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The escalating global environmental pollution leads to the increased exposure to heavy metals, including chromium, mercury, copper, and lead. These substances ubiquitous in our environment and food, can induce severe health issues, including intellectual disabilities, kidney damage, and certain types of cancer. The article presents a current literature review concerning breast milk and its potential contamination with heavy metals. Research reveals varied levels of heavy metal contamination in human milk, contingent on geographical location and lifestyle factors. Some studies have detected a higher concentration of heavy metals in urban areas compared to suburban ones, while others have reported an increased level in the milk of women who smoke cigarettes. Moreover, the concentration of heavy metals in human milk often exceeded permissible limits set by the World Health Organization. Given the increasing exposure to heavy metals, it is imperative to monitor their concentration in food and conduct further studies to understand the risk factors for exposure. [ABSTRACT FROM AUTHOR]

Background: Quality control including assessment of batch variabilities and confirmation of repeatability and reproducibility are integral component of high throughput omics studies including microbiome research. Batch effects can mask true biological results and/or result in irreproducible conclusions and interpretations. Low biomass samples in microbiome research are prone to reagent contamination; yet, quality control procedures for low biomass samples in large-scale microbiome studies are not well established. Results: In this study, we have proposed a framework for an in-depth step-by-step approach to address this gap. The framework consists of three independent stages: (1) verification of sequencing accuracy by assessing technical repeatability and reproducibility of the results using mock communities and biological controls; (2) contaminant removal and batch variability correction by applying a two-tier strategy using statistical algorithms (e.g. decontam) followed by comparison of the data structure between batches; and (3) corroborating the repeatability and reproducibility of microbiome composition and downstream statistical analysis. Using this approach on the milk microbiota data from the CHILD Cohort generated in two batches (extracted and sequenced in 2016 and 2019), we were able to identify potential reagent contaminants that were missed with standard algorithms and substantially reduce contaminant-induced batch variability. Additionally, we confirmed the repeatability and reproducibility of our results in each batch before merging them for downstream analysis. Conclusion: This study provides important insight to advance quality control efforts in low biomass microbiome research. Within-study quality control that takes advantage of the data structure (i.e. differential prevalence of contaminants between batches) would enhance the overall reliability and reproducibility of research in this field. Dksa_EC4VEZpmNY5pbL1BC Video abstract [ABSTRACT FROM AUTHOR]

Abstract Since 1999, a hazardous waste incinerator (HWI) is operating in Constantí (Tarragona County, Catalonia, Spain). In 1996–1998, when the facility was being built, we started a monitoring program aimed at evaluating the impact of the emissions of polychlorinated dibenzo- p -dioxins and dibenzofurans (PCDD/Fs) by the HWI on the environment and the human health. This study aimed at determining the current concentrations of PCDD/Fs in breast milk samples of women living nearby the HWI and at comparing these levels and profiles with those obtained in the baseline (1996–1998) and previous surveys (2002, 2007 and 2012). Furthermore, the association between the dietary intake of PCDD/Fs and the congener profiles in breast milk was also explored. Twenty milk samples were collected from women living in Tarragona downtown and near the industrial area where the HWI is placed. The content of PCDD/Fs was analyzed by following a procedure derived from the US EPA methods 1613 and 8290A. The mean concentration of PCDD/Fs was 2.26 pg WHO-TEQ/g fat. No significant differences were found between women living in industrial and urban areas (1.67 pg vs. 2.48 pg WHO-TEQ/g fat). Interestingly, a notable significant reduction (81%) was observed with respect to the concentrations found in the baseline study. The profiles of PCDD/Fs in breast milk were similar independently on the area and period of collection, being mainly influenced by the intake of fish, meat, oils and fats. The decreasing trend of PCDD/Fs in human milk agrees with the reduction observed in the dietary intake of these pollutants. It was also concluded that the current levels of PCDD/Fs in human milk levels are not influenced by the HWI stack emissions. Highlights • Results of a long-term exposure study of a HWI impact on the population are shown. • Breast milk is one of the most suitable biomonitors of PCDD/Fs for women. • A significant reduction of PCDD/Fs was noted after 19 years of regular operations. • The decreasing trend of PCDD/Fs agrees with the reduction of their dietary intake. [ABSTRACT FROM AUTHOR]

Polychlorinated biphenyls (PCBs) are persistent pollutants, harmful to human health, which enter the human body mainly through food and bind to body fat. For these reasons their use in most countries is prohibited. Human milk has an advantage over other types of human samples in measuring human exposure to PCBs, as it is obtained with non-invasive sampling methods. In Europe, including Croatia, PCB levels have been monitored for many years. This review summarises PCB trends in human milk across Europe. The trend is generally downward, with higher levels prevailing in urban areas near industrial plants. The highest PCB levels were reported in the Czech Republic and Slovakia. [ABSTRACT FROM AUTHOR]

Bisphenol A (BPA), widely used as additive in food packaging, is an environmental and food contaminant that shows a weak estrogenic activity in general population and toxicity in the infant population. A temporary tolerable daily intake (t-TDI) of 4 μg/kg bw/day and a migration limit of 0.6 mg/kg in food from plastic materials, intended to come in contact with food, were fixed. Dietary milk is important in the human diet. The review investigated the contamination levels in human milk and along the dairy supply chain. Despite the reported levels are generally below the fixed limits, breast milk is considered a continuous low-level exposure to endocrine-active compounds for infants. In addition, BPA residues are detected in milk and dairy products posing a risk to human health. BPA enters into milk chain via multiple pathways at various points during milk production (e.g., PVC tubing used during the milking process, transfer from bulk milk to storage tanks, during milk processing). To prevent or mitigate this hazard, a specific TDI for infants is recommended and evaluation of risk factors at each phase of the dairy supply chain, in the quality systems, is recommended. [ABSTRACT FROM AUTHOR]

Background: Expressed human milk (EHM) feed preparation areas represent a potential source of unintentional nosocomial infection. Daily disinfection of environmental surfaces remains an essential intervention to mitigate nosocomial infections. The inefficiency of conventional cleaning and disinfection contributes to an increased risk for the acquisition of multi-drug resistant pathogens. "Non touch" technologies such as the pulsed xenon ultraviolet (PX-UVD) light device have documented sustained reduction in surface bacterial colonization and reduced cross contamination.Methods: The impact of a PX-UVD on surface colony forming units per square centimeter (cfu/cm2) in feed preparation areas was evaluated following its implementation as standard care. A quasi-experimental study was performed documenting bacterial colonization from 6 high risk feed preparation areas in a community care hospital in South Africa. Pre and post conventional cleaning neutralizing rinse swabs were collected fortnightly over a 16 week control period prior to the introduction of the PX-UVD and compared to a matching set of samples for the PX-UVD period.Results: A 90% reduction in total surface bioburden was noted from the control period (544 cfu/cm2) compared to the corresponding PX-UVD period (50 cfu/cm2). Sub -analysis of both the Pre-clean Control: Pre-clean PX-UVD counts as well as the Post-clean Control: Post-clean PX-UVD counts noted significant improvements (p < 0.001). A statistically significant improvement was noted between pre-and post-cleaning total surface bioburden following exposure to the PX-UVD (p = 0.0004). The introduction of the PX-UVD was associated with a sustained reduction in the pre clean bioburden counts with a risk trend (per week) 0.19, (95% CI [0.056, 0.67], p = 0.01).Discussion: The use of a PX-UVD as adjunct to standard cleaning protocols was associated with a significant decrease in surface bioburden. The study demonstrated the inefficiency of conventional cleaning. Persistence of potentially pathological species in both periods highlights current health sector challenges. [ABSTRACT FROM AUTHOR]

Seven congeners of polybrominated diphenyl ethers (PBDEs) (BDE-28, BDE-47, BDE-99, BDE-100, BDE-153,BDE-154 and BDE-183) and six indicator polychlorinated biphenyls (PCBs) (PCB-28, PCB-52, PCB-101, PCB-138, PCB-153 and PCB-180) were measured in 32 regional pooled human milk samples originating from 1760 volunteering primiparous mothers to evaluate the current human body burden of general population and the temporal trend in China. Individual human milk samples were collected following a WHO-designed procedure. This work is one of parts of the evaluation of effectiveness of Stockholm Convention performance. The concentration of ∑ 7 PBDEs ranged from 0.3 ng g −1 lipid to 4.0 ng g −1 lipid with a mean of 1.5 ng g −1 lipid. The concentration of ∑ 6 PCBs ranged from 2.3 ng g −1 lipid to 19.0 ng g −1 lipid with a mean of 6.6 ng g −1 lipid. By comparing with background determination in 2007, there was no significance for ∑ 7 PBDEs. However, BDE-47, BDE-99, and BDE-100 significantly decreased with an average of 45%, 48%, and 46%, respectively, from 2007 to 2011, and an increase of BDE-183 was founded in most regions. For ∑ 6 PCBs, there was a significant decline with an average reduction of 41% from 2007 to 2011. These results indicate the effectiveness of reduction and elimination of POPs in China. Future national human milk biomonitoring is worthy to be done to further evaluate the time trend and effectiveness of the Convention performance. [ABSTRACT FROM AUTHOR]

In epidemiological studies on the toxic effects of prenatal exposure to hexachlorobenzene (HCB), researchers report HCB concentrations, either as wet-weight or per lipid weight basis, in matrices like breast milk, and maternal and cord blood. Conversion of exposures across matrices is needed for comparisons of concentrations and dose effect across cohorts. Using data from a birth cohort study in eastern Slovakia, we derived the maternal blood to cord blood HCB concentration ratio utilizing measured concentrations in 1027 paired maternal and cord blood samples, on a per-lipid basis. In addition to data from the Slovak study, the maternal milk to maternal serum ratio was summarized from 23 published studies on partitioning of HCB between human milk lipid and blood lipid. We identified two distinct groups of milk:blood ratios, those ≤0.45 and those ≥0.85. We assumed that using partition ratios ≤0.45 will underestimate HCB exposure estimates. Taking into account this precautionary measure, we suggest a conversion ratio of 1.21, which is the median of the 16 ratios identified in our literature review. We consider our estimate as conservative and providing appropriate safety in risk analysis. [ABSTRACT FROM AUTHOR]

Vector-borne diseases have increased pesticide use in urban areas (UA) and agricultural areas (AA) in Mexico. Breast milk can be contaminated by pesticide exposure. The objective of the study was to measure breast milk intake by deuterium oxide dilution as well as organochlorine and pyrethroid transfer from mother to infant in AA and UA of Sonora, Mexico. Human milk intake was determined by the ’dose-to-mother’ technique using deuterium oxide (D 2 O) dilution. Mothers’ body composition was also assessed by this technique and the intercept method. Pyrethroids (deltamethrin, cypermethrin and cyhalothrin) and organochlorine pesticide residues ( p,p’- DDT, p,p’ - DDE, p,p’- DDD) in breast milk samples were measured by gas chromatography. Sixty-two lactating women and their infants participated in the study, 32 lived in the UA and 30 lived in the AA. Breast milk intake was approximately 100 mL higher in the AA than in the UA 799 ± 193 and 707 ± 201 mL/day, respectively (p < 0.05). The concentrations of p,p’ - DDT and cypermethrin levels in breast milk were higher in the UA than in the AA (p < 0.05 and p = 0.001, respectively). None of the pyrethroids and organochlorine pesticides studied surpassed the Acceptable Daily Intake (ADI) in milk for humans according to EPA and FAO/WHO. In conclusion, breast milk intake was higher in the AA compared to the UA. The p,p’- DDT and cypermethrin levels in breast milk were higher in the UA compared to the AA. Since pesticide levels in human milk did not exceed the ADI, breastfeeding is still a safe practice and should be encouraged. [ABSTRACT FROM AUTHOR]

The aim of our study is to investigate the spatial distribution of polychlorinated biphenyls (PCBs), hexachlorobenzene (HCB), dichlorodiphenyltrichloroethane ( p,p′ -DDT) and its metabolites, α- and γ-isomers of hexachlorocyclohexane (HCH) in 155 samples of human milk (HM) from Eastern Siberia (six towns and seven villages in Irkutsk Region, one village of the Republic of Buryatia and one town in Zabaikal'sk Region, Russia), and to examine the dietary and social factors influencing the human exposure to the organochlorines. The median and range of the concentration of six indicator PCBs in HM in 14 localities in Eastern Siberia (114 (19–655) ng g −1 lipids respectively) are similar to levels in the majority of European countries. However, in one village, Onguren, the median and range of levels of six indicator PCBs (1390 (300–3725) ng g −1 lipids) were comparable to levels measured in highly contaminated populations. The Lake Baikal seals are highly exposed to persistent organic pollutants (POPs) and could be a potential source of PCB and DDT exposure in the Onguren cohort via the consumption of the Lake Baikal seal tissue. The location of food production in areas exposed to the emissions of local POP sources can also significantly influence POP levels in HM samples from industrialized areas. Estimated daily intakes (EDI) of HCH and HCB for infants are considerably lower or close to acceptable daily intake (ADI). The EDI of total DDTs and total PCBs are higher than ADI. [ABSTRACT FROM AUTHOR]

Background: Historically, bifidobacteria were the dominant intestinal bacteria in breastfed infants. Still abundant in infants in developing nations, levels of intestinal bifidobacteria are low among infants in developed nations. Recent studies have described an intimate relationship between human milk and a specific subspecies of Bifidobacterium, B. longum subsp. infantis (B. infantis), yet supplementation of breastfed, healthy, term infants with this organism, has not been reported. The IMPRINT Study, a Phase I clinical trial, was initiated to determine the safety and tolerability of supplementing breastfed infants with B. infantis (EVC001).Methods: Eighty mother-infant dyads were enrolled in either lactation support plus B. infantis supplementation (BiLS) or lactation support alone (LS). Starting with Day 7 postnatal, BiLS infants were fed 1.8-2.8 × 1010 CFU B. infantis EVC001 daily in breast milk for 21 days. Mothers collected fecal samples, filled out health questionnaires, and kept daily logs about their infants' feeding and gastrointestinal symptoms from birth until Day 61 postnatal. Safety and tolerability were determined from maternal reports.Results: There were no differences in the mean gestational age at birth, weight 1 and 2 months postnatal, and breast milk intake between groups. The mean Log10 change in fecal Bifidobacterium from Day 6 to Day 28 was higher (p = 0.0002) for BiLS (6.6 ± 2.8 SD) than for LS infants (3.5 ± 3.5 SD). Daily stool number was higher (p < 0.005) for LS and lower (p < 0.05) for BiLS infants during supplementation than at Baseline. During supplementation, watery stools decreased and soft stools increased by 36% over baseline in BiLS infants (p < 0.05) with no significant changes in stool consistency for the LS infants. None of the safety and tolerability endpoints, including flatulence, bloody stool, body temperature, ratings of gastrointestinal symptoms, use of antibiotics or gas-relieving medications, infant colic, jaundice, number of illnesses, sick doctor visits, or diagnoses of eczema were different for the groups at any point.Conclusions: The B. infantis EVC001 supplement was safely consumed and well-tolerated. Stools were fewer and better formed in infants in the BiLS group compared with LS group. Adverse events were those expected in healthy infants and not different between groups.Trial Registration: ClinicalTrials.gov NCT02457338 . Registered May 27, 2015. [ABSTRACT FROM AUTHOR]

Background: Zika virus (ZIKV) infection is an emerging mosquito-borne disease, which is associated with an increase in central nervous system malformations and newborn microcephaly cases. This review investigated evidence of breastfeeding transmission from ZIKV-infected mothers to their children and the presence of ZIKV infection in breastfeeding-related fluids. Methodology/Principal findings: We conducted a systematic review of observational studies, case studies, and surveillance reports involving breastfeeding women with ZIKV infection in several international databases. Data extraction and analysis were conducted following a PROSPERO-registered protocol. From 472 non-duplicate records, two case reports met criteria for inclusion. We reviewed three cases of ZIKV infection among lactating mothers near the time of delivery. Two of the three (2/3) associated newborns had evidence of ZIKV infection. ZIKV was detected in breast milk of all three mothers. Breast milk detection results were positive in all mothers (3/3) by RT-PCR, one was positive by culture (1/3), and none was tested for ZIKV-specific antibodies. Serum samples were ZIKV positive in all mothers (3/3), and sweat was not tested for ZIKV. Conclusions/Significance: We describe three cases of ZIKV-infected breastfeeding mothers who were symptomatic within three days of delivery, and two cases with ZIKV-infected newborns. While ZIKV was detected in the breast milk of all three mothers, the data are not sufficient to conclude ZIKV transmission via breastfeeding. More evidence is needed to distinguish breastfeeding transmission from other perinatal transmission routes. [ABSTRACT FROM AUTHOR]

This is the first study to report organochlorines (OCs), including chlorinated pesticides (OCPs) and polychlorinated biphenyls (PCBs) in human milk from Tanzania. The main aims of this study were to assess the level of contamination and the possible health risks related to OC exposure in nursing infants from the Northern parts of Tanzania. Ninety-five healthy mother-infant couples attending Mount Meru Regional Referral Hospital (MMRRH), Arusha, Tanzania, were assessed for associations between maternal/infant characteristics, i.e. mother's age, BMI, gestational weight gain, occupation, residence and fetal growth parameters and breast milk levels of OCPs, such as dichlorodiphenyltrichloroethane (DDT) and its metabolites, dieldrin and PCBs. p,p′-DDE and p,p′-DDT were detected in 100% and 75% of the breast milk samples, respectively, and ranged between 24 and 2400 ng/g lipid weight (lw) and

Fucosyllactoses (2'- or 3'-FL) account for up to 20% of human milk oligosaccharides (HMOs). Infant bifidobacteria, such as Bifidobacterium longum subsp. infantis, utilize the lactose moiety to form lactate and acetate, and metabolize L-fucose to 1,2-propanediol (1,2-PD). Eubacterium hallii is a common member of the adult gut microbiota that can produce butyrate fromlactate and acetate, and convert 1,2-PD to propionate. Recently, a Swiss cohort study identified E. hallii as one of the first butyrate producers in the infant gut. However, the global prevalence of E. hallii and its role in utilization of HMO degradation intermediates remains unexplored. Fecal 16S rRNA gene libraries (n = 857) of humans of all age groups from Venezuela, Malawi, Switzerland, and the USA were screened for the occurrence of E. hallii. Single and co-culture experiments of B. longum subsp. infantis and E. hallii were conducted in modified YCFA containing acetate and glucose, L-fucose, or FL. Bifidobacterium spp. (n = 56) of different origin were screened for the ability to metabolize L-fucose. Relative abundance of E. hallii was low (10-5-10-3%) during the first months but increased and reached adult levels (0.01-10%) at 5-10 years of age in all four populations. In single culture, B. longum subsp. infantis grew in the presence of all three carbohydrates while E. hallii was metabolically active only with glucose. In co-culture E. hallii also grew with L-fucose or FL. In co-cultures grown with glucose, acetate, and glucose were consumed and nearly equimolar proportions of formate and butyrate were formed. B. longum subsp. infantis used L-fucose and produced 1,2-PD, acetate and formate in a ratio of 1:1:1, while 1,2-PD was used by E. hallii to form propionate. E. hallii consumed acetate, lactate and 1,2-PD released by B. longum subsp. infantis from FL, and produced butyrate, propionate, and formate. Beside B. longum subsp. infantis, Bifidobacterium breve, and a strain of B. longum subsp. suis were able to utilize L-fucose. This study identified a trophic interaction of infant bifidobacteria and E. hallii during L-fucose degradation, and pointed at E. hallii as a metabolically versatile species that occurs in infants and utilizes intermediates of bifidobacterial HMO fermentation. [ABSTRACT FROM AUTHOR]

Although the habits of cigarette smoking and associated coffee drinking are generally ceased during pregnancy, they are often reinitiated after delivery when the breastfeeding period starts. This is a case report of a 32-year-old lactating smoker mother who consumed caffeinated drinks and who agreed to donate breast milk after smoking one cigarette (containing 0.6 mg of nicotine) and drinking one cup of espresso (containing 80 mg of caffeine) for an investigation of the excretion of nicotine, its major metabolite cotinine and caffeine into the breast milk and subsequent transfer to the infant. Nicotine and its metabolite cotinine peaked in the breast milk at 0.5 h after the cigarette smoking, and caffeine peaked 2 h after drinking coffee. Moreover, the nicotine disappeared from the milk by 3 h, the caffeine required 24 h and the cotinine required 72 h. The relative infant doses of caffeine, nicotine and cotinine were found to be 8.9, 12.8 and 77.6%, respectively. In the light of these results obtained after the mother smoked only one cigarette and consumed one cup of espresso, if a lactating mother cannot refrain from smoking cigarettes, she should extend the time between the last smoked cigarette and breastfeeding to at least 3 h when the nicotine has been completely eliminated from the milk. Similarly, nursing mothers should also drink coffee sparingly and immediately after nursing and avoid coffee or caffeinated beverages for at least 4 h prior to breastfeeding to minimize the infant's exposure to caffeine. [ABSTRACT FROM AUTHOR]

Breast milks can be contaminated with perfluoroalkyl substances (PFASs). Exposure to PFASs during early stages of life may lead to adverse health effects among breastfed infants. To date, perfluorootanoic acid (PFOA) and perfluorooctane sulfonate (PFOS) have been most frequently measured PFASs in breast milks worldwide. Information on shorter carbon-chain PFASs in breast milk is scarce. In this study, breast milks were sampled from 264 Korean lactating women, and measured for seventeen PFASs, including ten perfluoroalkyl carboxylates (PFCAs), four perfluoroalkyl sulfonates, and three perfluoroalkyl sulfonamides. PFOA and PFOS were detected in 98.5% of the breast milk samples, with median concentrations of 0.072 and 0.050 ng/mL, respectively. Perfluoropentanoic acid (PFPeA), perfluorohexanoic acid (PFHxA), and perfluoroheptanoic acid (PFHpA) were detected in higher frequencies, ranging between 67.4% and 81.8%. The concentrations of short carbon-chain PFCAs in breast milk such as PFPeA and PFHxA were the highest ever reported to date, and were comparable to that of PFOS. Concentrations of shorter chain PFCA in breast milk tended to be higher among the women with longer lactation period, while those of PFOA showed the opposite trend, suggesting a possibility that breastfeeding might be an important route of excretion for PFOA among lactating women. Fish consumption and the use of consumer products, e.g., skin care products, cosmetics and non-stick coated cooking utensils, were identified as significant predictors of PFAS concentrations in breast milk. Health risks associated with PFOA and PFOS exposure through breastfeeding were estimated negligible, however, risks of the short carbon-chain PFCAs could not be assessed because of lack of relevant toxicological information. Further efforts for source identification and exposure management measures for shorter chain PFCAs are necessary. [ABSTRACT FROM AUTHOR]

Background: Scratching in infants is considered to be related to early development of eczema. Little is known about the effects of maternal immune markers on scratching among infants. The objective is to compare the risks related to maternal serum immune markers (IMs) during pregnancy and IMs in breast milk for the occurrence of scratching in infants at 6 and 12 months of age. Methods: Pregnant women were recruited in Columbia and Charleston, South Carolina. Blood (median 3 weeks prepartum) and breast milk (3 weeks postpartum) samples were collected. The concentrations of interferon (IFN)-γ, IFN gamma-induced protein 10 (IP-10) (or CXCL10), CCL11, interleukin (IL) 1β, IL-4, IL-5, IL-6, IL-8 (CXCL8), IL-10, IL-12 (p70), IL-13, transforming growth factor (TGF)-β1, and immunoglobulin (Ig) A in both maternal serum and whey were assayed using optimized immunoassays. Scratching and skin manifestations were ascertained at 6 and 12 months. Generalized estimating equations were used to estimate relative risks (RRs) of IMs for repeated measurements of scratching, considering intra-individual correlations and adjusting for confounders. Results: Of 178 women, 161 provided blood and 115 breast milk samples. IL-1β, IL-4, IL-10, IL-12, and CCL11 in maternal serum and whey were not analyzed due to a large proportion of non-detectable values. Infants in the highest tertile of IL-6 and IL-13 in maternal serum were at higher risk of scratching (RR 1.73 and 1.84, respectively; p ≤ 0.002) compared to infants in the first tertile; similarly, infants born to mothers with high (versus low) levels of serum IL-5 were also at increased risk (RR 1.60, p = 0.002). None of the breast milk IMs studied were associated with scratching. Conclusions: Scratching but not doctors diagnosed eczema was associated with higher levels of maternal IL-5, IL-6, and IL-13 during pregnancy. Further investigations are necessary to determine how maternal serum IMs influence infants scratching. [ABSTRACT FROM AUTHOR]

Background: Chlorinated pesticides have been used in pest control for several decades in the world. These compounds are still applied in many regions, and their continuous usage has resulted in their bioaccumulation and residue in the food chain. These residues could transfer to food products and accumulate in fat tissues. Undoubtedly, the breast milk could be a significant biomarker for estimation of these residues in the human body. This study was conducted to review and compile the results of the studies undertaken in the world which surveyed the organochlorine pesticides residue in breast milk. Methods: A total of 710 national and international articles and texts related to the focused subject were extracted from the virtual databases using the following key words: Chlorinated pesticides, residue and breast milk. Thirty articles published between 1980 and 2013 were selected and reviewed. Results: The majority of the reviewed articles indicated the presence of two or more organochlorine pesticides in the collected samples of breast milk. Based on the reviewed studies, dichlorodiphenyltrichloroethane (DDT) had the highest level of concentration in the collected samples of breast milk. Moreover, there was a statistically significant positive correlation between mother's age, her multiparty and concentration of chlorinated pesticides in breast milk. Conclusion: The organochlorine pesticides are still applied in some developing countries including some regions of Iran. Thus, it seems essential to inform the community about the adverse effects of this class of pesticides; and most importantly the governments should also ban the use of such compounds. [ABSTRACT FROM AUTHOR]

Human health and the health of the environment have entwined. In this paper we underpin this position by presenting a modeling approach named CombiSimilarity, which has been developed by the first author in the software tool PyHasse comprising a wide variety of partial ordering tools. A case study of 18 Organochlorine Pesticides (OCPs) detected in soil as well as in human breast milk samples in the Taurus Mountains in Turkey is carried out. Seven soil samples and 44 breast milk samples were measured. We seek to answer the question whether the contamination pattern in breast milk is associated with the contamination pattern in soil by studying the mutual quantitative relationships of the chemicals involved. We could demonstrate that there is a similarity with respect to the concentration profiles between the soil and breast milk pollution. Therefore the hypothesis may be formulated that the concentrations of chemicals in the milk samples are strongly related to the soil contamination. This supports the concept that soil could be a surrogate for human exposure at background locations. [Copyright &y& Elsevier]

This study is a one of the very few investigating the dichloro-diphenyl-trichloroethanes (DDTs) (summation of o,p′-DDE, p,p′-DDE, o,p′-DDD, p,p′-DDD, o,p′-DDT, and p,p′-DDT) in multiple human matrices in mothers' milk, placenta and hair collected from residents from two coastal cities: Guiyu (GY) and Taizhou (TZ) and one inland city: Lin'an (LA). TZ (milk: 360±319ng/g lipid wt.) showed significantly higher concentrations of DDTs than those from LA (milk: 190±131ng/g lipid wt.), whereas, concentrations of DDTs in GY (milk: 305±109ng/g lipid wt.) were in between TZ and LA. In addition, levels of DDTs in the human tissues from TZ (placenta: 122±109ng/g lipid wt.; hair: 79.9±215ng/g dry wt.) were significantly higher than those from Lin'an (placenta: 49.2±30.2ng/g lipid wt.; hair: 10.8±7.09ng/g dry wt.). The above concentrations of DDTs in milk exceeded the Codex Maximum Residue Limits/Extraneous Maximum Residue Limits for milk (20ng/g lipid wt. whole milk), indicating that the human milk samples were grossly polluted. The present study revealed that human specimens collected from the coastal city (TZ) were more contaminated with inland one (LA), based on the levels of DDTs contained in samples which may be due to the higher dietary exposure to DDTs via consumption of contaminated seafood. The estimated daily intakes of DDTs by GY, TZ and LA infants were 1.69±1.86, 1.48±0.79, and 0.95±0.73μg/kg body wt./day, respectively which did not exceed 10μg/kg body wt./day, the provisional tolerable daily intake proposed by the Food and Agriculture Organization/World Health Organization. [ABSTRACT FROM AUTHOR]

We studied neurodevelopment in infants from two communities. Children living in the vicinity of tin-ore kilns and smelters – TOKS; n = 51) were compared to children from a fishing village (Itapuã; n = 45). Mean hair-Hg (HHg) concentrations were significantly higher in Itapuã children which received significantly (p = 0.0000001) less mean ethylmercury (88.6 μg) from Thimerosal-containing vaccines (TCV) than the TOKS children (120 μg). Breast-milk Pb concentrations were significantly higher in the TOKS mothers (p = 0.000017; 10.04 vs. 3.9 μg L−1). Bayley mental development index (MDI) and psychomotor development index (PDI) were statistically significant (respectively p < 0.0000001, p = 0.000007) lower for the TOKS children only at 24 months of age. Multivariate regression analysis showed that MDI was negatively affected by breast-milk Pb and by HHg. PDI was positively affected by breastfeeding and negatively affected by ethylmercury. Milestone achievements were negatively affected by breast-milk Pb (age of walking) and by HHg (age of talking). [Copyright &y& Elsevier]

Highlights: [•] The selected OCPs have been analysed in 28 samples of human milk. [•] The highest intake by the infant was found for p,p′-DDE, the lowest for γ-HCH. [•] Margin of safety below 1 was noted both for HCB in one sample and for ΣDDT in three samples. [ABSTRACT FROM AUTHOR]

Highlights: [•] We measured dioxins in breast milk from 100 primiparae from Naples and Caserta. [•] Dioxin levels were related to a set of environmental and individual risk factors. [•] Dioxin in breast milk is correlated to environmental contamination and age of donor. [•] Illegal burning of solid waste in the vicinage is also a significant risk factor. [ABSTRACT FROM AUTHOR]

Human breast milk represents the best choice for the nutrition of infants. However, in addition to containing beneficial nutrients and antibodies, it can also be considered the best indicator of infant exposure to contaminants. We developed a multi-residue method using a modified QuEChERS (quick, easy, cheap, effective, rugged, and safe) procedure and capillary gas chromatography–triple quadrupole mass spectrometry for the determination of 57 persistent organic pollutants, including 23 organochlorine pesticides, 18 polychlorinated biphenyl (PCB) congeners, and 16 polycyclic aromatic hydrocarbons in human milk and colostrum samples. We have used primary secondary amine in the clean-up step as it gave a more efficient separation of the analytes from fat and superior removal of the co-extracted substances compared with gel permeation chromatography. No significant matrix effect was observed for the tested pollutants, and therefore matrix-matched calibration was not necessary. The average recoveries from spiked samples were in the range of 74.8–113.0 %. The precision was satisfactory, with relative standard deviations below 16 %, while values of 0.1–0.4 μg L −1 were established as the limit of quantification for all the target analytes (0.05 and 100 μg L −1). The method was successfully applied to the analysis of 18 human colostrum and 23 mature milk samples. All the samples tested were positive for at least nine different residues, with some samples containing up to 24 contaminants. Remarkably, the contaminants hexachlorobenzene, p,p’-DDE, PCB 138, PCB 180, phenanthrene, fluoranthene, and pyrene were present in 100 % of the colostrum and mature milk samples analyzed. [ABSTRACT FROM AUTHOR]

Abstract: Breast milk is a valuable biological specimen to assess maternal and infant exposure to polybrominated diphenyl ethers (PBDEs). In this study, 208 breast milk samples were collected from 89 participants during lactation period, at <7, 15, 30, and 90 days postpartum, in four cities in Korea, and were determined for 19 PBDE congeners. The total PBDE concentrations (ΣPBDE) ranged from 0.23 to 68.4 (mean: 2.73) ng/g lipid weight, and were within the ranges reported for European and Asian countries. Within a month of lactation after delivery, no significant changes were found in the PBDE concentrations. The predominance of BDE 153 rather than BDE 47 was found in the most samples that BDE 153 was detected, and was likely to be associated with stepwise debromination of BDE 209. No associations were found between PBDE concentrations in breast milk and demographic parameters, except for ΣPBDE with maternal age and delivery mode. Certain types of diet such as corn, seafood and nut correlated significantly with PBDE levels in breast milk. The estimated daily intakes of ΣPBDE for breast-feeding infants were lower than the guidelines proposed by the US EPA, indicating limited health risk from PBDEs through breast feeding. [Copyright &y& Elsevier]

The use of expressed breast milk has been advocated as an effective way of encouraging and maintaining lactation when the mother is separated from the baby for a while. However, prospects of storage of expressed breast milk for any considerable period of time is hindered by the possibility of bacterial contamination and growth of infectious pathogens in the stored milk. Previous research worldwide has focused on optimal conditions for storing expressed breast milk. This study investigated bacterial growth in expressed breast milk stored at two different conditions and time periods. A total of 240 randomly selected lactating mothers participated in a survey used to elicit information on their practices concerning expressed and stored breast milk. Out of this, 20 lactating mothers were willing to donate their breast milk, which was used for microbial studies. Using antiseptic procedures, breast milk samples were collected from these 20 lactating mothers by manual expression and put into sterile containers. One half was stored at room temperature (30°C), while the other half was immersed in a container of water (26°C) for 0, 3, 6 and 9hrs. The samples at different time periods in both storage conditions were plated on three different culture media (Nutrient agar, MacConkey agar and Chocolate agar) and incubated for 24hrs. Bacterial load was enumerated and isolates were characterized and identified. Data was analyzed using one way ANOVA and presented as frequencies, percentages means and standard deviations. Results showed that in all the culture media, bacterial load was higher in breast milk samples stored at room temperature for up to 9hrs compared to that immersed in water (p<0.05). However, the average colony counts were within acceptable limits (<104CFU/ml). Enterococcus faecalis, Escherichia coli and Staphylococcus aureus were the predominant bacteria isolated in the breast milk samples under both storage conditions. The findings from this study revealed that storage of breast milk either at room temperature or immersed in a container of water appeared to be safe for up to 9 hours of storage in a tropical environment. Generally, the number of microbes was within levels considered acceptable in expressed breast milk. [ABSTRACT FROM AUTHOR]

Four new Standard Reference Materials (SRMs) have been developed to assist in the quality assurance of chemical contaminant measurements required for human biomonitoring studies, SRM 1953 Organic Contaminants in Non-Fortified Human Milk, SRM 1954 Organic Contaminants in Fortified Human Milk, SRM 1957 Organic Contaminants in Non-Fortified Human Serum, and SRM 1958 Organic Contaminants in Fortified Human Serum. These materials were developed as part of a collaboration between the National Institute of Standards and Technology (NIST) and the Centers for Disease Control and Prevention (CDC) with both agencies contributing data used in the certification of mass fraction values for a wide range of organic contaminants including polychlorinated biphenyl (PCB) congeners, chlorinated pesticides, polybrominated diphenyl ether (PBDE) congeners, and polychlorinated dibenzo- p-dioxin (PCDD) and dibenzofuran (PCDF) congeners. The certified mass fractions of the organic contaminants in unfortified samples, SRM 1953 and SRM 1957, ranged from 12 ng/kg to 2200 ng/kg with the exception of 4,4′-DDE in SRM 1953 at 7400 ng/kg with expanded uncertainties generally <14 %. This agreement suggests that there were no significant biases existing among the multiple methods used for analysis. [Figure not available: see fulltext.] [ABSTRACT FROM AUTHOR]

Abstract: There is a growing concern that persistent organic pollutants like organochlorine pesticides (OCPs) can impair fetal growth and affect birth size. However, currently available epidemiological evidence is inconclusive. In this case-control study, we examined the association between exposure to hexachlorocyclohexane (HCH) and its isomers (α-HCH, β-HCH and γ-HCH), dichlorodiphenyltrichloroethane (DDT) and dichlorodiphenyldichloroethylene (DDE) and birth size. We recruited 60 infant-mother pairs, comprising of 30 term, small for gestational age babies with their mothers (Case group), and another 30 term, appropriate for gestational age babies with their mothers (Control group). This study was conducted in a tertiary hospital in Delhi, India, between March, 2009 and February 2010. Organochlorine pesticides were estimated in maternal blood, cord blood, placenta and breastmilk samples, using gas–liquid chromatography. Transplacental and transmammary transfer of OCPs was assessed by correlating the maternal blood OCP levels with those in cord blood and breastmilk by simple linear regression. The birthweight, crown heel length, head circumference, mid-arm circumference and ponderal index of the neonates was correlated with OCP levels in the maternal blood, cord blood, placenta and breastmilk. The OCP estimates were compared between samples of the case and control group. There was a significant (P <0.001) transplacental transfer of all OCPs, however the transmammary transfer was insignificant for most OCPs except α-HCH. The OCP levels in the case group were higher than the control group; these were significantly more for t-HCH in cord blood and breastmilk; β-HCH in maternal blood, cord blood and breastmilk; DDE in placenta and DDT in breastmilk. There was a significant negative correlation between birthweight and t-HCH levels in maternal blood (P =0.022), cord blood (P <0.001), placenta (P =0.008) and breastmilk (P =0.005); β-HCH in cord blood (P <0.001) and placenta (P =0.020); γ-HCH in placenta (P =0.045); and DDT (P =0.009). Length at birth had a significant negative correlation with t-HCH in cord blood (P =0.014) and breastmilk (P <0.001); β-HCH in cord blood (P =0.016) and breastmilk (P =0.012); DDE in placenta (P =0.016); and DDT in breastmilk (P =0.006). Similarly, OCP levels were also found to be negatively correlated with head circumference, ponderal index and chest circumference in neonates. We conclude that prenatal exposure to some OCPs could impair the anthropometric development of the fetus, reducing the birthweight, length, head circumference, chest circumference and ponderal index. [Copyright &y& Elsevier]

Background Globally, diarrhea remains a leading killer of young children. In Sierra Leone, one in seven children die before their fifth birthday and diarrhea is a leading cause. Studies that emphasize the demand-side of health interventions--how caregivers understand causation and prevention of diarrhea--have been neglected in research and programming. Methods We undertook applied qualitative research including 68 in-depth interviews and 36 focus group discussions with mothers, fathers and older female caretakers to examine the causes and prevention of childhood diarrhea in villages near and far from health facilities across four rural districts. Verbal consent was obtained. Results Respondents reported multiple, co-existing descriptions of causation including: contaminated water and difficulties accessing clean water; exposure to an unclean environment and poor food hygiene; contaminated breast milk due to sexual intercourse, overheated breast milk or bodily maternal conditions such as menstruation or pregnancy; and dietary imbalances and curses. Respondents rarely discussed the role of open defecation or the importance of handwashing with soap in preventing diarrhea. Conclusions Categorizing behaviors as beneficial, harmful, non-existent or benign enables tailored programmatic recommendations. For example, respondents recognized the value of clean water and we correspondingly recommend interventions that reinforce consumption of and access to clean water. Second, respondents report denying "contaminated" breast milk to breastfeeding children. This is a harmful practice that merits attention. Third, the role of open defecation and poor hygiene in causing diarrhea is less understood and warrants introduction or clarification. Finally, the role of exposed feet or curses in causing diarrhea is relatively benign and does not necessitate programmatic attention. Further research supportive of communication and social mobilization strategies building on these findings is required to ensure that improved understanding regarding diarrhea causation translates into improved diarrhea prevention. [ABSTRACT FROM AUTHOR]

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Objective: To compare the fat loss between refrigerator and warm water thawed breast milk. Design: Experimental. Setting: Tertiary-care pediatric university hospital. Participants: Ninety samples of expressed breast milk were collected from mothers with singleton babies of a gestational age 32-42 weeks. Main Outcome Measures: Fat content in fresh breast milk (FM); thawed breast milk by refrigeration (RM); and thawed breast milk by warm water (WM). Results: The mean (SD) total fat content in FM, RM and WM were 2.98 (0.97), 2.76 (0.99) and 2.66 (0.88) g/100 mL, respectively. The mean difference (SD) of the total fat in FM declined significantly after the frozen milk was thawed by refrigeration or warm water at −0.22 (0.50) g/100 mL ( P=0.0001) and −0.32 (0.45) g/100 mL ( P<0.0001), respectively. The mean (SD) total fat loss of frozen breast milk thawed by refrigeration was less than thawing in warm water at 0.094 (0.38) g/100 mL ( P=0.02). Conclusion: The fat loss of thawed breast milk by refrigeration was significantly less than placing it in warm water. [ABSTRACT FROM AUTHOR]

Abstract: Exposure of mothers to organochlorine pesticides (OCPs) was assessed by measuring the levels of 20 OCPs in 70 human breast milk samples pooled from 210 individuals from China, Korea and Japan. The OCPs were analyzed using gas chromatography/mass spectrometry (GC/MS) in electron capture negative ionization (ECNI) monitoring. The results showed that β-hexachlorocyclohexane and hexachlorobenzene were one order of magnitude higher in China than in the other nations, whereas chlordanes and polychlorinated biphenyl levels were highest in Japan. Heptachlor epoxide, dieldrin, endrin, toxaphenes and mirex were detected in most samples, and levels of these chemicals were significantly higher in Japan (0.8–4.5ngg−1 lipid), followed by Korea (0.2–4.7ngg−1 lipid), and lowest in China (less than 1.0ngg−1 lipid). α- and β-endosulfans were detected at a range of 0.9–1.5ngg−1 lipid levels in all samples analyzed, and their levels were higher in Korean than in Chinese samples. [Copyright &y& Elsevier]

Abstract: Thirty persistent organohalogen compounds including organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs) were determined in breast milk samples (n =36) of primipara and multipara mothers from Bizerte in 2010. The analytical procedure involved the application of liquid–liquid extraction and gas chromatography with electron capture detector (GC–ECD) or mass spectrometry detector (GC–MS) for identification and quantification. Organohalogen compounds were found in all the analyzed samples, with predominance of p,p′-DDE, p,p′-DDT, p,p′-DDD, HCB and PCBs. The mean concentration of ∑DDTs in breast milk was 1163.9ngg−1 lipid wt. The ratio of p,p′-DDE/p,p′-DDT was low, suggesting that there is fresh intake of commercial DDT products in Bizerte. The mean levels of HCB and PCB were 286.8 and 331.2ngg−1 lipid wt respectively. These results were compared with the levels obtained in a previous study carried out in the same area in 2003. A general decrease of ∑DDTs levels and an increase of PCB levels were observed. Among the 10 PBDE congeners evaluated, BDE-28, BDE-47, BDE-99, BDE-66, BDE-138, BDE-100, BDE-154, BDE-153, and BDE-183 were detected in the analyzed samples at different frequency. The total PBDE concentrations ranged from 2.5 to 22.6ngg−1 lipid wt in the samples, with a mean and median value of 10.7 and 9.8ngg−1 lipid wt respectively. To our knowledge, this is the first data of PBDEs in Tunisian human milk. The present study shows that age and parity are factors influencing the levels of some organohalogen compounds in human milk. [Copyright &y& Elsevier]

The concentrations of musks (polycyclic musks and nitro musks) and traditional organochlorine pesticides (OCPs), including dichlorodiphenyltrichloroethane and its metabolites (DDT, DDE, DDD, and total DDTs), hexachlorobenzene (HCB), and hexachlorocyclohexanes (HCHs) in breast milk collected in Shanghai, China during the period 2006–2010, were determined. The total concentrations ranged from 4.7 to 276.2 (median: 58.4) ng/glipid weight (lw) for musks and from 88.3 to 2532.9 (median: 1003.8)ng/glw for OCPs. 4,4′-DDE (median: 655.4ng/glw) was the predominant OCP, followed by β-HCH (median: 172.5ng/g lw), and HHCB (1,3,4,6,7,8-hexahydro-4,6,6,7,8,8-hexamethylcyclopenta[γ]-2-benzopyran) (median: 17.7ng/g lw) was the dominant musk. There was no statistical correlation between total musk concentrations, and HCB, HCHs, DDTs or total OCP concentrations, indicating their different exposure routes and metabolism in humans (p=0.182–0.325). Clear reductions in temporal trends in the levels of DDTs and HCB, especially HCHs (p<0.01) were observed during the sampling period, and the high DDE/DDT ratios in the samples indicated past exposure to DDTs. The relatively high median concentrations of HHCB and HHCB-lactone in 2010 suggested a probably increasing tendency. There were statistically significant influences regarding maternal age and parity on OCP accumulation (p=0.001–0.002), but no significant effect on musks was found (p=0.542–0.919). Musk exposure in neonates via breast milk was 2–3 orders of magnitude lower than suggested provisional tolerable daily intakes (PTDI). The estimated daily intakes for HCB and DDTs were below the PTDI in Canada, however, 56% of those for HCHs exceeded the Canadian PTDI. OCP contamination of breast milk requires further attention. [Copyright &y& Elsevier]

Inhabitants of dwellings treated with DDT for indoor residual spraying show high DDT levels in blood and breast milk. This is of concern since mothers transfer lipid-soluble contaminants such as DDT via breastfeeding to their children. Focusing on DDT use in South Africa, we employ a pharmacokinetic model to estimate DDT levels in human lipid tissue over the lifetime of an individual to determine the amount of DDT transferred to children during breastfeeding, and to identify the dominant DDT uptake routes. In particular, the effects of breastfeeding duration, parity, and mother''s age on DDT concentrations of mother and infant are investigated. Model results show that primiparous mothers have greater DDT concentrations than multiparous mothers, which causes higher DDT exposure of first-born children. DDT in the body mainly originates from diet. Generally, our modeled DDT levels reproduce levels found in South African biomonitoring data within a factor of 3. [Copyright &y& Elsevier]

Abstract: Breast milk samples (n=74) from the general maternal population of Zhejiang province were analyzed for polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs), polychlorinated biphenyls (PCBs), and polybrominated diphenyl ethers (PBDEs). Samples were divided into urban and rural groups. Mean ∑PCDD/F, ∑PCB and ∑PBDE concentrations were 71.4±40.8, 42774±27841 and 2679±944pgg−1 lipid in the urban group and 38.6±38.1, 26546±11375 and 2731±1093pgg−1 lipid in the rural group, respectively. WHO-TEQ concentrations for dioxin-like PCBs and PCDD/Fs were 2.66±1.43 and 3.90±2.60pgg−1 lipid in the urban group and 1.83±0.93 and 2.27±1.55pgg−1 lipid in the rural group, respectively. Congener profiles for these pollutants were compared between human samples (adipose tissue and breast milk) and foodstuffs (seafood, hen eggs, and freshwater fish). Similar PCB and PCDD/F congener patterns were observed, suggesting that dietary intake is a significant source for human exposure to PCBs and PCDD/Fs. However, much lower PBDE congener levels were detected in breast milk than in foodstuffs, which implies that pathways other than dietary intake may also account for human exposure to PBDEs. [Copyright &y& Elsevier]

Abstract: Breast milk has been widely used as a bioindicator to assess the extent of human exposure to PBDEs via various exposure routes. In this study, 48 breast milk samples were collected from primiparous women in Shanghai city, and 14 PBDEs congeners (BDE-28, −47, −99, −100, −153, −154, −183, −196, −197, −203, −206, −207, −208, and −209) were quantified using gas chromatography-electron capture negative ionization-mass spectrometry. The mean concentration of total PBDEs was 8.6ng/g lipid weight, and ranged from 1.8 to 26.7ng/g lipid weight. These concentration levels were similar to those reported in Europe and Asia, but one order of magnitude lower than those in North America. The congener profiles in this study exhibited a specific pattern in human milk found worldwide, BDE-153 and BDE-28 accounted for a relatively higher proportion of lower brominated BDEs (from tri- to hepta-BDEs), whereas higher brominated BDEs (from octa- to deca-BDEs) contributed more than 70% of the total PBDEs. The Spearman''s correlation coefficient among higher brominated BDEs showed a positive relationship, and concentration levels of higher brominated BDEs were statistically different between office workers and housewives. Due to relatively higher proportion of PBDEs from octa- to deca-BDEs were detected, air inhalation and dust ingestion might be the major exposure routes of higher brominated BDEs. Further research is needed to clarify the major exposure route of higher brominated BDEs to humans. [Copyright &y& Elsevier]

Abstract: Sixty breast milk samples were collected in Shenzhen, China from July to November in 2007. The samples were analyzed of the concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and polychlorinated biphenyls (PCBs). The range of upper-bound for ∑TEQ-(PCDD/Fs+PCBs) in the samples was 4.10–35.3pgTEQg−1 lipid (median: 10.6pgTEQg−1 lipid; mean: 11.9pgTEQg−1 lipid). The levels of the measured contaminants in the breast milk had significant correlations with the length of inhabitation period in Shenzhen (r=0.487, p<0.05 for PCDD/Fs, r=0.431, p<0.05 for PCBs and r=0.478, p<0.05 for ∑TEQ-(PCDD/Fs+PCBs)), and the consumption rate of fish (r=0.366, p<0.05 for PCDD/Fs, r=0.486, p<0.05 for PCBs and r=0.416, p<0.05 for ∑TEQ-(PCDD/Fs+PCBs)), respectively. Moreover, significant positive correlations were also detected between the participant''s age (r=0.305, p<0.05 for ∑TEQ-PCBs and r=0.275, p<0.05 for ∑TEQ-(PCDD/Fs+PCBs)) and the body burdens of these contaminants respectively. It is estimated that the daily intake (EDI) of the sum of PCDD/Fs and DL-PCBs by the breast-fed infants was 5.60–161pgTEQkg−1 bw per day (mean: 48.2pgTEQkg−1 bw per day; median: 42.2pgTEQkg−1 bw per day). The result showed that both the body burdens of PCDD/Fs and PCBs of the recruit population and the calculated EDI of the breast-fed infants were higher than those in the non-exposed areas in mainland China. This suggests that continuous surveillance on PCDD/Fs and PCBs levels in human milk is critical to more precisely evaluate the human health risk posed by the negative environmental impact in Shenzhen in the future. [Copyright &y& Elsevier]

Abstract: Assessment of human exposure to environmental persistent organic pollutants such as organochlorine pesticides (OCPs), polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins/furans (PCDD/Fs) and polycyclic aromatic hydrocarbons (PAHs) based on the levels in human breast milk provides a reasonable tool not only to assess the contaminant burden in mothers but also to assess potential exposure of breast-fed neonates. There are limited data on levels of PCBs and OCPs in humans but no previous reports from Turkey on chemically determined levels PAHs in human milk. The aim of this study was to report the levels and accumulation profiles of OCPs, PCBs and PAHs in 47 breast milk samples obtained from a Mediterranean city, Mersin. High resolution analyses were performed by a gas chromatography coupled with mass spectrometer (GC–MS). Dichlorodiphenyldichloroethane (4.4′-DDE) was the dominant pollutant. Beta-hexachlorocyclohexane (ß-HCH), dichlorodiphenyltrichloroethane (4.4′-DDT), dieldrin, hexachlorobenzene, oxy-chlordane, cis-heptachlorepoxide were the other main OCPs detected. Mean levels of ΣPCB congeners and WHOPCB-TEQ were 9.94 and 0.001ng/g lipid, respectively. PCB 153 showed the highest concentration (3.37ng/g lipid), followed by PCB 138 and 180. For the dioxin-like PCBs, PCB 118 was the dominant (0.97ng/g lipid). Naphthalene, phenanthrene, pyrene and fluoranthene were the major PAHs among the 16 PAHs detected. The estimated daily intakes of DDTs, PCBs, HCHs and HCB were not exceeded the tolerable daily intake (TDI) proposed by the Health Canada Guideline. These results indicate that the neonates of Mersin city are exposed to persistent organic pollutants analyzed in this study. However, neonates born in Mersin province are less exposed than the ones born in other regions, considering OCP and PCB levels in breast milk. [Copyright &y& Elsevier]

This study focuses on the regional trends and possible sources of brominated organic contaminants accumulated in breast milk from mothers in southeastern (Okinawa) and northwestern (Hokkaido) areas of Japan. For persistent brominated flame retardants, polybrominated diphenyl ethers (PBDEs; major components, BDE-47 and BDE-153) were distributed at higher levels in mothers from Okinawa (mean, 2.1 ng/g lipid), while hexabromobenzene (HeBB) and its metabolite 1,2,4,5-tetrabromobenzene were more abundantly detected in mothers from Hokkaido (0.86 and 2.6 ng/g lipid), suggesting that there are regional differences in their exposure in Japan. We also detected naturally produced brominated compounds, one of which was identified as 2′-methoxy-2,3′,4,5′-tetrabromodiphenyl ether (2′-MeO-BDE68) at higher levels in mothers from Okinawa (0.39 ng/g lipid), while the other was identified as 3,3′,4,4′-tetrabromo-5,5′-dichloro-2,2′-dimethyl-1,1′-bipyrrole in mothers from Hokkaido (0.45 ng/g lipid). The regional variation may be caused by source differences, i.e. southern seafood for MeO-PBDEs and northern biota for halogenated bipyrroles in the Japanese coastal water. [Copyright &y& Elsevier]

Objective: To describe a case of infant meningoencephalitis that was probably caused by yellow fever vaccine virus transmitted via breastmilk. Description: A 38-day old patient was admitted to hospital on May 23, 2009, with fever. On May 25, 2009, convulsive crises began. Cerebrospinal fluid (CSF) test results were suggestive of meningoencephalitis. The mother had been given a dose of yellow fever vaccine and the baby was on exclusive breastfeeding. The baby was discharged after the convulsive crises were controlled. Tests identified IgM antibodies specific for yellow fever in both serum and CSF. Comments: In 2009, the first case was confirmed of meningoencephalitis caused by the yellow fever vaccine virus transmitted via breastmilk. We describe a second case in which the vaccine virus was possibly the etiologic agent of meningoencephalitis. The Brazilian Ministry of Health now recommends delaying vaccination of nursing mothers until their children reach 6 months or providing them with guidance on alternative options to avoid the risk of transmission of the vaccine virus via breastmilk. [ABSTRACT FROM AUTHOR]

In a nested case-control study, postnatal HIV infection was strongly associated with cumulative HIV RNA breastmilk exposure, even after allowing for maternal CD4 and plasma viral load; cases ingested approximately 15 times more HIV-1 RNA particles than controls.Background. We quantified the relationship between human immunodeficiency virus (HIV) RNA shedding in breast milk, cumulative RNA exposure, and postnatal transmission, relating timing of infection in the infant to estimated total volume of milk exposure.Methods. Nested case-control study of 36 infants of HIV-infected mothers. Case patients were infants who acquired HIV infection through breastfeeding from age 6 through 28 weeks, and control subjects were uninfected infants matched on age at obtainment of a breast milk sample. Mothers and infants received peripartum single-dose nevirapine prophylaxis. Feeding data were collected daily; breast milk samples were collected and infant anthropometry was performed at 6 weeks and monthly thereafter. Volume of milk ingested was estimated using infant weight and feeding pattern.Results. Before HIV acquisition in case patients, feeding pattern (exclusive breastfeeding; median duration, 65 vs 70 days; P = .6) and daily milk intake (mean volume, 638 vs 637 mL; P = .97) did not differ significantly between case patients and control subjects. Case mothers were more likely to shed virus (64% vs 9% always, 22% vs 20.5% intermittently, 14% vs 70.5% never shed; overall, P < .001). Case patients ingested ∼15 times more HIV-1 RNA particles than did control subjects (196.5 vs 13 × 106 copies; P < .001). Allowing for maternal antenatal CD4 cell count and plasma HIV-1 load, child sex and duration of mixed breastfeeding, the association between HIV RNA exposure and infection remained statistically significant (P < .001).Conclusions. Postnatal acquisition of HIV-1 is more strongly associated with cumulative exposure to cell-free particles in breast milk than with feeding mode. Reducing breast milk viral load through antiretroviral therapy to mother or child can further decrease postnatal transmission in exclusively breastfed infants. [ABSTRACT FROM AUTHOR]

The occurrence of persistent organochlorine pesticides (OCPs) in breast milk samples collected from mothers from twelve provinces in mainland China was investigated. Dichlorodiphenyltrichloroethanes (DDTs) were the most prevalent agent, followed by HCHs and HCB, whereas levels of chlordane compounds, drins and mirex were lower. The relatively lower DDE/DDT ratio in the Fujian rural area suggested more recent exposure to DDT than in other areas. The mean level of DDTs in breast milk from the southern China was higher than those from northern China (p < 0.05). A positive correlation was observed between concentration of DDTs in human milk and consumption of animal-origin food, suggesting that this parameter could play an important part in influencing OCPs burdens in lactating women. The mean estimated daily intakes of different OCPs for breastfed infants were lower than the tolerable daily intake. [Copyright &y& Elsevier]

The levels of six perfluorocarboxylates (PFCAs), four perfloroalkylsulfonates (PFASs), and one sulfonamide were measured in paired samples of maternal serum, umbilical cord serum, and breast milk. The maternal and cord sera were strongly correlated with each other for all measured compounds (r > 0.5 and p < 0.01). Nevertheless, there was a significant difference in compound composition profile between the two sera matrices, with a more depletion of the longer chain compounds in cord serum. The transfer efficiency values from maternal to cord serum (TFCS/MS) decreased by 70% with each increasing unit of –CF2 chain within a PFCA group, and for perfluorooctanesulfonate (PFOS), by a half compared to perfluorooctanoate (PFOA). In contrast to the strong correlation in concentrations between the two sera matrices, the pattern of compounds in breast milk differed considerably with those in sera. Accordingly, compound- and matrix-specific transfer must be considered when assessing prenatal and postnatal exposure. [Copyright &y& Elsevier]

Summary: Viruses, including retroviruses like human immunodeficiency virus (HIV) and mouse mammary tumor virus (MMTV), are transmitted from mother to infants through milk. Lymphoid cells and antibodies are thought to provide mammary gland and milk-borne immunity. In contrast, little is known about the role of mammary epithelial cells (MECs). The APOBEC3 family of retroviral restriction factors is highly expressed in macrophages and lymphoid and dendritic cells. We now show that APOBEC3 proteins are also expressed in mouse and human MECs. Lymphoid cell-expressed APOBEC3 restricts in vivo spread of MMTV to lymphoid and mammary tissue. In contrast, mammary gland-expressed APOBEC3 is packaged into MMTV virions and decreases the infectivity of milk-borne viruses. Moreover, APOBEC3G and other APOBEC3 genes are expressed in human mammary cells and have the potential to restrict viruses produced in this cell type. These data point to a role for APOBEC3 proteins in limiting infectivity of milk-transmitted viruses. [ABSTRACT FROM AUTHOR]

Abstract: The present study investigated the current contamination status and evaluated several kinetic-related features of organochlorine pesticides (OCPs) and PCBs in human breast milk collected from northern Vietnam. The variation in the levels of these contaminants was found to be strongly associated with total lactation time and dietary habits. OCPs exhibited the characteristics of steadily declining compounds: the overall levels of DDTs and HCHs in the population decreased with a half-time of only 5years and it can be suggested that OCPs depurated relatively fast with breastfeeding (5% per month). PCBs were slower in both regards, with a temporal decrease half-time of 12years and a suggested depuration rate via breastfeeding of 2.5% per month, indicating that the exposure level was still high relative to the human body burden. It was found that the PCB exposure levels of infant from breastfeeding exceeded the reference dose, and this situation may continue for the next two or three decades. Knowledge of these kinetic-related characteristics not only is useful for risk assessment and prediction of future trends of legacy contaminants but also may provide insight regarding similar kinetic processes of emerging persistent pollutants. [ABSTRACT FROM AUTHOR]

Abstract: In utero and lactational exposure to endocrine disruptors is thought to be potentially harmful on fetal and infant development. Data of exposure in France is scarce. This is a prospective study with (1) collection of 84 cord bloods (CB) and 69 milks from 86 mothers delivering healthy boys (gestational age ⩾34weeks) at two maternity wards in Southern France, between 2002 and 2005 and (2) screening for 15 xenobiotics with anti-androgenic and/or estrogenic effects: DDE, 7 PCBs, dibutylphthalate and its metabolite mBP, HCB, lindane, linuron, procymidone and vinclozoline. Correlations were made with delivery and neonatal outcomes. All CB and milks were contaminated by one or more xenobiotics (mainly PCBs, DDE, HCB, and phthalates) with good correlation between CB and milk concentrations. Compared to other geographical areas, exposure was usually in the lower bracket. Milk [PCB180] was associated with lower birth weight. Infant head circumference correlated negatively with [HCB] and positively with [mBP] in CB. There was a similar but not significant trend for birth weight and length. [DDE] in milk was higher in older mothers and in women born in Africa. In utero and lactational exposure is ubiquitous in our area. Contamination of milk with HCB, mBP, and PCB 180 showed weak correlations with infant growth. This snapshot of exposure in an area with no major industry will serve for further monitoring. [Copyright &y& Elsevier]

Abstract: Perfluorinated compounds (PFCs), especially perfluorooctanesulfonate (PFOS) and perfluorooctanoate (PFOA), are known to occur throughout the environment and in the human population (Houde et al., 2006). The occurrence of PFCs in human umbilical cord blood and human milk, coupled with the potential developmental toxicity of PFCs, suggests the need for determining the exposure sources and magnitudes of PFCs in infants. In this study, 10 PFCs were measured in 24 pooled samples consisting of 1237 individual human milk samples. The samples were collected from 12 provinces of China in 2007. PFOS and PFOA were the predominant PFCs found in all the samples tested. The geometric mean (GM) and median of the concentrations were 46pg/mL and 49pg/mL for PFOS, 46pg/mL and 34.5pg/mL for PFOA respectively. A large variation in geographical distribution was observed for PFCs in human milk. High concentrations of PFOA (814pg/ml for the rural samples and 616pg/ml for the urban samples) were found in human milk from Shanghai. Estimated dietary intakes (EDI) were established and the median, GM and the highest EDI of the total PFCs were 17.2ng/kg/d, 17.8ng/kg/d and 129.1ng/kg/d respectively. The EDI for PFOA (88.4ng/kg/d) for Shanghai was close to the tolerable daily intake (100ng/kg/d) proposed by the German Federal Institute for Risk Assessment and the Drinking Water Commission. The results suggest both mothers and infants have a high exposure to PFCs in the Shanghai region. The potential health impact of postnatal exposure through breastfeeding to infants should therefore be comprehensively evaluated. [Copyright &y& Elsevier]

Abstract: Brazilian scientific literature on the adverse effects of lead on the general population is still very limited. Lead, a potentially toxic substance, has become a public health problem due to its effects, mainly those affecting the central nervous system and on the synthesis of heme. The aim of this study is to evaluate the level of lead exposure of donors to the Breast Milk Bank in the city of Londrina, Parana, by estimating the levels of that metal in milk and blood samples. This is a cross-sectional study conducted during the period between January and July 2007. All mothers enrolled as donors in the Breast Milk Bank were included in this study. A total of 92 volunteers presenting the following inclusion criteria were evaluated in the project: volunteers who were healthy, without any chronic disease, full-term pregnancy, breastfeeding between the 15th and 210th day after giving birth, and living in the city of the study. Lead in milk and blood was quantified using the inductive coupled plasma mass spectroscopy (ICP-MS) technique. All mothers signed a consent form approved by the Research Ethics Committee from Londrina State University. The median lead concentration in milk samples was 3.0μg/L, varying from 1.0 to 8.0μg/L. The median of lead in blood was of 2.7μg/dl, varying from 1.0 to 5.5μg/dl. In Spearman correlation analysis, significant but modest correlations could be observed between the concentration of lead in blood and in milk (r s=0.207, p=0.048), hemoglobin and ALAD activity (r s=−0.264, p=0.011), level of lead in blood and mother’s age (r s=0.227, p=0.029). However, for hematocrit and hemoglobin, the correlation was higher (r s=0.837, p<0.001). No statistically significant associations were found between concentrations of lead in milk and blood and demographic variables studied, obtained through interviews and validated questionnaire. The mean of milk/blood lead ratio was equal to 0.11. In general, the values found in the present study are similar to those obtained in populations in other countries, and are within background levels. [Copyright &y& Elsevier]

Abstract: In experimental studies, it has frequently been observed that the homeostasis of thyroid hormones (THs) is affected by exposure to persistent organic pollutants (POPs), such as dioxins and PCBs. In man, similar effects have been indicated in several epidemiological studies. In order to investigate the possible effect on THs at low background exposures found among the Swedish population the following study was performed. Primiparous women (n =395) in the Uppsala region were recruited between 1996 and 1999. Of these, 325 mothers agreed to donate a serum sample in late pregnancy and breast milk was obtained from 211 women 3weeks after delivery. Babies were sampled for blood at 3weeks (n =150) and 3months (n =115) after birth. In connection to the sampling, questions on personal characteristics were asked. Levels of low (tri- to penta-) chlorinated PCB, di-ortho PCB, p,p′-DDE, (mono-ortho) PCB TEQ and PCDD/DF TEQ were monitored in breast milk and in mother''s blood (not PCDD/DF). The results showed that the measured TH levels (thyroid-stimulating hormone — TSH, total tri-iodothyronine — TT3, free thyroxine — FT4) in mothers and children were within the reference range. Some significant associations were seen between POP exposures and TH levels in mother or child after simple regression analysis. Following adjustment for important confounding factors, the significant associations mostly disappeared. However, significantly decreasing TT3 levels with increasing prenatal low-chlorinated PCB exposure were still seen in 3week old children, and on TT3 in mothers exposed to PCDD/DF. In conclusion, the study clearly shows the importance of adjustment for important confounding factors in the analysis of possible associations between POP exposure and hormonal effects. The remaining associations are weak in both children and mothers and the clinical consequences of these alterations are uncertain. When comparing studies that investigate associations between TH levels and POP levels during the perinatal stage, no obvious between-study concordance was seen regarding the critical dose for hormonal effects to occur. [Copyright &y& Elsevier]