Study of human lactation for effects of environmental contaminants: the North Carolina Breast Milk and Formula Project and some other ideas.

Abstract

The presence of environmental contaminant chemicals in human milk, their demonstrated toxicity, and the lack of data in human beings led to the North Carolina Breast Milk and Formula project, a three-center prospective birth cohort study of 856 children. In this study, we measure polychlorinated biphenyls (PCBs) and DDE in milk and other fluids, follow the course of lactation, and note growth, morbidity and development in the children. Lactation is hormonally complicated and has parts that are plausibly interfered with by contaminant chemicals, and certain kinds of morbidity that occur in breastfed children might also represent the result of chemical contamination of milk. Preliminary data analysis confirms the widespread presence of chemicals in milk; women with higher DDE levels do not breast-feed as long, but this is not true for women with higher PCBs. Besides this study, several case-control or survey-type studies, such as studies of failure to thrive, certain rashes, or short-term breast-feeding would be helpful. Laboratory studies of enzyme induction are now feasible in children and might be a very sensitive if not totally specific endpoint for study of PCBs in milk.

High levels of DDT in breast milk: Intake, risk, lactation duration, and involvement of gender

“…2C, and section 3.4). The levels reported here are the highest yet used to investigate the effect of DDT on duration of lactation that we could find (inter alia Rogan and Gladen, 1985;Gladen and Rogan, 1995;Kostyniak et al, 1999;Weldon et al, 2006;Cupul-Uicab et al, 2008). Fig.…”

“…DDT might reduce (Rogan and Gladen, 1985;Rogan et al, 1987;Gladen and Rogan, 1995;Kostyniak et al, 1999), lengthen (Weldon et al, 2006) or have no effect (Cupul-Uicab et al, 2008) on duration of lactation, due to the endocrine disruptive properties of DDT isomers and breakdown products (Wetterauer et al, 2012). The levels of DDT in SA are exceedingly high -the highest yet measured was 59.3 mg/kg ΣDDT mf (milk fat) (Bouwman et al, 1990a).…”

Chemical contaminants, pharmacokinetics, and the lactating mother.

“…There are two studies of morbidity in children occurring from background exposure PCBs in the United States, one in central North Carolina (the NC study) (38) and the other near Lake Michigan (the MI study) (39). Both were cohort studies in which mothers were identified at or near term, the levels of PCBs were measured in breast milk and other fluids, and the children tested for neurodevelopmental status over time.…”

“…Thus far, these studies show morbidity from PCBs at exposures lower than any other studies, and so it is this morbidity we wish to prevent by limiting the mother's exposures. Dose information is not available for the women who participated in these studies, and we need to make a number of assumptions to estimate maternal dose (38). In the NC study, the measure of prenatal exposure is the estimated amount of PCBs in the fat of breast milk at term.…”

Medical Toxicology and Public Health—Update on Research and Activities at the Centers for Disease Control and Prevention and the Agency for Toxic Substances and Disease Registry

“…The North Carolina Breast Milk and Formula Project investigated the effects of prenatal exposure to background levels of PCBs and the organochlorine pesticide, dichlorodiphenyl dichloroethene (DDE) via maternal breast milk. The authors reported that children with higher in-utero PCB and DDE exposure exhibited adverse neurologic findings, such as hyporeflexia and hypotonicity [5,6]. The Lake Michigan/ Maternal Infant Cohort Study reported both developmental disorders and cognitive deficits in the offspring of mothers who were exposed via fish consumption to PCBs and related compounds for at least 6 years before and during pregnancy [7][8][9][10].…”