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October 28, 2020
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How Much of Mom's Folate Supplement is Available to Her Nursing Infant?

It depends. In the first study to look into this, 28 lactating women were placed on a controlled diet that delivered 400 mcg of naturally occurring folate, and given a prenatal supplement containing 750 mcg of folic acid (FA)for up to 10 weeks. Breast milk samples were taken at baseline and at study end and analyzed for 5-methyl tetrahydrofolate (5-MTHF), a bioactive form of folate, and FA.  Total folate levels were not impacted, but folic acid level was increased (accounting for 40% of the folate species in breast milk) suggesting its displacement of 5-MTHF.  This is higher than what has been typically reported and this is why this is important.

A significant amount of breast-milk folate is bound to protein folate receptor (FR-⍺). This protein is important for bioavailability of folate to the infant. But here is the potential problem. The protein bindsFA more tightly than 5-MTHF and unfortunately, this may make it less available to the infant, resulting in an unexpected and paradoxical finding that enhancing breast milk with FA may not be optimal for the nursing infant's folate needs.

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Words You May Not Know
Bioavailability
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Bioavailability

The degree and rate at which a substance (such as a drug) is absorbed into a living system or is made available at the site of physiological activity.

Who Wrote This
Jonathan Bortz MD
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Jonathan’s background as a practicing diabetes specialist for 15 years and 17-year career developing nutritional prescriptive products for the pharmaceutical industry has contributed to his ability to understand nutrients, how they work and why they are important.

Over the years he has acquired broad and in-depth knowledge in minerals, essential fatty acids and other nutrients, but has special expertise in Vitamin B12 and choline metabolism. He is often asked to speak at national and international venues to articulate why B12, folate and choline are so important to gene function, brain development, liver and cardiovascular health. He applies pharmaceutical standards to nutrient science and has developed a unique ability to translate complicated concepts into simple promotional messages that resonate with practitioners and consumers. He has developed dozens of innovative nutritional products, of which many are category leaders in the US. Jonathan obtained his medical degree from the University of the Witwatersrand Medical School in South Africa and did his fellowship in Endocrinology at Washington University in St. Louis, MO.

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