Highly prevalent vitamin B‐12 deficiency in Guatemalan infants aged 12 months is predicted by poor maternal status and infant diet

Prevalence and predictors of deficient (<148 pmol/L) and marginal (148‐220 pmol/L) plasma vitamin B‐12 concentrations were assessed in 304 Guatemalan infants aged 12 mo, 80% of whom were breastfeeding, and their mothers. Exclusion criteria for infants included twins, severe stunting or wasting, reported health problems, severe developmental delay, hemoglobin (Hb) <95 g/L, maternal age <17 y or pregnancy >3 mo. Socio‐economic status data were collected and infant anthropometric measures performed. Vitamin B‐12 intake from complementary foods was estimated with a semi‐quantitative food frequency questionnaire and breastfeeding frequency reported by mothers. A complete blood count, and plasma vitamin B‐12, folate, ferritin, and C‐reactive protein were measured. Deficient and marginal plasma vitamin B‐12 concentrations were found in 29.8% and 19.5% of infants, and 35.7% and 32.5% of mothers, respectively. Daily B‐12 intake averaged 3.6 ug in mothers and 2.4 ug from complementary foods in infants. In linear regression analysis, higher maternal plasma B‐12, higher B‐12 intake from complementary foods, lower frequency of breastfeeding, and larger household size predicted infant plasma vitamin B‐12 (P <0.0001). Vitamin B‐12 status was associated with both iron (ferritin and Hb) and folate status in infants. Supported by National Cattleman's Beef Association and Global Livestock CRSP (USAID Grant PDE‐G‐00036‐00).