Low-Level Prenatal Toxin Exposures and Breastfeeding Duration: A Prospective Cohort Study

Abstract

Introduction Maternal exposure to tobacco smoke is associated with shortened breastfeeding duration, but few studies have examined the effects on breastfeeding outcomes of low level exposures to other toxic chemicals. Moreover, it is unclear if passive smoking is associated with duration of breastfeeding. Our objective was therefore to examine the effect of low-level prenatal exposures to common environmental toxins (tobacco smoke, lead, and phthalates) on breastfeeding exclusivity and duration. Methods We conducted an analysis of data from the HOME (Health Outcomes and Measures of the Environment) Study. Serum and urine samples were collected at approximately 16 and 26 weeks gestation and at delivery from 373 women; 302 breastfed their infants. Maternal infant feeding interviews were conducted a maximum of 8 times through 30 months postpartum. The main predictor variables for this study were gestational exposures to tobacco smoke (measured by serum cotinine), lead, and phthalates. Passive smoke exposure was defined as cotinine levels of 0.015–3.0 μg/mL. Primary outcomes were duration of any and exclusive breastfeeding. Results Serum cotinine concentrations were negatively associated with the duration of any breastfeeding (29.9 weeks unexposed vs. 24.9 weeks with passive exposure, p=0.04; and 22.4 weeks with active exposure, p=0.12; p=0.03 for linear trend), but not duration of exclusive breastfeeding. Prenatal levels of blood lead and urinary phthalate metabolites were not significantly associated with duration of any or exclusive breastfeeding. Conclusions Passive exposure to tobacco smoke during pregnancy was associated with shortened duration of any breastfeeding.

Secondhand Smoke Exposure During Pregnancy and Mothers’ Subsequent Breastfeeding Outcomes: A Systematic Review and Meta-Analysis

“…A study in the US reported that pregnant women who were exposed to SHS had a significantly shorter time (24.9 weeks) of any breastfeeding duration compared to unexposed pregnant women (29.9 weeks). However, there was no significant association with exclusive breastfeeding duration (2.7 weeks for unexposed vs. 2.1 weeks for exposed) 14 . The purpose of this systematic review to examine the associations between secondhand smoke exposure of nonsmoking women during pregnancy with initiation, prevalence, and duration.…”

Are mothers less likely to breastfeed in harsh environments? Physical environmental quality and breastfeeding in the Born in Bradford study

“…The rate of elimination depends on the amount of fat a person has (World Health Organisation, ) and, as South Asian populations have more fat mass than Europeans (Deurenberg, Deurenberg‐Yap, & Guiricci, ; Stanfield, Wells, Fewtrell, Frost, & Leon, ), the Pakistani‐origin mothers in our sample may have retained DBPs in their bodies for longer, resulting in greater physiological impact. The compounds may impact breast development and lactation (Bielmeier, Best, & Narotsky, ; Rosen‐Carole et al, ) and may transfer from mother to infant (Batterman, Zhang, Wang, & Franzblau, ), potentially altering the taste and acceptability of breastmilk (Office of Environmental Health Hazard Assessment California Environmental Protection Agency, ). Alternatively, rather than being driven by physiological variation, the observed ethnic differences could be explained by social factors not controlled for, for example, diet and stress (Smith et al, ), or even fertility (although further data exploration shows this to be unlikely [results available on request]).…”

“…There has been relatively little research explicitly linking environmental pollutant exposure with breastfeeding outcomes, but chemical compounds have been detected in breastmilk (Stefanidou, Maravelias, & Spiliopoulou, ), some of which are likely to have endocrine disrupting capabilities (Pedersen et al, , p. 72). Hormonal disruption or toxicity can impact mammary gland development during pregnancy (Rosen‐Carole, Auinger, Howard, Brownell, & Lanphear, ) and also the lactation process itself. This is certainly the case for maternal smoking as it has been shown to interfere with the milk ejection reflex, reduce milk output, alter the taste and composition of breastmilk, and suppress infant appetite and increase irritability (Amir, ).…”

How do reproduction, parenting, and health cluster together? Exploring diverging destinies, life histories and weathering in two UK cohort studies

“…As well as epigenetic effects (Beach et al 2016;Romens et al 2015), our autonomic, neuroendocrine, metabolic and immune systems track environmental information (Cabeza de Baca and Ellis 2017; Vitzthum 2009). Physical and social environments can affect our physiology in similar ways, with for example the chemical compounds in air and water and the experience of parental separation both having endocrine disrupting potential (Alvergne et al 2008;Pedersen et al 2013;Rosen-Carole et al 2017;Toppari and Juul 2010). Coordinating the development of a broad cluster of life historyrelevant traits may depend on consistent environmental information and using childhood environmental conditions to predict adult environmental conditions may only create optimal strategies if the two environments are similar (Alvergne et al 2008; Cabeza de Baca and Ellis 2017; Nettle et al 2011).…”