My objective in this article is to raise questions about sources of environmental toxins and possible effects on lactogenesis. Toxins are known to interrupt normal biological functioning. The effects of exposures to toxins and the underlying biological mechanisms are not well understood. Many possible negative influences on lactogenesis are not even considered for empirical research. For my purposes, toxins are defined broadly to include physical toxins (e.g., chemicals, hormones, drugs), as well as social toxins (unemployment, inadequate safety, lack of access to education) and emotional toxins (fear, uncertainty, humiliation). The social ecological model, shown in Figure 1, is a multilevel systems approach used in public health to consider multiple influences on health. The model looks at individual health behaviors (such as breastfeeding) within an expanded context of interpersonal relationships, community, institutions, and policies. The model can guide investigations and suggest sites for intervention that have significant impact. Open in a separate window FIG. 1. Social ecological model.

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