Moderate zinc and vitamin A deficiency in breast milk of mothers from East-Jakarta

Objective: To gain information about the micronutrient status of urban, mid dle-income, breast-feeding mothers in relation to zinc and selected fat-sol uble vitamins in plasma and breast milk and to assess possible interaction between the measured micronutrients. Design: Cross-sectional study. Subjects: 91 mothers and their infants living in middle-income areas of Jak arta, Indonesia. Results: None of the measured anthropometric data of the mothers (e.g. BMI: 22.0+/-3.1 kg/m(2)) and their infants (birth weight: 3.2+/-0.5 kg) gave an y indication of undernutrition. The mean concentrations in blood were 124+/ -18 g/l for hemoglobin, 385+/-111 mu g/l for retinol, 34+/-23 mu g/l for al pha-carotene, 104+/-72 mu g/l for beta-carotene, 7.7+/-3.3 mg/l for alpha-t ocopherol, 0.57+/-0.23 mg/l for gamma-tocopherol, 855 +/- 242 mu g/l for zi nc, and the median concentration of lycopene was 29 mu g/l. The median brea st milk concentrations were 420 mu g/l for retinol, 7.8 mu g/l for beta-car otene, and 2.7 mg/l for zinc. With increased duration of lactation, vitamin A and zinc concentrations significantly decreased in breast milk whereas p lasma zinc concentration increased. Plasma alpha- and beta-carotene were po sitively correlated (P < 0.0001) with each other and with plasma lycopene. Breast milk beta-carotene was positively correlated with breast milk retino l and with plasma beta-carotene (P < 0.0001). There was no correlation betw een zinc and vitamin A in either breast milk or plasma. Forty per cent of t he mothers were anemic, 29.1% had a low plasma zinc concentration, and 23.7 % had a moderately low plasma vitamin A concentration. Breast milk from 70% of the women had a low concentration of vitamin A and that from 66% had a low concentration of zinc. Conclusions: Multi-micronutrient intervention should be considered to provi de a sufficient supply of zinc and vitamin A for growth of exclusively brea st-fed infants.