura, T., & Picciano, M. (1991) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/53.4.930 · Cited by 53 · see citing works
Self-citationMaternal folate status and lactation.
O’Connor, D. L., Green, T., & Picciano, M. F. (1997) · Journal of Mammary Gland Biology and Neoplasia · doi:10.1023/a:1026388522182 · Cited by 50 · see citing works
Self-citationLim, H., Mackey, A. D., Tamura, T., et al. (1998) · Food Chemistry · doi:10.1016/s0308-8146(98)00054-5 · Cited by 46 · see citing works
Self-citationProtection of maternal iron stores in pregnancy.
Eb, D., & Wj, M. (1987) · PubMed · Cited by 44 · see citing works
Plasma, red cell, and breast milk folacin concentrations in lactating women
Ek, J. (1983) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/38.6.929 · Cited by 42 · see citing works
Self-Selected Diets of Lactating Women Often Fail to Meet Dietary Recommendations
Mackey, A. D., Picciano, M. F., Mitchell, D. C., et al. (1998) · Journal of the American Dietetic Association · doi:10.1016/s0002-8223(98)00070-4 · Cited by 41 · see citing works
Self-citationLocalized Deficiencies of Folic Acid in Aerodigestive Tissues
Heimburger, D. C. (1992) · Annals of the New York Academy of Sciences · doi:10.1111/j.1749-6632.1992.tb17091.x · Cited by 39 · see citing works
Forms of Human Milk Folacin and Variation Patterns
Brown, C. M., Smith, A. M. V., & Picciano, M. F. (1986) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/00005176-198603000-00020 · Cited by 29 · see citing works
Self-citationSalmenperä, L., Perheentupa, J., & Siimes, M. A. (1986) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/00005176-198605020-00021 · Cited by 27 · see citing works
Salmenperä, L., Perheentupa, J., & Siimes, M. A. (1986) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/00005176-198603000-00021 · Cited by 25 · see citing works
ABRUPTIO PLACENTAE AND DEFECTIVE FOLATE METABOLISM IN SINGAPORE WOMEN
HIBBARD, B. M., Hibbard, E. D., Hwa, T. S., et al. (1969) · BJOG An International Journal of Obstetrics & Gynaecology · doi:10.1111/j.1471-0528.1969.tb09467.x · Cited by 18 · see citing works
Forms of Human Milk Folacin and Variation Patterns
Brown, C. M., Smith, A. M. V., & Picciano, M. F. (1986) · Journal of Pediatric Gastroenterology and Nutrition · doi:10.1097/00005176-198605020-00020 · Cited by 18 · see citing works
Self-citationPicciano, M. F., & Bailey, L. B. (1995) · Cited by 3 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 11
- Institute of Medicine, Food and Nutrition Board, Subcommittee on Nutrition During Pregnancy. Nutrition during pregnancy. Washing- ton, DC: National Academy Press, 1991.
- Institute of Medicine, Food and Nutrition Board, Subcommittee on Nutrition During Lactation. Nutrition during lactation. Washington, DC: National Academy Press, 1991.
- O'Connor DL, Green T, Picciano MF. Maternal folate status and lac- tation. J Mammary Gland Biol Neoplasia 1997;2:279-89.
- Tamura T. Microbiological assay of folate. In: Picciano MF, Gre- gory JF, Stokstad ELR, eds. Folate in health and disease. New York: Wiley-Liss and Sons, 1990:121-37.
- Karlin R. Sur les variations du toux d'acide folique total dans le lait au cours de la lactation. Comparison avec le lait bovin. (Variations of the total folic acid of milk of women throughout lactation. Com- parison with bovine milk.) Com Ren Soc Biol 1996;160:123-7 (in French).
- Ueland PM, Refsum H, Stabler SP, Malinow MR, Andersson A, Allen RH. Total homocysteine in plasma or serum. Clin Chem 1993;39:1764-79.
- Kang S, Wong PWK, Cook HY, Nourusis M, Messer JV. Protein bound homocysteine. J Clin Invest 1986;77:1482-6.
- American College of Obstetrics and Gynecology. Nutrition during pregnancy. ACOG technical bulletin no. 179. Int J Gynaecol Obstet 1993;43:67-74.
- Food and Drug Administration. Food standards: amendment of stan- dards of identity for enriched grain products to require addition of folic acid. Fed Regist 1996;61:8781-97.
- Food and Drug Administration. Food labeling: health claims and label statements; folate and neural tube defects. Fed Regist 1993;58:53254-95.
- Mitchell DC, Mackey AD, Picciano MF, Smiciklas-Wright H. Major contributors of folate to diets of lactating women. FASEB J 1998;12:A226 (abstr).
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- Authors
- Mackey, A. D., & Picciano, M. F.
- Affiliations
- Pennsylvania State University (US)
- Corresponding author
- Picciano, Mary Frances
- Venue
- The American Journal of Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 1999-02
- Volume
- 69
- Issue
- 2
- Pages
- 285-292
- ISSN
- 0002-9165 (ISSN-L)
- OpenAlex
- W1877315604
- Cited by
- 84
- References
- 51
- Citations by year
- 2026: 2 · 2025: 4 · 2024: 3 · 2023: 5 · 2022: 2 · 2020: 1 · 2019: 3 · 2018: 8 · 2017: 3 · 2016: 1 · 2015: 2 · 2014: 6 · 2013: 3 · 2012: 4
- FWCI
- 1.93
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- American Journal of Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Pennsylvania State University
- Topics
- Health Sciences › Medicine › Rheumatology › Folate and B Vitamins Research
- Health Sciences › Nursing › Nutrition and Dietetics › Infant Nutrition and Health
- Health Sciences › Medicine › Epidemiology › Breastfeeding Practices and Influences
- Keywords
- maternal folate status, extended lactation, folic acid supplementation, lactating women, red blood cell folate, plasma homocysteine, infant growth, hemoglobin, reticulocytes
- MeSH terms
- Adult, Analysis of Variance, Anthropometry, Child Development, Double-Blind Method, Female, Folic Acid, Hematologic Tests, Homocysteine, Humans, Infant, Newborn, Lactation, Longitudinal Studies, Milk, Human, Dietary Supplements
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