| Chemical Contaminants in Breast Milk and
Their Impacts on Children's Health: An Overview Philip J. Landrigan,1 Babasaheb Sonawane,2 Donald Mattison,3 Michael McCally,1 and Anjali Garg1 1Center for Children's Health and the Environment, Department of Community and Preventive Medicine, Mount Sinai School of Medicine, New York, New York, USA; 2National Center for Environmental Assessment, U.S. Environmental Protection Agency, Washington, DC, USA; 3March of Dimes Birth Defects Foundation, White Plains, New York, USA
Abstract
Human milk is the best source of nutrition for infants. Breast milk contains the optimal balance of fats, carbohydrates, and proteins for developing babies, and it provides a range of benefits for growth, immunity, and development. Unfortunately, breast milk is not pristine. Contamination of human milk is widespread and is the consequence of decades of inadequately controlled pollution of the environment by toxic chemicals. The finding of toxic chemicals in breast milk raises important issues for pediatric practice, for the practice of public health, and for the environmental health research community. It also illuminates gaps in current knowledge including a) insufficient information on the nature and levels of contaminants in breast milk ; b) lack of consistent protocols for collecting and analyzing breast milk samples ; c) lack of toxicokinetic data ; and d) lack of data on health outcomes that may be produced in infants by exposure to chemicals in breast milk. These gaps in information impede risk assessment and make difficult the formulation of evidence-based health guidance. To address these issues, there is a need for a carefully planned and conducted national breast milk monitoring effort in the United States. Additionally, to assess health outcomes of toxic exposures via breast milk, it will be necessary to examine children prospectively over many years in longitudinal epidemiologic studies that use standardized examination protocols that specifically assess breast milk exposures. Finally, current risk assessment methods need to be expanded to include consideration of the potential risks posed to infants and children by exposures to chemical residues in breast milk. Key words: breast milk, breast-feeding, children's health, chemical contaminants. Environ Health Perspect 110:A313-A315 (2002) . [Online 13 May 2002] http://ehpnet1.niehs.nih.gov/docs/2002/110pA313-A315landrigan/ abstract.html Address correspondence to P. J. Landrigan, Center for Children's Health and the Environment, Department of Community and Preventive Medicine, Box 1057, 1 Gustave L. Levy Place, Mount Sinai School of Medicine, New York, NY 10029 USA. Telephone: (212) 241-4804. Fax: (212) 996-0407. E-mail: phil.landrigan@mssm.edu This article is an introduction to the Mini-Monograph on "Chemical Contaminants in Breast Milk." The series of articles in this mini-monograph were developed from ideas developed at the conference on "Chemical Contaminants in Breast Milk: Impacts on Children's Health." The conference, "Chemical Contaminants in Breast Milk: Impacts on Children's Health," was supported by the following federal agencies: the U.S. Environmental Protection Agency, the Agency for Toxic Substances Disease Registry, the National Institute of Child Health and Human Development, the National Institute of Environmental Health Sciences, and the Centers for Disease Control and Prevention. The conference also received support from the following private foundations: the March of Dimes Birth Defects Foundation, the Pew Charitable Trusts, the Bauman Family Foundation, the Shulsky Foundation, and the Wallace Genetic Foundation. We thank L. Boni of the Center for Children's Health and the Environment for her valuable contributions to successfully organizing the conference. The views expressed in this paper are the opinions of the authors and do not represent endorsement or policy of their affiliated institutions or the U.S. Environmental Protection Agency. Received 20 December 2001 ; accepted 11 February 2002.
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