Relationship of B12 level in breastfeeding mothers with B12 and homocysteine levels of baby

Introduction and Aim: Vitamin B12 deficiency, which is an essential vitamin for the human body, is very common in our country and infants are at great risk in this respect. Since the only nutritional source of infants at 1-6 months is breast milk, they should be fed with the richest breast milk in terms of nutritional elements. Since vitamin B12 deficiency is very common in our country, it was aimed to investigate the effect of vitamin B12 levels of breastfeeding mothers on vitamin B12 and homocysteine levels in the baby. Materials and Methods: In this study, 142 girls (48%) and 154 males (52%) who were 1-6 months old and admitted to the infant outpatient clinic of Istanbul Medeniyet University Göztepe Education and Research Hospital between November 1,2018 and November 21,2019 were screened. The aim of this study was to examine the relationship between the vitamin B12 and homocysteine levels of babies and their mothers' vitamin B12 levels. Babies were selected according to that who have normal birth time and week, do not use vitamin B12 and folic acid, do not take formula or supplementary food, do not have any additional disease or infection. And mothers who do not have additional disease, who do not have malnutrition, who do not have intestinal absorption disorder and infection and who do not take metformin, proton pump inhibitor and medicines containing vitamin B12 were selected. For vitamin B12 levels, normal was defined as higher than 300 pg/mL, possible deficiency was 200-300 pg/mL and deficiency was defined as lower than 200 pg/mL. 3.3-8.3 mmol/L was defined as normal for homocysteine and 5-20 ng/mL was defined as normal for folic acid. In the last 3 months of pregnancy, the use of drugs containing vitamin B12, the number of weekly meals consumed with red meat, the birth patterns and weights of babies, and the relationship between mother's B12 and babies' vitamin B12 and homocysteine levels were examined. Findings: The average age of the infants included in the study was 85.33±42.16 days and the average birth weight was 3250.17±443.77 grams. The mean of vitamin B12 in mothers was 319.10±123.88 pg/mL, while the mean B12 of infants was 236.24±126.81 pg/mL. The mean of homocysteine in infants is 12.50±5.78 and the average of folate is 14.89±3.05. While the rate of mothers who use vitamin B12 in the last 3 months of pregnancy is 71.38%, the average vitamin B12 of these mothers' babies is 248.42 pg/mL. The mean value of vitamin B12 is 198.09 pg/mL for babies of mothers who do not use vitamin B12 during pregnancy. Vitamin B12 levels were found below 200 pg/mL in 14.8% of breastfeeding mothers included in the study, the ratio of mothers with 200-300 pg/mL B12 vitamin levels is 33.1%. The average vitamin B12 value of the mothers with 300 pg/mL of the baby is 385.24 pg/mL, while the average vitamin B12 value of the mothers with normal homocysteine level of the baby is 382.91 pg/ml. There was no correlation between birth weight and postnatal age and vitamin B12 levels of the normal birth weight babies in the study. There was no correlation between the number of meals mothers consumed in red meat per week and their babies' vitamin B12 levels. When 220 pg/mL was taken for vitamin B12 cut-off value predicting homocysteine normality, 76.67% sensitivity, 65.53% specificity, 39.32% were calculated. Results: According to the findings of this study, vitamin B12 deficiency and possible deficiency in three out of four infants and if breastfeeding mothers have sufficient vitamin B12 levels, infants have much less vitamin B12 deficiency it was seen that it would be seen. The study of the mothers at the time of pregnancy and lactation in terms of vitamin B12 deficiency with certain intervals and the support given to the mothers showed that the babies' vitamin B12 and homocysteine levels could be more normalized. Although the study was conducted with a large number of patients, it was a restrictive feature that it was based on retrospective data, it should be supported by prospective observational studies with a wider patient group.