The presence of pollutants in human breast milk is of major concern, especially in malaria control areas where 1,1,1-trichloro-2, 2-bis(4-chlorophenyl) ethane (DDT) is currently used as indoor residual spray (IRS). The levels of DDT and pyrethroids (PYR) were determined in breast milk, bovine milk, and drinking water from northern KwaZulu-Natal, South Africa. Both reference and exposed mothers used the same market food, but the DDT levels in the exposed mothers (mean SDDT 10 mg/g milk fat) were much higher than for the reference mothers (mean SDDT 1.3 mg/g milk fat). This difference in residue levels indicates uptake from IRSapplied DDT, most likely via air and skin contact, and excludes food as main source of pollutants. DDT levels in bovine milk (mean SDDT 0.15 mg/g milk fat) from the exposed area were less than levels in breast milk from the reference area, and lower than the 20 mg/L maximum residue limit (MRL) set by the FAO. Mean SDDT in water was 0.0065 mg/L, much lower then the World Health Organization (WHO) limit of the sum of all metabolites in drinking water of 1 mg/L, and therefore highly unlikely to have contributed to any extent toward levels in breast milk. Permethrin in breast milk (mean 1.1-1.6 mg/g milk fat) was probably derived from home garden and indoor use, while the other pyrethroids (cypermethrin and cyfluthrin) at lower concentrations were probably derived from food and agricultural exposure. It is postulated that a better understanding of the indoor dynamics of DDT and other insecticides, through a concept of Total Homestead Environment Approach (THEA), is crucial for investigating options of reducing human exposure and uptake under malaria control conditions.