Impact of Maternal Moringa oleifera Leaf Supplementation on Milk and Serum Vitamin A and Carotenoid Concentrations in a Cohort of Breastfeeding Kenyan Women and Their Infants

<b>Background:</b> Childhood vitamin A deficiency leads to increased morbidity and mortality. Human milk is the only source of vitamin A for exclusively breastfed infants. Dried <i>Moringa oleifera</i> leaf powder (moringa) is a good food source of provitamin A and other carotenoids. Its effect during lactation on human milk vitamin A and carotenoid content is unclear. <b>Objectives:</b> Our objective was to investigate the effect of maternal moringa consumption on human milk retinol and carotenoid concentrations and maternal and infant vitamin A status. Methods: We conducted a 3-month pilot single-blinded cluster-randomized controlled trial in breastfeeding mother-infant pairs (n = 50) in Kenya. Mothers received corn porridge with (20 g/d) or without moringa with complete breast expressions and maternal and infant serum collected at enrollment (infant <30 days old) and 3 months. Milk was analyzed for retinol and selected carotenoids; maternal/infant serum was analyzed for retinol binding protein (RBP). <b>Results:</b> 88% (n = 44) pairs completed milk and serum samples. Four mothers (9%) had vitamin A deficiency (RBP <0.07 µmol/L); 11 (25%) were vitamin A insufficient (VAI; RBP <1.05 µmol/L). Alpha-carotene concentration in milk was higher in the moringa than the control group at baseline (<i>p</i> = 0.024) and at exit (least squares means, LSM, 95%CI µg/mL 0.003, 0.003-0.004 moringa vs. 0.002, 0.001-0.003 control, n = 22/cluster; <i>p</i> = 0.014). In mothers with VAI, alpha-carotene was higher in the moringa group than controls at exit (LSM, 95%CI µg/mL 0.005, 0.003-0.009 moringa, n = 3, vs. 0.002, 0.000-0.004 control, n = 8, <i>p</i> = 0.027) with no difference at baseline. Milk carotenoids did not correlate with vitamin A status (serum RBP) in infants or mothers. <b>Conclusions:</b> Maternal moringa consumption did not impact concentration of milk vitamin A and resulted in limited increase in milk carotenoids in this cohort.