Concurrent micronutrient deficiencies in lactating mothers and their infants in Indonesia

Background: Deficiencies of vitamin A, iron, and zinc are prevalent worldwi de, affecting vulnerable groups such as lactating women and infants. Howeve r, the existence of concurrent deficiencies has received little attention. Objective: The aim was to investigate the extent to which deficiencies of v itamin A, iron, and zinc coexist and the nutritional relation between lacta ting mothers and their infants. Design: In a cross-sectional survey in rural West Java, Indonesia, 155 lact ating mothers and their healthy infants were assessed anthropometrically an d blood, urine, and breast-milk samples were obtained. Results: Marginal vitamin A deficiency was found in 54% of the infants and 18% of the mothers. More than 50% of the mothers and infants were anemic an d 17% of the infants and 25% of the mothers were zinc deficient. There was a strong interrelation between the micronutrient status of the mothers and infants and the concentrations of retinol and beta -carotene in breast milk . Vitamin A deficiency in infants led to an increased risk of anemia and zi nc deficiency (odds ratios: 2.5 and 2.9, respectively), whereas in mothers the risk of anemia and iron deficiency (odds ratios: 3.8 and 4.8, respectiv ely) increased. In infants, concentrations of insulin-like growth factor I were related to concentrations of plasma retinol and beta -carotene but not to zinc. Conclusions: Micronutrient deficiencies were prevalent in West Java. The mi cronutrient status of lactating mothers and that of their infants were clos ely related; breast milk was a key connecting factor for vitamin A status. Furthermore, concurrent micronutrient deficiencies appeared to be the norm.