Performance of Metrics From the Diet Quality Questionnaire (DQQ) for Predicting Human Milk Micronutrient Concentrations Among Lactating Women From Northern Ghana

Objectives: According to the United States Department of Agriculture (USDA) dietary guidelines, nutrients of concern during lactation are choline, folate, iron, iodine, eicosapentaenoic acid (EPA)/docosahexaenoic acid (DHA), vitamin A, and vitamin D. Therefore, our objectives were to describe the supplement behavior for these 7 nutrients among lactating mothers in Cincinnati, Ohio.Methods: The MOM2CHild sub-cohort study enrolled expectant mothers in the third trimester of pregnancy who planned to exclusively breastfeed for at least 1 month and followed up with home visits at 2 and 6 weeks postpartum.At the home visit, we recorded supplement use in the last 7 days.We summarized intake via supplements for the 7 nutrients of concern, including the proportion of supplement intake below 50% and above 100% of the recommended dietary allowance (RDA), and the upper limit (UL).Results: The study included 90 lactating mothers between 24-44 years old.At 2 and 6 weeks postpartum, 83% and 80% of participants were taking any dietary supplement, with 79% and 71% taking prenatal supplements.In week 2, the proportion of participants with intakes from dietary supplements below 50% of the RDA was highest for choline (20%) followed by vitamin A (16%), DHA/ EPA (15%), iron (1%), and vitamin D (1%).Intakes exceeding 100% of the RDA were most common for iron (83%), followed by folate (69%), vitamin D (67%), DHA/EPA (3%), iodine (3%), and vitamin A (3%).Exceeding the UL was reported for folate (17%), iron (9%), and vitamin D (4%).Results at week 6 were nearly identical.Conclusions: This study highlights concerns regarding oversupplementation of folate and iron and potentially inadequate choline, vitamin A and DHA/EPA intake.These findings emphasize the need for targeted nutritional guidance on supplement use specifically during lactation.