HUMAN MILK SURVEILLANCE AND RESEARCH OF ENVIRONMENTAL CHEMICALS: CONCEPTS FOR CONSIDERATION IN INTERPRETING AND PRESENTING STUDY RESULTS

This article describes issues related to the interpretation, presentation, and use of data from human milk surveillance and research studies. It is hoped that researchers conducting human milk studies in the future will consider these concepts when formulating study conclusions and presenting data. The key issues discussed are; (1) communication of information on human milk constituents to health care providers and the public; (2) complexities associated with assessing risks and benefits when comparing breast-feeding and formula-feeding; (3) use of human milk information for trends analysis and assessment of the efficacy of restrictions on use/release of chemicals in the environment; and (4) risk assessment and regulatory decision-making concepts regarding environmental chemicals in human milk. As researchers conduct surveillance and research involving human milk, it is of the utmost importance that the results of these studies are provided with information on risk and benefits that place the data in perspective, so that those involved in decision making regarding infant nutrition (e.g., expectant mothers, physicians, midwives, nurses, and lactation consultants) can appropriately interpret the research data.

[1]  D. Naiman,et al.  Methodology for characterizing distributions of incremental body burdens of 2,3,7,8-TCDD and DDE from breast milk in North American nursing infants. , 2000, Journal of toxicology and environmental health. Part A.

[2]  E. Volkin What was the message? , 1995, Trends in biochemical sciences.

[3]  H. Fineberg,et al.  Improving Public Understanding: Guidelines for Communicating Emerging Science on Nutrition, Food Safety, and Health , 1998 .

[4]  A. Morgan Improving public understanding: guidelines for communicating emerging science on nutrition, food safety, and health. , 1998, Journal of the National Cancer Institute.

[5]  B. Gladen,et al.  Polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) in human milk: effects on growth, morbidity, and duration of lactation. , 1987, American journal of public health.

[6]  G. Beauchamp,et al.  Beer, breast feeding, and folklore. , 1993, Developmental psychobiology.

[7]  Means,et al.  Risk-assessment guidance for Superfund. Volume 1. Human Health Evaluation Manual. Part A. Interim report (Final) , 1989 .

[8]  R. Uauy,et al.  E – Nucleotides and Related Compounds in Human and Bovine Milks , 1995 .

[9]  Michael K. Georgieff,et al.  Breastfeeding and the use of human milk , 1997 .

[10]  R. H. Garrett,et al.  Biochemistry, 2nd ed. , 1999 .

[11]  C. Portier,et al.  Should the presence of carcinogens in breast milk discourage breast feeding? , 1991, Regulatory toxicology and pharmacology : RTP.

[12]  B C Gladen,et al.  Polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethene (DDE) in human milk: effects of maternal factors and previous lactation. , 1986, American journal of public health.

[13]  B. Liebl,et al.  Nitro musks in human milk , 1993 .

[14]  Michigan.,et al.  Toxicological profile for dichloropropenes , 2008 .

[15]  K. Kaufman,et al.  PCP in amniotic fluid and breast milk: case report. , 1983, The Journal of clinical psychiatry.

[16]  G. H. Lambert,et al.  Transfer of drugs and other chemicals into human milk. , 2001, Pediatrics.

[17]  R. Gray,et al.  Interpregnancy interval and low birth weight: findings from a case-control study. , 1988, American journal of epidemiology.

[18]  O. Koldovský,et al.  D – Hormones and Growth Factors in Human Milk , 1995 .

[19]  Richard A. Harvey,et al.  Lippincott's Illustrated Reviews , 1987 .

[20]  B. Ark What Do the Numbers Mean , 2004 .

[21]  J. W. Frank,et al.  Breast-feeding in a polluted world: uncertain risks, clear benefits. , 1993, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[22]  J. Bitman,et al.  Lipids in milk and the first steps in their digestion. , 1985, Pediatrics.

[23]  W. Walker,et al.  Human milk as a carrier of biochemical messages , 1999, Acta paediatrica (Oslo, Norway : 1992). Supplement.

[24]  D. Smith,et al.  Worldwide trends in DDT levels in human breast milk. , 1999, International journal of epidemiology.

[25]  S. Hoover Exposure to Persistent Organochlorines in Canadian Breast Milk: A Probabilistic Assessment , 1999 .

[26]  M. Burr,et al.  Infant feeding, wheezing, and allergy: a prospective study. , 1993, Archives of disease in childhood.

[27]  Hugh Hansen,et al.  Using the ATSDR Guidance Manual for the Assessment of Joint Toxic Action of Chemical Mixtures. , 2004, Environmental toxicology and pharmacology.

[28]  M. Lorber,et al.  Infant exposure to dioxin-like compounds in breast milk. , 2002, Environmental health perspectives.

[29]  M. Bracken,et al.  Short Interpregnancy Interval: A Risk Factor for Low Birthweight , 1987, American journal of perinatology.

[30]  R. Alexander The Transfer of Drugs and Other Chemicals Into Human Milk , 1994, Pediatrics.

[31]  J. Potter,et al.  Breast-feeding and risk of childhood acute leukemia. , 1999, Journal of the National Cancer Institute.

[32]  R. Wiggins,et al.  Pharmacokinetics of cocaine: basic studies of route, dosage, pregnancy and lactation. , 1989, Neurotoxicology.

[33]  O. Koldovský Hormones in milk. , 1995, Vitamins and hormones.

[34]  E. Lieberman,et al.  Interpregnancy interval and risk of preterm labor. , 1990, American journal of epidemiology.

[35]  Robert G. Jensen,et al.  Handbook of milk composition , 1995 .

[36]  A. A. Jensen Chemical Contaminants in Human Milk , 1990 .

[37]  D. Haines,et al.  Twenty-Five Years of Surveillance for Contaminants in Human Breast Milk , 1998, Archives of environmental contamination and toxicology.

[38]  K. Norén,et al.  Analysis of polybrominated diphenyl ethers in Swedish human milk. A time-related trend study, 1972-1997. , 1999, Journal of toxicology and environmental health. Part A.

[39]  S M Hoover,et al.  Exposure to Persistent Organochlorines in Canadian Breast Milk A Probabilistic Assessment , 1999, Risk analysis : an official publication of the Society for Risk Analysis.

[40]  E. Birch,et al.  Visual Acuity and the Essentiality of Docosahexaenoic Acid and Arachidonic Acid in the Diet of Term Infants , 1998, Pediatric Research.

[41]  D. Savitz,et al.  INFANT FEEDING AND CHILDHOOD CANCER , 1988, The Lancet.

[42]  P. Nestel,et al.  The effects of dietary fatty acids and cholesterol on the milk lipids of lactating women and the plasma cholesterol of breast-fed infants. , 1976, The American journal of clinical nutrition.

[43]  J. S. Rawlings,et al.  Prevalence of low birth weight and preterm delivery in relation to the interval between pregnancies among white and black women , 1995, The New England journal of medicine.

[44]  W. Cox,et al.  Dietary nucleotide effects upon immune function in infants. , 1991, Pediatrics.

[45]  Current issues in lactation: advantages, environment, silicone. , 1994, Biomedical and environmental sciences : BES.

[46]  Ruth A.Lawrence Robert M.Lawrence Breast-feeding, a guide for the medical profession , 1980 .

[47]  G. Gaull Taurine in pediatric nutrition: review and update. , 1989, Pediatrics.

[48]  D. Naiman,et al.  Infant exposure to chemicals in breast milk in the United States: what we need to learn from a breast milk monitoring program. , 2000, Environmental health perspectives.

[49]  M. Hamosh,et al.  Glycoproteins of the Human Milk Fat Globule in the Protection of the Breast-Fed Infant against Infections , 1998, Neonatology.

[50]  B. Sonawane,et al.  Chemical contaminants in human milk: an overview. , 1995, Environmental health perspectives.

[51]  M. Harmsen,et al.  Antiviral activities of lactoferrin. , 2001, Antiviral research.

[52]  H. Humphrey,et al.  BREAST-MILK MONITORING TO MEASURE MICHIGAN'S CONTAMINATION WITH POLYBROMINATED BIPHENYLS , 1978, The Lancet.

[53]  Jill Turner,et al.  WORLD HEALTH ASSEMBLY , 1989, The Lancet.

[54]  Breastfeeding and the use of human milk. American Academy of Pediatrics. Work Group on Breastfeeding. , 1997, Pediatrics.

[55]  N. Levasseur,et al.  Breastfeeding: A Guide for the Medical Profession , 1995 .

[56]  B. Hardy Avery's Drug Treatment (4th edition) , 1998 .

[57]  F. Gruskay Comparison of Breast, Cow, and Soy Feedings in the Prevention of Onset of Allergic Disease , 1982, Clinical pediatrics.

[58]  K. Norén,et al.  Certain organochlorine and organobromine contaminants in Swedish human milk in perspective of past 20-30 years. , 2000, Chemosphere.

[59]  M. Hamosh,et al.  Bioactive factors in human milk. , 2001, Pediatric clinics of North America.

[60]  Maria Pettersson,et al.  Triclosan, a commonly used bactericide found in human milk and in the aquatic environment in Sweden. , 2002, Chemosphere.

[61]  C. Borgert,et al.  Influence of soil half-life on risk assessment of carcinogens. , 1995, Regulatory toxicology and pharmacology : RTP.

[62]  J. Bitman,et al.  CHAPTER 6 – Milk Lipids: A. Human Milk Lipids , 1995 .

[63]  Donald Voet,et al.  Biochemistry, 2nd ed. , 1995 .