Environmental Chemicals in Breast Milk and Formula: Exposure and Risk Assessment Implications

Lehmann, Geniece M.; LaKind, Judy S.; Davis, Matthew H.; Hines, Erin P.; Marchitti, Satori A.; Alcala, Cecilia Sara; Lorber, Matthew

doi:10.1289/ehp1953

Cited by 87 publications

(74 citation statements)

References 151 publications

(192 reference statements)

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“…L'exposition à ces composés toxiques a également été mise en évidence chez les femmes enceintes en France avec les dernières études nationales EDEN : « Etude sur les déterminants pré-et post-natals précoces du développement psychomoteur et de la santé de l'enfant » et ELFE : « Etude longitudinale française depuis l'enfance » en lien avec la deuxième étude de l'alimentation totale française EAT2 [22]. Durant la petite enfance, dès la naissance, des expositions sont aussi possibles au cours de l'allaitement ou lors de l'ingestion de préparations infantiles [23]. Des études récentes montrent des modifications possibles du microbiote intestinal de l'enfant en lien avec la présence de contaminants chimiques lors de l'allaitement pour des femmes ayant été exposées à des contaminants chimiques [24,25].…”

Section: Alimentation Aliments Transformés Et Microbiote Intestinalunclassified

Effets des polluants environnementaux et alimentaires sur le microbiote intestinal

Comtet-Marre

Mosoni

Peyret

2020

Cahiers de Nutrition et de Diététique

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La population humaine est exposée à de très nombreux contaminants chimiques environnementaux et alimentaires (métaux lourds, pesticides, nanoparticules, plastiques, polluants organiques persistants, additifs alimentaires, produits néoformés). Ces expositions pourraient perturber le microbiote intestinal, acteur clé de la santé humaine, et ainsi participer directement ou indirectement à l'établissement de diverses affections chroniques telles que l'obésité, le diabète de type 2, les désordres métaboliques, les cancers, les maladies inflammatoires, les pathologies reproductives, immunitaires mais aussi neurologiques.

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Section: Alimentation Aliments Transformés Et Microbiote Intestinalunclassified

Effets des polluants environnementaux et alimentaires sur le microbiote intestinal

Comtet-Marre

Mosoni

Peyret

2020

Cahiers de Nutrition et de Diététique

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“…However, it may also pose unexpected risks: maternal exposure to food contaminants, such as mycotoxins, for example, may subject offspring not only to in utero, but also breast milk mycotoxins, thereby potentially increasing the risk for childhood and adulthood disease through gene x environment interactions or adverse epigenetic programing (Thornburg et al 2010;Warth et al 2019). Currently, no clear data on excretion patterns of food contaminants in breast milk at different stages during breastfeeding exist Lehmann et al 2018). To date, studies have mainly focused on AFM1 and OTA, and they used enzyme linked immunosorbent assays (ELISA) or liquid chromatography coupled to fluorescence detection (LC-FD), both of which lack the specificity and sensitivity of state-of-the-art LC-MS systems as reviewed by Warth et al (2016) andSengling Cebin Coppa et al (2019).…”

Section: Introductionmentioning

confidence: 99%

Longitudinal assessment of mycotoxin co-exposures in exclusively breastfed infants

Braun

Schernhammer

Marko

et al. 2020

Preprint

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Early-life development of infants may be critically affected by man-made or natural contaminants including mycotoxins. However, data on the occurrence of food contaminants in breast milk is scarce and prohibits a comprehensive exposure and risk assessment for mothers and their infants. Here, we present a longitudinal exposure assessment over the first 211 days of a single newborn girl (study A) by measuring multiple mycotoxins in milk. Eighty-seven consecutive breast milk samples were obtained from the newborn's mother living in Austria and following a regular mixed local diet. Mycotoxins were analyzed by utilizing a highly sensitive LC-MS/MS approach covering 29 mycotoxins and key metabolites. In addition to this longitudinal study, three mothers provided breast milk samples each on five consecutive days, for a preliminary comparison of inter-day and inter-individual variation in exposures (study B). Study A revealed that mycotoxin occurrence in breast milk was limited to the emerging mycotoxins alternariol monomethyl ether (AME), beauvericin (BEA), enniatins (A, A1, B, B1) and to ochratoxin A (OTA), which is regulated in commercial infant food. These mycotoxins were, if present, mostly detected at very low concentrations (<10 ng/L), except AME which exceeded this concentration on two distinct days by a factor of 3x and 5x. Overall, longitudinal results indicated chronic low-dose exposure to the detected mycotoxins. Other regulated mycotoxins including the carcinogenic aflatoxins or the estrogenic zearalenone and their biotransformation products were absent in all tested samples. Study B confirmed the results of study A, with minimal inter-day and inter-individual variation. Based on the data set obtained in study A, exposure of the infant was estimated. Exposure estimates of individual mycotoxins were on average below 1 ng/kg body weight per day. Our findings suggest that exposure to mycotoxins in Austrian breast milk may be negligible. Recommended maximum daily intake levels were clearly not exceeded. However, exposure is likely to be higher in populations with lower food safety standards. In the light of co-occurrence of several emerging mycotoxins in breast milk, future studies should address lowdose mixture effects. This also includes other environmental contaminants which may be present in this bio-fluid and should involve an exposome-scale risk assessment. All these efforts must be intended to minimize exposure of mothers and infants in a window of high susceptibility.

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“…There is a need to monitor, regulate, and consciously avoid these chemicals wherever possible. Biomonitoring of human milk is therefore inevitable (Sonawane, 1995;Landrigan et al, 2002;Mead, 2008;Lehmann et al, 2018;Leibson et al, 2018;LaKind et al, 2018). Environmental contaminants are mostly lipophilic, persistent and bioaccumulative in nature, and have a tendency to deposit in adipose tissues of women or mothers who are exposed to these chemicals (Sonawane, 1995;Mead, 2008).…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have also compiled the list of chemicals detected in human milk, and these studies were published as research articles or scientific reports. A prominent example is the work of Lehmann et al (Lehmann et al, 2018) (which was not certified by peer review) is the author/funder. All rights reserved.…”

Section: Introductionmentioning

confidence: 99%

“…In this work, we present our comprehensive knowledgebase, ExHuMId, on human milk contaminants in India. We also utilize the information compiled in our resource, and in two other resources (Neveu et al, 2017;Lehmann et al, 2018) to understand the human milk exposome from three perspectives. Firstly, we understand the nature of human milk contaminants through a comparative analysis with several chemical regulatory and guideline lists (Karthikeyan et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

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ExHuMId: A curated resource and analysis of Exposome of Human Milk across India

Karthikeyan

Ravichandran

Aparna

et al. 2020

Preprint

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Human milk is a vital source of nourishment for infants, containing nutrients, immunoprotective components, and bioactive substances. However, several environmental contaminants find their way into human milk. Although lactation physiology has been well documented, the effect of human milk contaminants on maternal and infant health remains unclear. Human milk is the major route of contaminant exposure to infants; these contaminants and their effects can themselves be considered an exposome. While there are chemical regulations in India and scientific literature on environmental contaminants is available, yet there is a lack of systematic compilation, monitoring, and risk management of human milk contaminants. We have harnessed the potential of this large body of literature to develop the Exposome of Human Milk across India (ExHuMId) containing detailed information on 101 environmental contaminants detected in human milk samples, studied across 13 Indian states, compiled from 36 research articles. ExHuMId also compiles the detected concentrations of the contaminants, structural and physicochemical properties, and factors associated with the donor of the sample. Here, we also present findings from a three-pronged analysis of ExHuMId and two other resources on human milk contaminants, with a focus on the Indian scenario. Through a comparative analysis with global chemical regulations and guidelines, we identify human milk contaminants of high concern, such as potential carcinogens, endocrine disruptors and neurotoxins. We then study the physicochemical properties of the contaminants to gain insights on their propensity to transfer into human milk. Further, we employ a systems biology approach to shed light on potential effects of human milk contaminants on maternal and infant health, by identifying contaminant-gene interactions associated with lactation, cytokine signalling and production, and protein-mediated transport. ExHuMId is accessible online at: https://cb.imsc.res.in/exhumid/.

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Environmental Chemicals in Breast Milk and Formula: Exposure and Risk Assessment Implications

Abstract: Better-designed studies are needed to characterize infant exposures to environmental chemicals in breast milk and infant formula as well as to improve risk assessments of chemicals found in both foods. https://doi.org/10.1289/EHP1953.

Cited by 87 publications

References 151 publications

Effets des polluants environnementaux et alimentaires sur le microbiote intestinal

Effets des polluants environnementaux et alimentaires sur le microbiote intestinal

Longitudinal assessment of mycotoxin co-exposures in exclusively breastfed infants

ExHuMId: A curated resource and analysis of Exposome of Human Milk across India

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