Folate Deficiency Conditioned by Lactation

Abstract

Folate-deficient megaloblastic anemia occurs in lactating subjects many months after delivery of their infants. Lactation produces a drain on maternal folate stores as evidenced by 1) the increasing incidence of abnormality in tests of folate nutrition as lactation progresses, 2) the increased amounts of folic acid required to induce hematological response in lactating patients with megaloblastic anemia, 3) the increased minimal daily requirement for folate by lactating subjects, and 4) the relative ease with which lactation produces folate deficiency in the rat. The supply of folate to the breast milk takes precedence over maternal needs even when the mother is severely folate deficient. The increased folate requirement during lactation may be of considerable importance in the nutrition of developing populations where dietary folate intake is suboptimal and prolonged lactation the rule. In these populations lactation may be a common conditioning factor for severe folate deficiency in adults.