Last update Jan. 23, 2021



Safe substance and/or breastfeeding is the best option.

Vitamin B12 exists naturally in milk at a concentration of 1 nanogram / mL (Sauberan 2019; range: 0.3 to 3 ng / mL). Maternal supplementation with cyanocobalamin barely increases milk levels in well-nourished women (Sandberg 1981), but it does improve the levels in women of low socioeconomic status (Sneed 1981). The concentration in colostrum is up to 28 times higher than that of mature milk.
The daily requirements for Vitamin B12 are 2.4 micrograms (Sauberan 2019) and increase to 2.8 micrograms daily during breastfeeding. Foods rich in vitamin B12 are meat, offal, eggs, dairy products, salmon, sardines, clams and fortified cereals.

With a varied and balanced diet no vitamin supplements are needed, but B12 deficiency has been observed in the plasma and milk of women with strict vegetarian diets (vegans), malabsorptive diseases (eg, Crohn's disease, celiac disease), bariatric surgery, poor nutritional status, pernicious anemia, low socio-economic status and in cases of natural disasters or wars. There are numerous publications showing that infants of these mothers are at high risk of disease due to vitamin B12 deficiency, which can lead to anemia, stunting and psychomotor retardation.

"Flash pasteurization" applied to breast milk of mothers who are HIV+ does not decrease vitamin B12 concentration.

American Academy of Pediatrics: medication usually compatible with breastfeeding (AAP 2001).
List of WHO essential medicines: compatible with breastfeeding (WHO / UNICEF 2002).

See below the information of this related product:

  • Vegetarian Diets (Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.)

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

Your contribution is essential for this service to continue to exist. We need the generosity of people like you who believe in the benefits of breastfeeding.

Thank you for helping to protect and promote breastfeeding.

José María Paricio, founder of e-lactancia.


Main tradenames from several countries containing Cobamin in its composition:


Variable Value Unit
Molecular weight 1344 - 2791 daltons
Protein Binding Alta - High %
Tmax 2 - 8 hours
144 hours
M/P ratio 1 -


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  2. NIH. National Institutes of Health. Vitamin B12. Fact Sheet for Health Professionals. 2020 Full text (link to original source) Full text (in our servers)
  3. Dubaj C, Czyż K, Furmaga-Jabłońska W. Vitamin B(12) deficiency as a cause of severe neurological symptoms in breast fed infant - a case report. Ital J Pediatr. 2020 Mar 30;46(1):40. Abstract
  4. Sauberan JB. High-Dose Vitamins. Breastfeed Med. 2019 Apr 30. Abstract
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  6. Hampel D, Allen LH. Analyzing B-vitamins in Human Milk: Methodological Approaches. Crit Rev Food Sci Nutr. 2016 Abstract
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  8. Abe SK, Balogun OO, Ota E, Takahashi K, Mori R. Supplementation with multiple micronutrients for breastfeeding women for improving outcomes for the mother and baby. Cochrane Database Syst Rev. 2016 Abstract Full text (link to original source)
  9. Ares Segura S, Arena Ansótegui J, Díaz-Gómez NM; en representación del Comité de Lactancia Materna de la Asociación Española de Pediatría. La importancia de la nutrición materna durante la lactancia, ¿necesitan las madres lactantes suplementos nutricionales? [The importance of maternal nutrition during breastfeeding: Do breastfeeding mothers need nutritional supplements?] An Pediatr (Barc). 2015 Abstract Full text (link to original source) Full text (in our servers)
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  11. Akcaboy M, Malbora B, Zorlu P, Altınel E, Oguz MM, Senel S. Vitamin B12 Deficiency in Infants. Indian J Pediatr. 2015 Abstract
  12. Bae S, West AA, Yan J, Jiang X, Perry CA, Malysheva O, Stabler SP, Allen RH, Caudill MA. Vitamin B-12 Status Differs among Pregnant, Lactating, and Control Women with Equivalent Nutrient Intakes. J Nutr. 2015 Abstract
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  15. Duggan C, Srinivasan K, Thomas T, Samuel T, Rajendran R, Muthayya S, Finkelstein JL, Lukose A, Fawzi W, Allen LH, Bosch RJ, Kurpad AV. Vitamin B-12 supplementation during pregnancy and early lactation increases maternal, breast milk, and infant measures of vitamin B-12 status. J Nutr. 2014 Abstract
  16. Dong C, Ge P, Ren X, Zhao X, Fan H, Yin SA, Weiderpass E. Evaluating the micronutrient status of women of child-bearing age living in the rural disaster areas one year after Wenchuan Earthquake. Asia Pac J Clin Nutr. 2014 Abstract
  17. Neumann CG, Oace SM, Chaparro MP, Herman D, Drorbaugh N, Bwibo NO. Low vitamin B12 intake during pregnancy and lactation and low breastmilk vitamin 12 content in rural Kenyan women consuming predominantly maize diets. Food Nutr Bull. 2013 Abstract
  18. Demir N, Koc A, Üstyol L, Peker E, Abuhandan M. Clinical and neurological findings of severe vitamin B12 deficiency in infancy and importance of early diagnosis and treatment. J Paediatr Child Health. 2013 Abstract
  19. Guez S, Chiarelli G, Menni F, Salera S, Principi N, Esposito S. Severe vitamin B12 deficiency in an exclusively breastfed 5-month-old Italian infant born to a mother receiving multivitamin supplementation during pregnancy. BMC Pediatr. 2012 Abstract
  20. Quentin C, Huybrechts S, Rozen L, De Laet C, Demulder A, Ferster A. Vitamin B12 deficiency in a 9-month-old boy. Eur J Pediatr. 2012 Abstract
  21. Roumeliotis N, Dix D, Lipson A. Vitamin B(12) deficiency in infants secondary to maternal causes. CMAJ. 2012 Abstract
  22. Ohman I, De Flon P, Tomson T. Pregabalin kinetics in the neonatal period, and during lactation. Epilepsia. 52 (Suppl 6):249-50 (poster 824). 2011 Full text (link to original source) Full text (in our servers)
  23. Rodrigues V, Dias A, Brito MJ, Galvão I, Ferreira GC. Severe megaloblastic anaemia in an infant. BMJ Case Rep. 2011 Abstract
  24. Honzik T, Adamovicova M, Smolka V, Magner M, Hruba E, Zeman J. Clinical presentation and metabolic consequences in 40 breastfed infants with nutritional vitamin B12 deficiency--what have we learned? Eur J Paediatr Neurol. 2010 Abstract
  25. Hall Moran V, Lowe N, Crossland N, Berti C, Cetin I, Hermoso M, Koletzko B, Dykes F. Nutritional requirements during lactation. Towards European alignment of reference values: the EURRECA network. Matern Child Nutr. 2010 Oct;6 Suppl 2:39-54. Abstract Full text (link to original source) Full text (in our servers)
  26. Celiker MY, Chawla A. Congenital B12 deficiency following maternal gastric bypass. J Perinatol. 2009 Abstract
  27. Mariani A, Chalies S, Jeziorski E, Ludwig C, Lalande M, Rodière M. [Consequences of exclusive breast-feeding in vegan mother newborn--case report]. Arch Pediatr. 2009 Abstract
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  30. Israel-Ballard KA, Abrams BF, Coutsoudis A, Sibeko LN, Cheryk LA, Chantry CJ. Vitamin content of breast milk from HIV-1-infected mothers before and after flash-heat treatment. J Acquir Immune Defic Syndr. 2008 Abstract
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  33. Fadyl H, Inoue S. Combined B12 and iron deficiency in a child breast-fed by a vegetarian mother. J Pediatr Hematol Oncol. 2007 Abstract
  34. Ramlau-Hansen CH, Møller UK, Henriksen TB, Nexø E, Møller J. Folate and vitamin B12 in relation to lactation: a 9-month postpartum follow-up study. Eur J Clin Nutr. 2006 Abstract
  35. EFSA. European Food Safety Authority. Tolerable upper intake levels for vitamins and minerals. Scientific Committee on Food. 2006 Full text (link to original source) Full text (in our servers)
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  37. Baatenburg de Jong R, Bekhof J, Roorda R, Zwart P. Severe nutritional vitamin deficiency in a breast-fed infant of a vegan mother. Eur J Pediatr. 2005 Abstract
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  42. WHO / UNICEF. BREASTFEEDING AND MATERNAL MEDICATION Recommendations for Drugs in the Eleventh WHO Model List of Essential Drugs. Department of Child and Adolescent Health and Development (WHO/UNICEF) 2002 Abstract Full text (link to original source) Full text (in our servers)
  43. AAP - American Academy of Pediatrics Committee on Drugs. Transfer of drugs and other chemicals into human milk. Pediatrics. 2001 Sep;108(3):776-89. Abstract Full text (link to original source) Full text (in our servers)
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