Effect of Small‐Quantity Lipid‐Based Nutrient Supplement (SQ‐LNS) on Breast Milk Vitamin A Concentration among Ghanaian Women

Background Vitamin A deficiency remains a global public health problem. Design Women 蠄 20 weeks of gestation (N=1,320) were randomly assigned to receive either a multiple micronutrient supplement (MMN) providing 18 micronutrients including 800 µg RE vitamin A or SQ‐LNS with the same nutrients as the MMN group, plus four minerals and macronutrients contributing 118 kcal daily until 6 months postpartum; a control group received iron and folic acid only (IFA) during pregnancy and a placebo during the first 6 months postpartum. Breast milk samples collected at 6 months postpartum were analyzed for retinol and fat concentrations in a subsample of 756 women. Results Average ± SD breast milk retinol concentration, per gram of fat, was 56.3 ± 2.1 nmol/g; there were no significant differences between groups [IFA (n=243) 59.1 ± 2.8, MMN (n=260) 55.4 ± 2.5, LNS (n=253) 54.7 ± 2.5 nmol/g fat; p=0.45], regardless of whether the woman had or had not received a high‐dose vitamin A supplement (200, 000 IU) soon after childbirth. About 17% of participants had low milk retinol (蠄 28 nmol/g fat), whereas we estimated that 36% of infants were potentially receiving vitamin A at levels above the Tolerable Upper Level (UL, 600 µg RAE/day). Conclusion Daily low dose vitamin A supplementation did not increase breast milk vitamin A levels in this sample of Ghanaian women. Women in this population may have had adequate dietary vitamin A intake.