Association between prolonged exclusive breastfeeding and vitamin B and cobalamin statuses in infants with subnormal birth weights
Exclusive breastfeeding is believed to provide adequate micronutrients to term infants. However, infants with low birth weight are at increased risk of decreased micronutrient stores, which may affect gross motor development. Deficiency is uncommon in infants fed with formulas fortified with several B vitamins. This study published in BMC Pediatrics investigated the impact of exclusive breastfeeding on vitamin B status and neurodevelopment of subnormal birth weight (2000-3000 g) infants as well as the impact of cobalamin supplementation on infants with biochemical signs of cobalamin deficiency at 6 months.
Overall, 80 infants were included in the study and were assigned to either the formula fed (FF) (never breastfed or breastfed for <1 month) or exclusively breastfed (EBF) (breastfed for >1 month) groups. The levels of cobalamin, riboflavin, pyridoxal 5´-phosphate, and the metabolic markers methylmalonic acid (MMA) and tHcy were evaluated at 6 weeks, 4 months and 6 months. Alberta Infants Motor Scale (AIMS) and the parental questionnaire Ages and Stages (ASQ) were used to assess neurodevelopment at 6 months. Infants with tHcy level >6.5 μmol/L (n=32) were randomised to receive either hydroxycobalamin intramuscularly or placebo injection. An evaluation of biochemical status and neurodevelopment was done after 1 month.
The B vitamin levels were higher and tHcy and MMA levels were lower in FF infants compared to EBF infants in all assessments. Lower AIMS and ASQ scores were recorded in EBF infants at 6 months. Cobalamin supplementation resulted in decreased plasma tHcy and MMA levels and increased AIMS and ASQ gross motor scores compared to placebo group.
Prolonged EBF may result in deficiency of B vitamins in low birth weight infants, subsequently affecting early gross motor development. In addition, prolonged EBF may be a reason for cobalamin deficiency. Cobalamin treatment can result in improved cobalamin status and motor function.
News Source:Torsvik I, Ueland P, Markestad T, et al. Motor development related to duration of exclusive breastfeeding, B vitamin status and B12 supplementation in infants with a birth weight between 2000-3000 g, results from a randomized intervention trial. BMC Pediatrics. 2015;15(1).