Title: Human milk mycotoxin contamination: smoking exposure and breastfeeding problems.
In: The Journal of Maternal-Fetal and Neonatal Medicine 2021 Jan;34(1):31-40. doi: 10.1080/14767058.2019.1586879.
Authors: Esra Yasemin Memiş, Sıddıka Songül Yalçın.
Abstract: "Purpose: Mammalian milk may contain pollutants as a result of the maternal exposure. The objective was to determine the presence of selected mycotoxins in human milk and to investigate the effect of maternal characteristics on breastmilk mycotoxin levels and to examine the effect of mycotoxin contamination on lactational problems. Materials and methods: Information about maternal characteristics were taken by a questionnaire and breast milk samples were collected. Levels of aflatoxins M1 (AFM1), ochratoxins A (OTA), zearalenone (ZEN), Deoxynivalenol (DON) were determined by the solid-phase direct competitive enzyme immunoassay. Results: Median levels of breast milk AFM1 and OTA was 3.07 pg/mL and 1.38 ng/mL, respectively. ZEN and DON levels were higher than 0.3 ng/mL in 59% and higher than 10 ng/mL in 37.7%. After controlling for confounding factors, mothers who experienced ‘delayed onset of lactogenesis’ had odds 3.33 times more for the highest quartile of ZEN and mothers with cracked nipples had odds 8.36 times more for the highest quartile of DON. Multiple regression analysis revealed that smoking exposure (environmental, maternal smoking versus never) significantly affected being in the highest quartile of OTA. Conclusion: Mycotoxin can pass to breast milk and smoking exposure of the mother may influence this situation. Mycotoxin exposure may lead to lactation problems. Maternal and infant health can be protected by preventing smoking exposure."
Abstract only: https://www.tandfonline.com/doi/abs/10.1080/14767058.2019.1586879?journalCode=ijmf20
Title: Persistence of Δ-9-Tetrahydrocannabinol in Human Breast Milk.
In: JAMA Pediatrics, 2021; DOI:10.1001/jamapediatrics.2020.6098
Authors: Erica M. Wymore; Claire Palmer; George S. Wang; Torri D. Metz; David W. A. Bourne; Cristina Sempio; Maya Bunik.
Abstract: "Δ-9-Tetrahydrocannabinol (THC) crosses the placenta, is highly lipophilic, and can be detected in breast milk. National guidelines recommend abstinence from marijuana use during pregnancy and lactation, with limited data regarding the presence of THC in breast milk. We aimed to estimate the amount and duration of THC excretion in breast milk among women with known prenatal marijuana use."
Excerpts from the ScienceDaily news release: "In a new study published in JAMA Pediatrics, researchers at Children's Hospital Colorado (Children's Colorado) have found that tetrahydrocannabinol (THC), the psychoactive component of marijuana, stays in breast milk for up to six weeks, further supporting the recommendations of the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists and the Academy of Breastfeeding Medicine to abstain from marijuana use during pregnancy and while a mother is breastfeeding. This is the first study examining THC in breastmilk and plasma among women with known marijuana use in pregnancy since a 1982 study in the New England Journal of Medicine." "'This study provided invaluable insight into the length of time it takes a woman to metabolize the THC in her body after birth, but it also helped us understand why mothers use marijuana in the first place,' said Maya Bunik, MD, MPH, senior investigator, medical director of the Child Health Clinic and the Breastfeeding Management Clinic at Children's Colorado and professor of pediatrics at the CU School of Medicine. 'To limit the unknown THC effects on fetal brain development and promote safe breastfeeding, it is critical to emphasize marijuana abstention both early in pregnancy and postpartum. To help encourage successful abstention, we need to look at -- and improve -- the system of supports we offer new moms.'"
"Longitudinal studies from the 1980s have shown that children born to mothers who used marijuana during pregnancy experienced long-term issues with cognitive and executive functioning, including impulsivity, as well as deficits in learning, sustained attention and visual problem-solving skills."
ScienceDaily news release: https://www.sciencedaily.com/releases/2021/03/210308131719.htm
Abstract only: https://jamanetwork.com/journals/jamapediatrics/article-abstract/2776975
Title: Vegan or vegetarian diet and breast milk composition - a systematic review.
In: Critical Reviews in Food Science and Nutrition 2021;61(7):1081-1098. doi: 10.1080/10408398.2020.1753650.
Authors: Karolina Karcz, Barbara Królak-Olejnik.
Abstract: "It is known that nutritional composition of breast milk is, to a certain extent, related to maternal diet. The question of nutritional adequacy of mothers’ milk is often raised whenever a vegetarian or vegan diet during the lactation process is concerned. For this reason, in some countries, the recruitment of vegan lactating women as milk donors is excluded by milk banks. The purpose of this systematic review is to summarize existing knowledge on variability of specific nutrients in breastmilk of mothers adhering to a plant-based diet. The databases, including MEDLINE (Pubmed) and Scopus, were used to identify relevant publications. Data extraction and analysis were conducted following a PRISMA protocol. Thirteen publications concerning the impact of dietary pattern and levels of animal-origin food intake on breast milk composition were included. The systematic review has shown that all non-vegetarian, vegetarian and vegan mothers produce breast milk of comparable nutritional value. Several differences are primarily attributed to fatty acids and some micro-components, primarily vitamin B12. Regardless of dietary choices, nourishment and adequate nutrition have a significant impact on human milk composition – on the basis of the current evidence, vegetarian and vegan mothers are capable of producing nutritionally valuable milk for their infants, as far as the appropriate supplementation compensating for breastfeeding mother’s nutritional requirements is provided. Dietary choices should not be a permanent exclusion criterion for donor candidates in human milk banks."
Abstract only: https://www.tandfonline.com/doi/abs/10.1080/10408398.2020.1753650?journalCode=bfsn20