Evaluation of xenobiotics in human milk and ingestion by the newborn - An epidemiological survey in Lombardy (Northern Italy)

Background Many human milk benefits have been well documented; nevertheless the newborn potential risk to the xenobiotic exposition maybe relevant and it requires a biological monitoring in general prevention. Concerning this problem, attention should be paid to mycotoxins and heavy metals. Aim of the study Assessing the presence of the xenobiotics aflatoxins, ochratoxin A, lead and cadmium in human milk, defining their level of contamination and evaluate the potential risk for the newborn derived from this xenobiotic ingestion. Methods A study has been carried out on lactating women randomly selected in seven hospitals in Lombardy (Northern Italy). Two hundred and forty-seven puerparae were recruited; 231 women participated in the study. Womens milk samples on the third or fourth day after delivery were tested to determine aflatoxins and ochratoxin A levels. Lead and cadmium were determined in 143 women because supplemental milk could be taken only from these women. Results Aflatoxin B 1 (11.4 ng/l) and aflatoxin M1 (194 ng/l) were found only in one sample, while ochratoxin A was detected in 198 samples (85.7%) at an average value of 6.01 +/- 8.31 ng/l. A total of 75.7% of samples were positive for lead; the cadmium situation was better with 87.4% of the sample with values below detection limits (2 mug/l). A high percentage of babies (71%) are exposed to mycotoxin levels on day 6 greater than the TDI value of 0.2 ng/kg b.w. Lead and cadmium presence in human milk presented risk respectively for 8% and 0.7% of newborns on the fourth day; 9.5% and 1.4% on the sixth day. Conclusions The study points out that mycotoxins and lead are present in maternal milk, and the data confirm the need to continue biological monitoring in general prevention.