Webb, A LAboud, SFurtado, JeremyMurrin, CCampos, HanniaFawzi, WafaieVillamor, Eduardo2016-05-062007Webb, A L, S Aboud, J Furtado, C Murrin, H Campos, W W Fawzi, and E Villamor. 2007. “Effect of Vitamin Supplementation on Breast Milk Concentrations of Retinol, Carotenoids and Tocopherols in HIV-Infected Tanzanian Women.” Eur J Clin Nutr 63 (3) (October 17): 332–339. doi:10.1038/sj.ejcn.1602929.0954-3007http://nrs.harvard.edu/urn-3:HUL.InstRepos:26966952Background The effect of daily prenatal and postnatal vitamin supplementation on concentrations of breast milk nutrients is not well characterized in HIV-infected women. Objective We examined the impact of vitamin supplementation during pregnancy and lactation on breast milk concentrations of retinol, carotenoids, and tocopherols during the first year post-partum among 626 HIV-infected Tanzanian women. Design We conducted a randomized, double-blind, placebo controlled trial. Women were assigned to one of four daily oral supplements: vitamin A + β-carotene (VA+BC); multivitamins (B, C, E (MV)); MV+VA+BC; or placebo. Concentrations of breast milk nutrients were determined by HPLC at birth and every 3 mo thereafter. Results Supplementation with VA+BC increased concentrations of retinol, β-carotene, and α-carotene at delivery by 4799, 1791, and 84 nmol/L, respectively, compared to no VA+BC (all p<0.0001). MV supplementation did not increase concentrations of α-tocopherol or δ-tocopherol at delivery but significantly decreased concentrations of breast milk γ-tocopherol and retinol. Although concentrations of all nutrients decreased significantly by 3 months postpartum, retinol, α-carotene, and β-carotene concentrations were significantly higher among those receiving VA+BC at 3, 6, and 12 mo compared to no VA+BC. Alpha tocopherol was significantly higher, while γ-tocopherol concentrations were significantly lower, among women receiving MV compared to no MV at 3, 6, and 12 mo post-partum. Conclusions Sustained supplementation of HIV-infected breastfeeding mothers with MV could be a safe and effective intervention to improve vitamin E concentrations in breast milk. VA+BC supplementation increases concentrations of breast milk retinol but it is not recommended in HIV-infected mothers due to the elevated risk of vertical transmission.en-USbreast milkHIVvitamin supplementationretinolcarotenoidstocopherolJournal Article2016-05-0610.1038/sj.ejcn.1602929