The Vegetarian Resource Group Blog

Vitamin A and Breastfed Babies

Posted on June 06, 2013 by Nina Casalena, The VRG Blog Editor

By Reed Mangels, PhD, RD

Jack Norris, RD, a vegan dietitian and author, recently contacted me to ask if there have been any studies of the amount of vitamin A in breast milk from vegan women. There are no published reports of studies of the vitamin A content of vegan breast milk. Although vitamin A is only found in nature in animal products, plants contain precursors of vitamin A including beta-carotene, alpha-carotene, and beta-cryptoxanthin. Humans are able to convert these carotenoids into active vitamin A.

Breastfed babies could get the essential nutrient in several ways:

  1. Their mothers eat foods (and/or take supplements) containing precursors of vitamin A. The mothers’ bodies convert these precursors into vitamin A and this vitamin A (possibly along with vitamin A from the mothers’ stores) goes into breast milk.
  2. Their mothers eat foods (and/or take supplements) containing vitamin A and this dietary/supplemental vitamin A (possibly along with vitamin A from the mothers’ stores) appears in the milk.
  3. Their mothers eat foods containing precursors of vitamin A. These vitamin A precursors appear in the milk and the infants make vitamin A from these precursors.

The first scenario clearly takes place and is relevant for vegans. Lactating women who are given foods high in beta-carotene, a precursor of vitamin A, have more vitamin A in their breast milk (1,2). If a breastfeeding woman has generous amounts of beta-carotene in her diet, it is likely that her baby will have adequate vitamin A status (3). This is the most likely way that breastfed infants of vegan women get adequate vitamin A.

The second scenario is not really an option for vegans, at least in terms of food sources of vitamin A. Vitamin A is only naturally found in foods derived from animals. Supplemental vitamin A may be synthetic or derived from animals (4). Vegan supplements containing a mix of vitamin A and vitamin A precursors are available.

The third scenario seems possible but we don’t know for sure that it takes place. The first step – vitamin A precursors appear in milk – definitely happens (1, 2, 5) but we don’t know for certain that babies are able to make vitamin A from precursors of vitamin A (6). It doesn’t really matter since mothers are clearly able to make vitamin A from plant precursors.

The bottom line – Vegan women who are breastfeeding should make sure that their diet includes good sources of precursors of vitamin A. These are foods rich in beta-carotene such as winter squash, carrots, pumpkin, sweet potatoes, cantaloupe, and green leafy vegetables. Dietary fat is needed to promote beta-carotene absorption so it is important that lactating women not overly limit dietary fat.

References:
1. Khan NC, West CE, de Pee S, Bosch D, Phuong HD, Hulshof PJ, Khoi HH, Verhoef H, Hautvast JG. The contribution of plant foods to the vitamin A supply of lactating women in Vietnam: a randomized controlled trial. Am J Clin Nutr. 2007 Apr;85(4):1112-20.
2. Haskell MJ. The challenge to reach nutritional adequacy for vitamin A: Beta-carotene bioavailability and conversion – evidence in humans. Am J Clin Nutr. 2012;96(suppl):1193S-203S.
3. Canfield LM, Taren DL, Kaminsky RG, Mahal Z. Short-term beta-carotene supplementation of lactating mothers consuming diets low in vitamin A. J Nutr Biochem. 1999 Sep;10(9):532-8.
4. Yacoubou J. Vegetarian Journal’s Guide to Food Ingredients. http://www.vrg.org/ingredients/index.php#vitamin_a
5. Canfield LM, Guiliano AM, Neilson EM, Blashill BM, Graver EJ, Yap HH. Kinetics of the response of milk and serum β-carotene to daily β-carotene supplementation in healthy, lactating women. Am J Clin Nutr 1998;67:276–83.
6. Institute of Medicine, Food and Nutrition Board. Dietary Reference Intakes for Vitamin A, Vitamin K, Arsenic, Boron, Chromium, Copper, Iodine, Iron, Manganese, Molybdenum, Nickel, Silicon, Vanadium, and Zinc. Washington, DC: National Academy Press, 2001.

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