Vitamin B12, folate, homocysteine and urinary methylmalonic acid levels in infants

Serum vitamin B-12 and folate, and their functional markers, plasma homocysteine and urinary methylmalonate (uMMA) were measured in 204 healthy, term infants at birth, and at 2 and 6 months. Compared with infants receiving formula food, those fed mother's milk had lower vitamin B-12 and folate at 2 and 6 months. In infants receiving mother's milk, vitamin B-12 levels were similar at birth (238 pg/ml) and 2 months (243 pg/ml), whereas with formula milk the level was significantly higher at 2 months (558 pg/ml) than at birth (257 pg/ml). Vitamin B-12 was negatively correlated with homocysteine at birth and 6 months. The level of uMMA (mmol/mol creatinine) was higher at 2 (mother's milk, 25.5; formula, 23.97) and 6 months (19.77; 15) than at birth (11.97; 10.88), and was not correlated with vitamin B-12 levels. Homocysteine may be a reliable marker of vitamin B-12 status in neonates and infants; however, uMMA is not suitable as a marker of vitamin B-12 status.