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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]

In this current study, a systematic review and meta-analysis in a global scale regarding the prevalence and concentration of aflatoxin M 1 (AFM 1) in the human breast milk were conducted based on the socioeconomic indexes and amounts of precipitation. All available studies published in PubMed, Scopus, Web of sciences and Embase databases were screened between 1 January 1983 and 25 December 2017. Also, the probabilistic carcinogenic risk by the hazard index (HI) in the Monte Carlo simulation (MCS) was calculated. The meta-analysis of 57 papers containing 196 studies showed that the minimum and maximum concentrations of AFM 1 in human breast milk was noted in Sierra Leone (0.80 ng/L) and the United Arab Emirates (UAE) (465.76 ng/L), respectively. The lowest prevalence of AFM 1 in human breast milk was reported in Brazil (2%) while the highest was observed in the Gambia ∼ Tanzania ∼ Jordan (100%). The minimum and maximum concentrations of AFM 1 in human breast milk were observed in America (10.30 ng/L) and South-East Asia continents (358.99 ng/L), respectively. Also, the lowest and highest prevalence of AFM 1 in human breast milk was observed in the West Pacific (7%) and Africa (52%) continents, respectively. According to findings, with increasing average rain annual and poverty (GDP ranking), the prevalence of AFM 1 in human breast milk significantly (P-value<0.05) increased. Moreover, the prevalence of AFM 1 in human breast milk significantly (P-value<0.05) decreased with over time (Among the selected period; 1983 and 2017) which can be correlated with improvements in hygienic conditions as well as public awareness regarding the contamination of food products by AFM 1. The health risk assessment indicated that except for one month's infant in the UAE and Thailand, all infants' consumer of human breast milk in the world is not at considerable risk (HI < 1). Image 1 • Concentration and prevalence AFM 1 in human milk from 196 studies were meta-analyzed.. • The highest and lowest of AFM 1 concentration was in United Arab Emirates (UAE) and Sierra Leone, respectively. • The lowest and highest of AFM 1 prevalence was in the Brazil and in the Gambia ∼ Tanzania ∼ Jordan, respectively. • With increasing annual rain and poverty, the prevalence of AFM 1 was increased. • Except for one month's infant in UAE and Thailand, all infants' are not at considerable risk (HI < 1). [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]

This study analyzes the bacteriological quality of breast milk samples destined to direct milk donation to preterm infants under 34 Gestational Weeks (GW) hospitalized in a neonatology and a neonatal intensive care unit of a French university hospital. All samples of breast milk destined to direct milk donation between April 2007 and December 2016 were included. A sample was defined as compliant if its total flora was less than 106 Colony Forming Units per milliliter (CFU/mL) and in the absence of Staphylococcus aureus and other pathogens. A total of 777 samples were taken from 629 mothers. The overall non-compliance rate for the initial sample was 21.3%; 63 samples (10.0%) had a total flora ≥ 106 CFU/mL, 63 (10.0%) were contaminated by a pathogenic bacteria and 8 (1.3%) were non-compliant because of both. An increase of the non-compliance rate was observed between 2008 and 2016 (10.2%-26.1%). The increase of the total flora non-compliance rate began in 2011, in link with the doubling of the number of samples taken, to reach a peak in 2013 then decreased in link with development of portable pump. No statistically significant difference of the presence of S. aureus in breast milk was observed. For the other pathogenic bacteria, the rate increased significantly in 2014. The increase of the non-compliance rate could be explained by a decrease of best practices in milk collection. Education of mothers should be strengthened. [ABSTRACT FROM AUTHOR]

Per- and polyfluoroalkyl substances (PFASs) have since become a major health concern as they have been reportedly found in human tissues, blood and breast milk. The main aim of the study was to review the current data on PFASs in human breast milk, including the challenges of analysis as well as the possible modes of transfer from maternal blood. In this paper, previously published data on the concentrations of PFASs in human breast milk from around the world were reviewed and summarised. Eligible studies with reference lists published before 1 June 2017 were included by searching several databases (including Scopus, ScienceOpen and SciFinder). From this search, studies with the number of participants in each study ranging from 2 to 1237 were identified. The review indicated that based on the structural profiles and concentration levels, there was variation in the geographical distribution of these compounds in breast milk. Although there are no recorded investigations on the modes of transfer from maternal blood to breast milk, literature suggests that the PFASs tend to be transferred through binding to various proteins. The review also examined the different sample preparation and analytical methods employed to measure the concentrations of PFASs in human breast milk. This showed that solid phase extraction was the most common extraction method. After extraction, liquid chromatography coupled with tandem mass spectrometry was the most common analysis method. Since several of these methods were initially dedicated to monitoring PFASs in food and water, they demonstrate some limitations with regard to specificity and sensitivity to human fluids. Additionally, there are currently no published records of certified reference materials and/or proficiency scheme devoted to standardising PFAS concentrations in breast milk. [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]

Abstract: The occurrence of aflatoxin M1 (AFM1), ochratoxin A (OTA), and deoxynivalenol (DON) in human milk and their correlation to the lactating donors dietary habits from Southern Brazil were investigated. Milk samples were collected from 86 nursing mothers who were also interviewed through a Food Frequency Questionnaire (FFQ). The occurrence of AFM1, OTA, and DON in the human milk samples was evaluated by liquid chromatography tandem mass spectrometry (LC‐MS/MS) and correlated with the FFQ data. The analysis of the FFQs revealed a high intake of foods susceptible to mycotoxin contamination, such as wheat flour and its derivatives, bovine milk, and coffee which had habitual consumption reported by 71, 50, and 43% of the participants, respectively. AFM1, OTA, and DON were not detected in any sample of human milk, even though the results obtained by LC‐MS/MS suggest a possible occurrence of DON in four samples (>LOD: 2.5 ng/mL;

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]

Breast milk is recommended as the sole source of nutrition for the first 6 months of life and its purity is essential for the beginning of human life. Aflatoxins, a group of highly toxic metabolites, can be accumulated in breast milk as a result of maternal dietary exposure. Therefore, the objective of this study was to determine the occurrence, levels and dietary factors associated with the presence of aflatoxin B 1 and aflatoxin M 1 in breast milk samples collected from Kurdish lactating women in Iran. A total of 88 breast milk samples obtained from urban and rural areas were analyzed for the presence of aflatoxin B 1 and M 1 using Enzyme linked-immunosorbent assay method (ELISA). A Semi-Quantitative Food Frequency Questionnaire was used to determine the daily intake of foods, focused on more probable AFs contaminated foodstuffs. Aflatoxin B 1 and aflatoxin M 1 were detected in 93.2% and 100% of samples in the range of 10–80 and 0.1–13.6 ng/L respectively. There were no significant differences in the occurrence and levels of aflatoxins in breast milk samples between urban and rural regions (p > 0.05). The presence of aflatoxin B 1 was significantly associated to consumption of bread and egg (p < 0.05) and the presence of aflatoxin M 1 was associated to consumption of wheat flour and traditional Doogh (p < 0.05). The mean daily intake of aflatoxin B 1 by mothers and infant was 0.61 and 3 ng/kg b.w./day, respectively which suggested, for the first time, that breast-fed infants in Kurdish areas in West Azarbaijan province, Iran, are exposed to significant levels of this toxin through mother's breast milk. However, the mean daily intake of aflatoxin M 1 by infants (0.33 ng/kg b.w./day) was close to the calculated tolerable daily intake of 0.2 ng/kg b.w./day of AFM 1 . These findings highlight the high risk of infants’ exposure to aflatoxins and the necessity for developing strategies to reduce exposure to aflatoxins especially aflatoxin B 1 , involving interventions targeted at decreasing contamination of consumed foods. [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]

Human milk was collected between 2008 and 2011 as part of the Maternal – Infant Research on Environmental Chemicals (MIREC) study that was initiated to establish Canadian national estimates of maternal and infant exposure to a broad suite of environmental contaminants (e.g., persistent organic pollutants [POPs], trace elements, phthalates, etc.). Among the 1017 human milk samples collected, 298 were analysed for polychlorinated dibenzo- p -dioxins (PCDDs), dibenzofurans (PCDFs) and polychlorinated biphenyls (PCBs). World Health Organization (WHO) toxic equivalency concentrations (WHO TEQ 2005 ) for PCDD/F + dioxin-like (DL) PCB ranged from 2.2 pg TEQ 2005 g − 1 lipid to 27 pg TEQ 2005 g − 1 lipid. The relative contribution of PCDDs to the overall WHO TEQ 2005 (PCDD/F + DL PCB) has decreased from earlier investigations into POP levels in Canadian human milk. Significantly higher PCB concentrations were observed in milk from women born in Europe relative to those born in Canada (p < 0.001), in contrast to results for the PCDD/Fs (p = 0.496). Age was found to significantly impact milk ∑ PCB concentrations (p = 0.018), with elevated concentrations observed in milk from women > 30 years relative to those < 30 years of age. While this trend was also observed for the PCDD/Fs, this relationship was impacted by parity. WHO TEQ 2005 concentrations were significantly higher in milk from primiparous women (p = 0.019) and those > 30 years relative to those < 30 years of age (p < 0.001). No significant differences were associated with education level or pre-pregnancy body mass index. PCB and PCDD/F concentrations have continued to decline in Canadian human milk since the last sampling of human milk was performed. [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]

Since 1987, the World Health Organization (WHO) carried out global surveys on polychlorinated dibenzo- p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and polychlorinated biphenyls (PCBs) in human milk. This study presents a review of the three most recent surveys from 2000 to 2010, including DDT. The objective was to identify global quantitative differences and provide baseline information for 52 countries or provide time-trends for countries with previous data. Individual human milk samples were collected following a WHO-designed procedure and combined to form a national pooled sample. Here, we report global levels for PCDDs, PCDFs, PCBs and the sum of o, p′-DDT, p, p′-DDT, o, p′-DDE, p, p′-DDE, o, p′-DDD and p, p′-DDD ( ΣDDTs). A concise risk-benefit evaluation related to human milk contamination with these persistent organic pollutants (POPs) was also done. Large global and regional differences were observed. Levels of PCDDs and PCDFs were highest in India and some European and African countries. PCB levels were highest in East and West Europe. The highest levels of ΣDDTs were found in less industrialized countries. A temporal downward trend for PCDDs, PCDFs and PCBs is indicated. A risk-benefit assessment indicates that human milk levels of PCDDs, PCDFs and PCBs are still significantly above those considered toxicologically safe, while ΣDDTs are below or around those considered safe. With respect to potential adverse health effects, a more dominant role of in utero exposure versus lactational exposure is indicated. If potential adverse effects are balanced against positive health aspects for (breastfed) infants, the advantages of breastfeeding far outweigh the possible disadvantages. Our observations provide a strong argument to plea for further global source-directed measures to reduce human exposure further to dioxin-like compounds. [ABSTRACT FROM AUTHOR]

The fatty acid compositions of 180 commercial infant, follow-on and growing-up formulas with different fat sources (plant-oil, cows' milk, goats' milk) on the Chinese market were analysed and compared with mature human milk. Fatty acid composition in formulas was dependent on fat source. The plant-oil formulas were more similar to mature human milk, while the cows' milk and goats' milk formulas contained higher levels of saturated (C4:0–C10:0) and lower levels of oleic acid and long-chain polyunsaturated fatty acids than those of mature human milk. There was little difference among formulas for the three stages except for the goats' milk formulas. The major fatty acids of formulas were similar to those of mature human milk, while levels of some micro-fatty acids in formulas, such as nervonic acid and long-chain polyunsaturated fatty acids, were significantly lower than in mature human milk. [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]

The levels of 12 synthetic musks and one musk metabolite in 24 pooled human milk samples were examined in order to assess the health risks of these contaminants to breast-feeding infants of China. The 24 pooled samples comprised of 1237 individual human milk samples collected from 12 provinces of China according to WHO guidelines. Among the 13 target analytes, OTNE ([1,2,3,4,5,6,7,8-octahydro-2,3,8,8-tetramethylnaphthalen-2yl]ethan-1-one), HHCB (1,3,4,6,7,8-hexahydro-4,6,6,7,8,8-hexamethylcyclopenta[?]-2-benzopyran), AHTN (7-acetyl-1,1,3,4,4,6-hexamethyl- 1,2,3,4-tetrahydronaphthalene), musk ketone (4-tert-butyl-2,6-dimethyl-3,5-dinitroacetophenone, MK), Musk T (1,4-dioxacyclohepta decane-5,17-dione), HHCB-lactone (1,3,4,6,7,8-hexahydro- 4,6,6,7,8,8-hexamethyl cyclopenta[γ]-2-benzopyran-1-one) and musk ambrette (1-(1,1-dimethylethyl)-2-methoxy-4-methyl-3,5-dinitrobenzene, MA), were found in the milk samples analysed with mean (median) concentrations of 3.96 (3.91), 18.03 (15.10), 10.30 (9.38), 4.68 (4.45), < 3.70 (< 3.70), 10.02 (9.20) and < 5.20 (< 5.20) ng g-1 lipid weight, respectively, whereas ADBI (4-acetyl-1,1-dimethyl- 6-tert-butylindan), AHDI (6-acetyl-1,1,2,3,3,5-hexamethylindan), ATII (5-acetyl-1,1,2,6-tetramethyl-3-isopropylindan), musk xylene (1-tert-butyl-3,5-dimethyl-2,4,6-trinitrobenzene, MX), musk tibetene (1- tert-butyl-3,4,5-trimethyl-2,6-dinitrobenzene, MT) and musk moskene (1,1,3,3,5-pentamethyl-4,6-dinotroindane, MM) were not detected. Significantly positive associations were observed in concentration levels between HHCB and AHTN (p < 0.001), HHCB and HHCB-lactone (p < 0.05), AHTN and HHCB-lactone (p < 0.001), and MK and OTNE (p < 0.05). No statistical difference was found in musk concentrations between rural and urban areas in China (p > 0.05). Themean (median) estimated daily intakes by infants were 20.5 (20.2), 93.4 (78.2), 53.4 (48.6), 24.2 (23.0) and 51.9 (47.6) ng kg-1 body weight for OTNE, HHCB, AHTN, MK and HHCB-lactone, respectively. The musk exposure levels of infants in China via breast feeding were very low according to the current toxicological information. [ABSTRACT FROM AUTHOR]

We aimed to determine the relationship between dioxin congeners in maternal breast milk and maternal glucocorticoid levels with newborn birth weight after nearly 45 years of use of herbicides in the Vietnam War. The study subjects comprised 58 mother-infant pairs in a region with high dioxin levels in the soil (hotspot) and 62 pairs from a control region. Dioxin levels in maternal breast milk were measured by HRGC-HRMS. Salivary glucocorticoid levels were determined by LC-MS/MS. Dioxin congener levels in mothers from the hotspot were found to be two to fivefold higher than those in mothers from the control region. Birth weight was inversely correlated with 2,3,7,8-TeCDD and 2,3,4,7,8-PeCDF congener levels. The rate of newborns whose birth weight was less than 2500 g was threefold higher in the hotspot (12 %) than in the control region (4 %). Salivary glucocorticoid levels in mothers with low birth weight infants were significantly higher than those in the normal birth weight group. Low birth weight of Vietnamese newborns in a hotspot for dioxin levels is related to some dioxin congener levels and high glucocorticoid levels in mothers. This finding in mother-infant pairs suggests that excess maternal glucocorticoid levels are related to dioxin burden and they result in low birth weight. [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]

Human breast milk samples ( n = 87) collected between July 2004 and July 2005 from primipara and multipara mothers from Thessaloniki, Greece were analysed for six groups of persistent organic pollutants (POPs): polybrominated diphenyl ethers (PBDEs), polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloroethane and its metabolites (DDTs), chlordane compounds (CHLs), hexachlorocyclohexane isomers (HCHs) and hexachlorobenzene (HCB). DDTs [median: 410 ng/g lipid weight (lw)], PCBs (median: 90 ng/g lw) and HCHs (median: 40 ng/g lw) were the predominantly identified compounds in all the breast milk samples. Levels of PBDEs (median: 1.5 ng/g lw) in human breast milk samples from Thessaloniki, Greece were lower compared to other countries. Maternal age had a positive correlation with most compounds, but not with PBDEs. Women with a higher occupational exposure to PBDEs (i.e., working in office environments) had higher PBDE concentrations than all others and showed strong correlations, especially for BDE 47 and BDE 153. None of the analysed compounds showed any correlation with parity. Based on these levels, the daily intake of each group of POPs via human milk was calculated and compared with the tolerable daily intakes (TDI) or the reference doses (RfD). For the majority of samples (85 out of 87) a higher daily intake of PCBs than the TDI was calculated, while 11 out of 87 samples had a higher HCB intake than the TDI. The TDI and the RfD were not exceeded for DDTs and PBDEs, respectively. This is the first report of brominated flame retardants in human breast milk from Greece. [ABSTRACT FROM AUTHOR]

This study aimed to identify metalloproteins that lose their metal ions in the presence of mercury (Hg) and bind to Hg in breast milk samples collected from the riverine population of the Madeira River, a tributary of the Amazon River. Initially, total Hg was determined from the hair of lactating women to identify individuals who were contaminated followed by a proteomic analysis of breast milk samples through two-dimensional polyacrylamide gel electrophoresis after acetone precipitation. The presence of Hg in the obtained protein spots was determined by cold vapor atomic absorption spectrometry and cold vapor atomic fluorescence spectrometry. These determinations indicated the presence of Hg in one protein spot, which was then characterized through electrospray ionization tandem mass spectrometry. Based on searches in the UniProt database, this protein spot was identified as lysozyme C. [ABSTRACT FROM AUTHOR]

Chronic exposure to aflatoxins, and especially to aflatoxin B1(AFB1), causes hepatocellular carcinoma with prevalence 16–32 times higher in developing compared with developed countries. Aflatoxin M1(AFM1) is a monohydroxylated metabolite from AFB1 that is secreted in milk and which can be used as a biomarker of AFB1 exposure. This study aimed to determine AFM1 levels in human breast milk using immunoaffinity column clean-up with HPLC and fluorescence detection. Breast milk samples were obtained from 50 nursing mothers. Volunteers filled in a questionnaire giving their consent to analyse their samples as well as details of their socioeconomic, demographic and clinical data. The possible dietary sources of aflatoxins were assessed using a food frequency questionnaire. A total of 90% of the samples tested positive for AFM1, with a mean of 5.2 ng l−1and a range of 0.9–18.5 ng l−1. The study demonstrated a high frequency of exposure of mothers and neonates to AFB1 and AFM1 in Colombia, and it points out the need to regulate and monitor continuously the presence of aflatoxins in human foods. Further research is needed in order to determine the presence of other mycotoxins in foods and in human samples as well as to devise protection strategies in a country where mycotoxins in human foods are commonly found. [ABSTRACT FROM PUBLISHER]

Organochlorine pesticides (OCPs) are persistent organic pollutants that could cause deleterious effects on human health. Breast milk represents a noninvasive specimen source to assess maternal and infant exposure to OCPs. This study recruited 142 pregnant mothers in 2011-2012 in Shanghai, China, and their breast milk samples were collected during lactation and analyzed for 27 OCP compounds. Detection rates were in a range of 65.5 to 100 %. In particular, metabolites of 2,2-bis(chlorophenyl)-1,1,1-trichloroethane (DDT) such as 2-chloro-1,1-bis(4-chlorophenyl)ethylene (DDMU), 2,2-bis(4-chlorophenyl)ethanol (DDOH), bis(4-chlorophenyl)ketone (DBP), and 4,4′-dichlorodiphenylmethane (DDM) were detected in most milk samples. DDTs, hexachlorobenzene (HCB), and hexachlorocyclohexane (HCH) were dominant OCPs with mean levels of 316, 49.8, and 41.5 ng/g lipid content, respectively, whereas levels of methoxychlor, ∑Drins, ∑Heptachlor, ∑Chlordane, and ∑Endosulfan were fairly low (0.87-5.6 ng/g lipid content). Milk concentrations of OCPs were weakly correlated with maternal age, body weight, and body mass indexes (BMIs). ∑OCPs in this study were much lower than those in human breast milk samples collected in 2002 and 2007. Consumption of higher amounts of fish was associated with higher milk levels of OCPs. Specific OCP patterns in breast milk samples from migrant mothers in Shanghai reflected features of OCP production, use, and exposure in their home provinces. The probabilistic exposure assessment model reveals that Shanghai infants were exposed to low levels of OCPs through breast milk consumption. However, infants as the vulnerable group might be subject to the potential additive and/or synergistic health effects from complex OCP exposure. [ABSTRACT FROM AUTHOR]

A study on polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs) and dioxin-like polychlorinated biphenyls (dl-PCBs) was conducted in a pooled sample of breast milk from 27 first-time mothers (primiparous) living in twelve locations at mesoregion industrial area, southern of Rio de Janeiro, Brazil, between August 2012 and July 2014. Questionnaires with questions regarding to food habits, social and economic conditions, places of dwelling were applied. Mothers were breast-feeding only one infant and milk was collected between 4 and 6 weeks after delivery. TEQs of PCDDs/Fs, and dl-PCBs were 10.6, 4.77, 6.96 TEQ pg/g, respectively. The understanding and identification of pollution sources may be helpful for taking better counter measures against breast milk dioxin contamination. It's important for pregnant women to have a diet free as possible of contaminants chemical. Further research must be undertaken in the context of epidemiological investigations to more accurately assess the effects of these compounds. [ABSTRACT FROM AUTHOR]

Hyaluronan (HA) in human milk mediates host responses to microbial infection via TLR4- and CD44-dependent signaling. Signaling by HA is generally size specific. Because pure HA with average molecular mass ( M ) of 35 kDa can elicit a protective response in intestinal epithelial cells, it has been proposed that human milk HA may have a bioactive low- M component. Here we report the size distribution of HA in human milk samples from 20 unique donors. A new method for HA analysis, employing ion exchange (IEX) chromatography to fractionate HA by size and specific quantification of each size fraction by competitive enzyme-linked sorbent assay (ELSA), was developed. When separated into four fractions, milk HA with M ⩽ 20 kDa, M ∼ 20 to 60 kDa, and M ∼ 60 to 110 kDa comprised averages of 1.5, 1.4, and 2.0% of the total HA, respectively. The remaining 95% was HA with M ⩾ 110 kDa. Electrophoretic analysis of the higher M HA from 13 samples showed nearly identical M distributions, with an average M of approximately 440 kDa. This higher M HA component in human milk is proposed to bind to CD44 and to enhance human beta defensin 2 (HBD2) induction by the low- M HA components. [ABSTRACT FROM AUTHOR]

Background: Benznidazole (BNZ) is safe and effective for the treatment of paediatric Chagas disease. Treatment of adults is also effective in many cases, but discouraged in breastfeeding women because no information on BNZ transfer into breast milk is available. We aimed to evaluate the degree of BNZ transfer into breast milk in lactating women with Chagas disease. Patients and methods: Prospective cohort study of lactating women with Chagas disease treated with BNZ administered for 30 days. Patients and their breastfed infants were evaluated at admission, the 7th and 30th day of treatment (and monthly thereafter, for 6 months). BNZ was measured in plasma and milk by high performance liquid chromatography. The protocol was registered in ClinicalTrials.gov (#NCT01547533). Results: 12 lactating women with chronic Chagas disease were enrolled (median age 28.5 years, range 20-34). Median BNZ dose was 5.65 mg/kg/day twice daily. Five mothers had adverse drug events (45%), but no adverse drug reactions or any untoward outcomes were observed in the breastfed infants. Median milk BNZ concentration was 3.8 mg/L (range 0.3-5.9) and 6.26 mg/L (range 0.3-12.6) in plasma. Median BNZ milk to plasma ratio was 0.52 (range 0.3-2.79). Median relative BNZ dose received by the infant (assuming a daily breast milk intake of 150 mL/kg/day) was 12.3% of the maternal dose per kg (range 5.5%-17%). Conclusions: The limited transference of BNZ into breast milk and the reassuring normal clinical evaluation of the breastfed babies suggest that maternal BNZ treatment for Chagas disease during breast feeding is unlikely to present a risk for the breastfed infant. [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]

A sensitive and selective GC-MS method was developed and used to analyse human milk samples for both free and total bisphenol A (BPA). Total BPA was detected in 72 of the 278 human milk samples (25.9%) at concentrations from < 0.036 to 2.5 ng g–1with a geometric mean (GM) of 0.13 ng g–1and median of 0.11 ng g–1, while free BPA was detected in fewer samples, 46 of the 278 samples (16.5%) at concentrations ranging from < 0.036 to 2.3 ng g–1with a GM of 0.11 ng g–1and median of 0.10 ng g–1. Ratios of [free BPA]/[total BPA] for the positive samples ranged from 7.9% to 100% with a GM of 57.2% and median of 70.3%. Concentrations of free and total BPA in most samples were low with 0.39 and 0.65 ng g–1at the 95th percentile for free and total BPA, respectively, and they are also lower than those reported in other countries. Based on the low frequency of detection of free BPA in human milk samples, in general, dietary exposure to BPA for Canadian breast-fed infants is expected to be somewhat lower compared with exposure among formula-fed infants. [ABSTRACT FROM PUBLISHER]

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]

The objective of this study was to determine the extent of aflatoxin M1 (AFM1) and ochratoxin A (OTA) contamination in human breast milk in the city of Ribeirão Preto, São Paulo State, Brazil. During 2012, 100 samples of human milk were collected at the local Human Milk Bank. The method comprised, immunoaffinity column purification and isolation, liquid chromatography separation and fluorescence detection. The average percentage recoveries of AFM1 and OTA spiked at 20 and 50ng/L in control human milk were 78.1±11.7% and 73.7±9.6%, respectively. The average relative standard deviations of AFM1 and OTA spiked at the same levels were 11.7 and 9.6% respectively. The limits of detection was 0.3ng/L for AFM1 and OTA. The limit of determination was 0.8ng/L for both mycotoxins. This method was used to analyze 100 human milk samples, of which, two samples were found to contain AFM1 at level greater than 0.3ng/L. OTA was detected in 66 samples (66%), wherein 32 were above the limit of detection and 34 were in the range of from 0.8 to 21ng/L. Results of our study indicate that breast-fed Brazilian infants had only an insignificant exposure to AFM1 and OTA. [ABSTRACT FROM AUTHOR]

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]

The article presents several researches related to the role of contaminated milk in group B Streptococcus (GBS)-induced onset neonatal infections (LONI). It mentions researches on the pathophysiology of GBS LONI and the role of breast milk, bacteriological features of GBS LONI and the demonstration of the hypervirulent ST-17 clone. It reveals that breast milk accounts for repeated GBS transmission to neonate, which may favor gut translocation and LONI.

Abstract: Due to the tendency of polychlorinated biphenyls (PCB) to accumulate in matrixes with high lipid content, the contamination of the breast milk with these compounds is a serious issue, mainly to the newborn. In this study, milk samples were collected from breastfeeding mothers belonging to 4 Brazilian regions (south, southeast, northeast and north). Twelve PCB were analyzed by HS-SPME-GC-ECD and the corresponding peak areas were correlated to the answers to a questionnaire of general habits, breastfeeding and characteristics of the living places. To realize this exploratory analyze, self-organizing maps generated applying Kohonen neural network were applied. It was possible to verify the occurrence of different PCB congeners in the breast milk relating to the region of the Brazil that the breastfeeding lives, the proximity to an industry, the proximity to a contaminated river or sea, the type of milk (colostrum, foremilk and hindmilk) and the number of past pregnancies. [Copyright &y& Elsevier]

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]

We compared Pb concentration in human milk from 37 mothers living in a neighborhood of tin-ore smelters to that from 45 mothers living in a fishing community. The median breast-milk-Pb (BM-Pb) concentration was significantly ( p = 0.0000001) higher (11.3 μg L; ≤0.96-29.4 μg L) in mothers living in the vicinity of smelters than that of rural mothers (1.9 μg L; ≤0.96-20.0 μg L). These mothers also showed a statistically significant correlation between length of residence and BM-Pb concentration (Spearman r = 0.6864; p < 0.0001). The estimated median exposure (for infants <6 months) was 3.0 μg kg b.w. for rural infants compared to 7.5 μg kg b.w. for infants in the vicinity of metal smelters. Overall, most BM-Pb concentrations (79 %) in the metal smelter area were above the critical limit of 5.0 μg L set by the WHO. [ABSTRACT FROM AUTHOR]

Human milk has been traditionally considered germ free, however, recent studies have shown that it represents a continuous supply of commensal and potentially probiotic bacteria to the infant gut. Mammary microbioma may exercise anti-infective, anti-inflammatory, immunomodulatory and metabolic properties. Moreover human milk may be a source of pathogenic microorganism during maternal infection, if contaminated during expression or in case of vaccination of the mother. The non-sterility of breast milk can, thus, be seen as a protective factor, or rarely, as a risk factor for the newborn. [ABSTRACT FROM AUTHOR]

Abstract: Dioxins are a family of persistent organic pollutants (POPs) listed under the Stockholm Convention, and include PCDDs, PCDFs, and dioxin-like PCBs. These toxic chemicals are carcinogenic, widely dispersed, and have long half-lives. They have contaminated the food web and, being fat-soluble, accumulate in adipose tissues and milk in the human body. To assess human exposure, we collected breast milk samples from 137 first-time mothers recruited from around Hong Kong. Samples were analysed by HRGC–HRMS in four pools, according to the subject's age and length of residency. Exposure was related to age, duration of stay, and possibly diet. Generally, older mothers, and mothers with a longer stay in Hong Kong, had higher levels of dioxins in their milk. This pattern was clearest for the PCBs, although deviations were observed for some of the PCDD/Fs. Mean concentrations, measured per gram of lipid weight in terms of WHO toxic equivalents (WHO-TEQs), were 7.48pg/g for PCDD/Fs and 3.79pg/g for PCBs, giving a total of 11.27pg/g for PCDD/Fs and PCBs combined. Compared to an earlier Hong Kong study we conducted in 2002, the mean WHO-TEQ values in our latest findings were about 9% lower overall for PCDD/Fs and 19% lower for PCBs, with the mean total WHO-TEQ for PCDD/Fs and PCBs being around 13% lower in this study. This indicates a general declining trend in the levels of POPs in Hong Kong. However, our levels were still high when compared to those in some other Asian-Pacific countries. More stringent policies on reducing and eliminating POPs should help to lower these. Continued surveillance for POPs in human milk, as well as in common foodstuffs, will provide us with important information on human exposures that will be necessary for tracking our progress, and making future health risk assessments. [Copyright &y& Elsevier]

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]

Abstract: Breast milk samples of 39 first time mothers aged 20–30 were collected in 2007–2010 from rural and urban areas of New Zealand, following the fourth World Health Organization coordinated survey protocol. Samples were individually analysed for persistent organic pollutants (POPs) including dioxins and furans (PCDD/Fs), polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs) and polybrominated diphenyl ethers (PBDEs). The lipid adjusted concentrations of PCDD/Fs (mean toxic equivalent (TEQ): 3.54pg/g) and PCBs (mean TEQ 1.29pg/g) were low in comparison to those reported for other countries, and concentrations of dieldrin (10ng/g) and p,p′-DDE (379ng/g) and PBDEs were in the mid-range. Breast milk concentrations of PCDD/F-TEQ, PCB-TEQ, dieldrin and p,p′-DDE were significantly higher in rural compared to urban areas (+23%, 33%, 59%, and 44% respectively), while concentrations of several PBDEs and lindane were higher in urban areas. Concentrations of PCDD/Fs, PCBs and OCPs, but not PBDEs, increased with age, and higher body mass index was associated with lower concentrations of PCBs. Despite New Zealand's low body burdens of many chlorinated POPs in comparison to other countries, breast milk concentrations continued to decrease over time, with a decrease by half over the last 10years for PCDD/F-TEQ (−40%), PCB-TEQ (−54%) and OCPs −34 to −90%), indicating that regulatory measures continue to have beneficial effects. Continued monitoring is needed particularly for the brominated POPs for which little New Zealand specific data is available. [Copyright &y& Elsevier]