Estimating daily intakes of manganese due to breast milk, infant formulas, or young child nutritional beverages in the United States and France: Comparison to sufficiency and toxicity thresholds

Abstract

Laboratories provided no input in choosing the subject matter of this project, the hypotheses that were tested, the method of analysis, the research findings, the decision to publish, or the manner of disseminating the results. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Highlights1. Mn deficiency is unlikely with exclusive breast milk or infant formula feeding.2. Breast milk Mn mean intake is 1.2 µg/kg/day (3 weeks)-0.16 µg/kg/day (18 months).3. Formula Mn intake range is 130 µg/kg/day (3 weeks)-4.8 µg/kg/day (18 months). 4. Formula products reconstituted with 250 µg Mn/L water may exceed 140 µg Mn/kg/day. 5. Formula products may surpass regulatory tolerable daily intake levels for Mn. Abstract BackgroundAlthough manganese (Mn) is an essential nutrient, recent research has revealed that excess Mn in early childhood may have adverse effects on neurodevelopment. MethodsWe estimated daily total Mn intake due to breast milk at average body weights by reviewing reported concentrations of breast milk Mn and measurements of body weight and breast milk intake at 3 weeks, 4.25 months, 7 months, and 18 months. We compared these figures to the Mn content measured in 44 infant, follow-up, and toddler formulas purchased in the United States and France. We calculated Mn content of formula products made with ultra-trace elemental analysis grade water (0 µg Mn/L) and with water containing 250 µg Mn/L, a concentration which is relatively high but less than the World Health Organization Health-based value of 400 µg Mn/L or the United States Environmental Protection Agency Health Advisory of 350 µg Mn/L. ResultsEstimated mean daily Mn intake from breast milk ranged from 1.2 µg Mn/kg/day (3 weeks) to 0.16 µg Mn/kg/day (18 months), with the highest intakes at the youngest age stage we considered, 3 weeks. Estimated daily Mn intake from formula products reconstituted with 0 µg Mn/L water ranged from 130 µg Mn/kg/day (3 weeks) to 4.8 µg Mn/kg/day (18 months) with the highest intakes at 3 weeks. Formula products provided 28 to 520 times greater than the mean daily intake of Mn from breast milk for the 4 age stages that we considered. Estimated daily Mn intake from formula products reconstituted with water containing 250 µg Mn/L ranged from 12 µg Mn/kg/day to 170 µg Mn/kg/day, which exceeds the United States Environmental Protection Agency Reference Dose of 140 µg Mn/kg/day for adults. ConclusionsMn deficiency is highly unlikely with exclusive breast milk or infant formula feeding, but established tolerable daily intake levels for Mn may be surpassed by some of these products when following labeled instructions.

Health Risk Assessments of Selected Trace Elements and Factors Associated with Their Levels in Human Breast Milk from Pretoria, South Africa

“…However, Cr levels in breast milk reported from Iran were much higher than in the present study, with median levels of 3.95 µg/L, and these levels were attributed to exposure through contaminated foodstuff [ 13 ]. The median Mn levels from breast milk were significantly lower ( p < 0.05) than those reported in literature, with most other studies reporting values ≥ 1 µg/L [ 35 , 55 , 56 , 57 , 58 ]. A study by Mitchell et al (2020) summarized the levels of Mn in breast milk reported in more than 20 different countries from January 1980 to December 2017.…”

“…A study by Mitchell et al (2020) summarized the levels of Mn in breast milk reported in more than 20 different countries from January 1980 to December 2017. From this summary, levels of Mn in 5 423 breast milk samples ranged from 0.17 to 30.27 µg/L, and a mean of means of 7.7 µg/L was established [ 35 ].…”

“…Although arsenic, lead and cadmium are some of the most studied trace elements in human breast milk, elevated levels of cobalt, chromium, mercury and manganese have also been detected in breast milk [ 32 , 33 , 34 , 35 ]. Cobalt, chromium and manganese are considered to be micro-elements needed in small amounts for the proper growth and function of the human body [ 36 , 37 , 38 ].…”