POLLUTANTS IN BREAST-MILK

Objective: To review data on the occurrence and toxicity of the common ly reported pesticides and industrial environmental pollutant chemical s in breast milk. Data Sources: Continuous automated literature survei llance plus contact with investigators and governmental agencies. Sele ctions: For data on occurrence, the most recent data from the largest data sets on the most representative donors were used. For data on tox icity, the primary report that was publicly available was used. Delta Extraction: When necessary, data were reexpressed or concentrations we re rescaled. The original investigator was contacted if necessary. Dat a Synthesis: Although pollutant chemicals are readily detected in most human milk worldwide, there is little evidence for consequent morbidi ty in nurslings. There have been several mass poisonings in which chem icals that were transmitted through breast milk clearly affected child ren who were breast-fed, and there is some evidence chat prenatal expo sure to background levels resulted in mild developmental delay and tha t lactation per se was disturbed. Conclusions: Breast-feeding is recom mended despite the presence of chemical residues. The prenatal period in the child and the initiation of lactation in the mother may be sens itive periods to the toxicity of the chemicals that are considered her e, 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 nutriti on should continue to support breast-feeding.