Effect of vitamin supplementation on breast milk concentrations of retinol, carotenoids, and tocopherols first year‐pospartum in HIV‐infected Tanzanian women

We examined the effect of vitamin supplementation during pregnancy and lactation on breast milk concentrations of retinol, á‐ and â‐carotene (AC and BC), and á‐, ä‐, and ã‐tocopherols (AT, DT, and GT) among 643 HIV‐infected Tanzanian women. Women were randomly assigned to one of four daily oral supplements: vitamin A + BC (VA+BC); vitamins B, C, E (MV); MV + VA+BC; or placebo. Concentrations of breast milk nutrients were determined by HPLC at birth and every 3 mo thereafter. At birth, supplementation with VA+BC significantly increased the concentrations of retinol, AC, and BC by 4799, 84, and 1791 nmol/L, respectively, compared to no VA+BC (all p<0.0001). MV supplementation had no effect on AT or DT but significantly decreased GT by an average of 522 nmol/L (p=0.003). The concentrations of all nutrients decreased significantly after birth irrespective of supplementation. Retinol, AC, and BC remained significantly higher among those receiving VA+BC at 3, 6, and 12 mo compared to no VA+BC. AT was significantly higher and GT lower among women receiving MV compared to no MV at 3, 6, and 12 mo. There were no significant interactions between treatment arms. Daily supplementation with VA+BC increases retinol and carotenoid concentrations in breast milk of HIV‐infected women. MV supplementation increases AT but decreases GT concentrations in breast milk.