Bejegyzés

Lead exposure during breastfeeding

Jacquelyn Choi, Toshihiro Tanaka, Gideon Koren, Shinya Ito

Can Fam Physician Vol. 54, No. 4, April 2008, pp.515 – 516

QUESTION Owing to the recent concerns of lead (Pb) leaking into tap water, one of our female patients is concerned about the effects of Pb exposure to newborns while breastfeeding. How should I advise her and should she switch to formula feeding?

ANSWER Lead exposure through drinking tap water while breastfeeding is not associated with any serious concerns in most available studies. There is currently no safe level of Pb exposure, but environmental exposure within Canada is low. At present, Pb levels in drinking water are carefully monitored by Health Canada and are not likely to be of concern to breastfeeding mothers.
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Concentrations of Certain Toxins in Breast Milk Are Low

Newswise — Nursing mothers worried about passing harmful chemicals to their infants through breast milk should be aware that the air inside their home may pose a greater health risk.

Researchers from Ohio State and Johns Hopkins universities measured the levels of harmful gases called “volatile organic compounds” (VOCs) in human milk and in the air inside the homes of three lactating mothers in inner-city Baltimore.

A nursing infant’s exposure to VOCs from indoor air was 25- to 135-fold higher than what that infant ingested through breast milk. In fact, levels found in milk were far below the U.S. EPA’s maximum contaminant levels for drinking water.
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Változatlanul alacsony az ólomszint az anyatejben

NEW YORK (Reuters Health) – Egy új tanulmány felfedezése megnyugtatást nyújthat a szoptató anyáknak. Még ha szervezetük nagy mennyiségű ólomnak van is kitéve, nagyon kevés választódik ki az anyatejbe ebből a mérgező anyagból. Ráadásul kalcium tabletták alkalmazásával még alacsonyabbra csökkenthető az ólom mértéke.

Dr. Adrienne S. Ettinger és kollégái, a bostoni Harvard Közegészségügyi Iskolából, 367 mexikóvárosi nőt vizsgáltak meg annak kiderítésére, hogy milyen hatással van a fokozott ólomveszély, a szoptatási gyakorlat, és a kalcium bevitel az anyatejben megjelenő ólom szintjére.
A kutatók a szoptató anyák vérében és anyatejében mérték az ólomszintet szülésük utáni 1., 4., és 7. hónapban, illetve az 1.
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Influence of Maternal Bone Lead Burden and Calcium Intake on Levels of Lead in Breast Milk over the Course of Lactation

Adrienne S. Ettinger, Martha María Téllez-Rojo, Chitra Amarasiriwardena, Karen E. Peterson, Joel Schwartz, Antonio Aro, Howard Hu and Mauricio Hernández-Avila

American Journal of Epidemiology 2006 163(1):48-56

The authors studied 367 women who were breastfeeding their infants in Mexico City, Mexico, between 1994 and 1995 to evaluate the effect of cumulative lead exposure, breastfeeding practices, and calcium intake on breast milk lead levels over the course of lactation.

Maternal blood and breast milk lead levels were measured at 1, 4, and 7 months postpartum. Bone lead measurements were obtained at 1 month postpartum. At 1, 4, and 7 months postpartum, respectively, the mean breast milk lead levels were 1.4 (standard deviation (SD), 1.1), 1.2 (SD, 1.0), and 0.9 (SD, 0.8) µg/liter and showed a significant decreasing trend over the course of lactation (p < 0.00001). The relations of bone lead and blood lead to breast milk lead were modified by breastfeeding practice, with the highest breast milk lead levels among women with a high level of patella lead who were exclusively breastfeeding. Dietary calcium supplementation increased the rate of decline in breast milk lead by 5–10%, in comparison with a placebo, over the course of lactation, suggesting that calcium supplementation may constitute an important intervention strategy, albeit with a modest effect, for reducing lead in breast milk and thus the potential for exposure by infants. A cikk kivonata az American Journal of Epidemiology weboldalán található.
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A toxinok és a csecsemőtáplálás

Handout #28. Toxins and Infant Feeding. January 2005 Written by Jack Newman, MD, FRCP.2005

Az anyatejben megjelenő toxinok kérdésének tárgyalását azért tartom fontosnak, mert néhány havonta, szinte óramű pontossággal, újra és újra felvetődik ez a téma a médiában. A hírek rémületet keltenek a várandós nők körében, ezzel eltántorítva őket a szoptatástól, és sok már szoptató anyát a szoptatás befejezésére késztetnek. Az újságírók szemmel láthatóan nem tudják, hogyan kellene ezt a kérdést jól kezelni. Néhányukat minden bizonnyal saját korábbi tapasztalataik motiválnak („az én kisbabám nem szopott és mégis jól van”), amelyeket teherként cipelnek, és így találnak lehetőséget arra, hogy igazolják az „általuk választott csecsemőtáplálási módot” a szoptatás pártolóival szemben.
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Prenatal exposure to PCBs and breastfeeding: opposing effects on auditory P300 latencies in 9-year-old Dutch children

Vreugdenhil HJ, Van Zanten GA, Brocaar MP, Mulder PG, Weisglas-Kuperus N.

Dev Med Child Neurol. 2004 Jun;46(6):398-405

Effects of perinatal exposure to polychlorinated biphenyls (PCBs) on auditory P300 latencies and amplitudes were evaluated in children from a Rotterdam cohort. From this cohort of healthy, term babies, the 26 lowest and 26 highest prenatally PCB-exposed children from the breastfed and the formula-fed groups (n=104) were invited for P300 assessment when they were 9 years of age. For P300 assessment an auditory simple odd-ball paradigm was used. In the 83 participating children, 60 assessments (32 males, 28 females) satisfied the measurement criteria and were included in the data analyses.
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Breastfeeding, Exposure to Organochlorine Compounds, and Neurodevelopment in Infants

Núria Ribas-Fitó, MD, Esther Cardo, MD, PhD, Maria Sala, MD, PhD, M. Eulàlia de Muga, MD, Carlos Mazón, MD, Antoni Verdú, MD, Manolis Kogevinas, MD, PhD, Joan O. Grimalt, PhD and Jordi Sunyer, MD, PhD

PEDIATRICS Vol. 111 No. 5 May 2003, pp. e580-e585

ABSTRACT
Objective. Exposure to organochlorine compounds (OCs) occurs both in utero and through breastfeeding. Levels of hexachlorobenzene (HCB) found in the cord serum of newborns from a population located in the vicinity of an electrochemical factory in Spain were among the highest ever reported. We studied the association between exposure to OCs and breastfeeding on neurodevelopment in the 1-year-old infants of this population.
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Environmental exposure to polychlorinated biphenyls (PCBs) and dioxins

Consequences for longterm neurological and cognitive development of the child lactation.

Boersma ER, Lanting CI.

Adv Exp Med Biol. 2000;478:271-87.

Polychlorinated biphenyls (PCBs) and dioxins are environmental pollutants. Prenatally, as well as postnatally through breast feeding, large amounts are transferred from mother to the child. Formula is free of these substances. Considering their potential developmental neurotoxicity, we investigated long term effects of perinatal exposure to PCBs and dioxins on neurological and cognitive development. Given the evidence that PCBs exert oestrogenic effects, and oestrogens are known to suppress lactation, we investigated the effect of maternal PCB body load on lactation performances as well.
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Comment on “Breast Milk: An Optimal Food”

Adriano Cattaneo

Environ Health Perspect. 2005 Jan;113(1):A18-9.

In their editorial “Breast Milk: An Optimal Food,” Pronczuk et al. (2004) stated that “in most cases, mothers can and should be reassured that breast milk is by far the best food to give to their babies,” despite the evidence that “a myriad of potential chemical contaminants . . . can be detected in breast milk,” mainly because a) levels of environmental contaminants, as determined by subsequent surveys, continue to decrease; b) exposure through breast milk may be less important than exposure in utero; and c) there is little evidence that exposure through breast milk is associated with damage.
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Breast Milk: An Optimal Food

Jenny Pronczuk, Gerald Moy, and Constanza Vallenas

Environ Health Perspect. 2004 Sep;112(13):A722-3.

Human breast milk offers the optimal nutrition for all infants and provides immunological, developmental, psychological, economic, and practical advantages when compared to artificial feeding. For proper growth, development, and health, infants should be exclusively breastfed with no other food or drink–not even water–for their first 6 months of life [World Health Organization (WHO) 2001]; they should then receive nutritionally adequate and safe complementary foods while breast-feeding continues up to 24 months of age or beyond.

Given the considerable benefits of breast-feeding for mothers and children everywhere, special efforts are being undertaken by the WHO and partners to promote it in all countries.
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