| Infant Exposure to Chemicals in Breast Milk in the United States: What We Need To Learn From a Breast Milk Monitoring Program Judy S. LaKind,1 Cheston M. Berlin,2 and Daniel Q. Naiman3 1LaKind Associates, LLC, Catonsville, Maryland, USA
2The Milton S. Hershey Medical Center, Department of Pediatrics, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, USA
3Department of Mathematical Sciences, The Johns Hopkins University, Baltimore, Maryland, USA Abstract
The presence of environmental chemicals in breast milk has gained increased attention from regulatory agencies and groups advocating women's and children's health. As the published literature on chemicals in breast milk has grown, there remains a paucity of data on parameters related to infant exposure via breast-feeding, particularly those with a time-dependent nature. This information is necessary for performing exposure assessments without heavy reliance on default assumptions. Although most experts agree that, except in unusual situations, breast-feeding is the preferred nutrition, a better understanding of an infant's level of exposure to environmental chemicals is essential, particularly in the United States where information is sparse. In this paper, we review extant data on two parameters needed to conduct realistic exposure assessments for breast-fed infants: a) levels of chemicals in human milk in the United States (and trends for dioxins/furans) ; and b) elimination kinetics (depuration) of chemicals from the mother during breast-feeding. The limitations of the existing data restrict our ability to predict infant body burdens of these chemicals from breast-feeding. Although the data indicate a decrease in breast milk dioxin toxic equivalents over time for several countries, the results for the United States are ambiguous. Whereas available information supports the inclusion of depuration when estimating exposures from breast-feeding, the data do not support selection of a specific rate of depuration. A program of breast milk monitoring would serve to provide the information needed to assess infant exposures during breast-feeding and develop scientifically sound information on benefits and risks of breast-feeding in the United States. Key words: breast milk, chlorinated organic chemicals, depuration, dioxin, monitoring program, time trends. Environ Health Perspect 109:75-88 (2001) . [Online 20 December 2000] http://ehpnet1.niehs.nih.gov/docs/2001/109p75-88lakind/ abstract.html Address correspondence to J.S. LaKind, LaKind Associates, LLC, 106 Oakdale Avenue, Catonsville, MD 21228 USA. Telephone: (410) 788-8639. Fax: (410) 788-1971. E-mail: Lakindassoc@worldnet.att.net We thank G. Liberson for his thoughts on elimination kinetics. Funding for this research was provided by the Chlorine Chemistry Council. Received 21 June 2000 ; accepted 15 August 2000.
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