Pollutants in breast milk
W. J. Rogan
Office of Clinical Research, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA. rogan@niehs.nih.gov
OBJECTIVE: To review data on the occurrence and toxicity of the commonly
reported pesticides and industrial environmental pollutant chemicals in
breast milk. DATA SOURCES: Continuous automated literature surveillance
plus contact with investigators and governmental agencies. STUDY
SELECTIONS: For data on occurrence, the most recent data from the largest
data sets on the most representative donors were used. For data on
toxicity, the primary report that was publicly available was used. DATA
EXTRACTION: When necessary, data were reexpressed or concentrations were
rescaled. The original investigator was contacted if necessary. DATA
SYNTHESIS: Although pollutant chemicals are readily detected in most human
milk worldwide, there is little evidence for consequent morbidity in
nurslings. There have been several mass poisonings in which chemicals that
were transmitted through breast milk clearly affected children who were
breast-fed, and there is some evidence that prenatal exposure to background
levels resulted in mild developmental delay and that lactation per se was
disturbed. CONCLUSIONS: Breast-feeding is recommended despite the presence
of chemical residues. The prenatal period in the child and the initiation
of lactation in the mother may be sensitive periods to the toxicity of the
chemicals that are considered here, and the potential for poisoning at
higher levels is clear. However, in the vast majority of women, the
benefits of breast-feeding appear to outweigh the risks, and those who
advise women about infant nutrition should continue to support
breast-feeding.
