Aflatoxin M1 In Breast Milk Research Articles

Prevalence and concentration of aflatoxin M1 in breast milk in Africa: a meta-analysis and implication for the interface of agriculture and health

Breast milk is one of the many distinct forms of food that can be contaminated with aflatoxin M1 (AFM1). They may be consumed by eating contaminated foods, such as contaminated meat and crops, which would then be present in breast milk and cause health problems, including nervous system disorders and cancers of the lungs, liver, kidneys, and urinary tract. However, the prevalently inconsistent explanation of prevalence and concentration remains a big challenge. Thus, this meta-analysis was conducted to determine the prevalence and concentration of harmful chemicals in breast milk in an African context. The databases MEDLINE, PubMed, Embase, SCOPUS, Web of Science, and Google Scholar were searched for both published and unpublished research. To conduct the analysis, the collected data were exported to Stata version 18. The results were shown using a forest plot and a prevalence with a 95% confidence interval (CI) using the random-effects model. The Cochrane chi-square (I2) statistics were used to measure the studies' heterogeneity, and Egger's intercept was used to measure publication bias. This review included twenty-eight studies with 4016 breast milk samples and newborns. The analysis showed the overall prevalence and concentration of aflatoxin M1 in breast milk were 53% (95% CI 40, 65; i2 = 98.26%; P = 0.001). The pooled mean aflatoxin M1 concentration in breast milk was 93.02 ng/l. According to this study, the eastern region of Africa was 62% (95% CI 39–82) profoundly affected as compared to other regions of the continent. In subgroup analysis by publication year, the highest level of exposure to aflatoxins (68%; 95% CI 47–85) was observed among studies published from 2010 to 2019. This finding confirmed that more than half of lactating women’s breast milk was contaminated with aflatoxin M1 in Africa. The pooled mean aflatoxin M1 concentration in breast milk was 93.02 ng/l. According to this study, the eastern region of Africa was profoundly affected compared with other regions. Thus, the government and all stakeholders must instigate policies that mitigate the toxicity of aflatoxins in lactating women, fetuses, and newborns.

Determination of aflatoxin M1 in breast milk and related factors.

SUMMARYOBJECTIVE:Breastfeeding in women with aflatoxin M1 exposure may be a risk factor for the newborn. Thus, it is crucial to determine aflatoxin M1 levels in breast milk and raise mothers’ awareness about nutrition in lactation and other periods. This study was carried out to determine aflatoxin M1 contamination in milk samples taken from mothers who gave birth.METHODS:The study was carried out in the postpartum department of Training and Research Hospital between December 31, 2018, and June 31, 2019, and 90 breastfeeding mothers were included in the study.RESULTS:A total of 75 (83.3%) of the examined samples were found positive. The mean aflatoxin M1 ratio in positive samples was 12.16 pg/mL (5.00–23.18 pg/mL). Mothers’ consumption of processed food was associated with aflatoxin M1 levels (p=0.043). It was determined that the aflatoxin M1 levels of mothers who consumed processed food products 1 or 2 times a month were 3.22 times lower than those who consumed 1–2 times a week.CONCLUSIONS:This study emphasized the importance of monitoring aflatoxin M1 levels in breast milk for infant health. It is thought that nutrition education given to mothers during pregnancy will significantly impact aflatoxin M1 results. In addition, the dangers of mycotoxins in mother-infant nutrition should be emphasized regularly in health education.

Levels of Aflatoxin M1 in Breast Milk of Lactating Mothers in Monterrey, Mexico: Exposure and Health Risk Assessment of Newborns.

The present study aimed to determine the presence of the aflatoxin M1 (AFM1) in breast milk samples from 123 nursing women and the degree of exposure of infants to this toxin, in the metropolitan area of Monterrey, Nuevo Leon state (northeast Mexico). Upon analysis, 100% of the samples were found to be contaminated with the toxin at an average concentration of 17.04 ng/L, with a range of 5.00 to 66.23 ng/L. A total of 13.01% of the breast milk samples exceeded the regulatory limit of 25 ng/L for AFM1 concentration, set by the European Union. The estimated daily intake for AFM1 and the carcinogenic risk index were also determined in the 0- to 6-, 7- to 12-, 13- to 24-, and 25- to 36-month-old age groups. The AFM1 intake through breast milk ranged from 1.09 to 20.17 ng/kg weight/day, and was higher than the tolerable daily intake, indicating a carcinogenic risk for infants in the age groups of 0- to 24-months old. This evidence demonstrates a susceptibility of breast milk to AFM1 contamination that may suggest a carcinogenic risk for the breastfed infants in Monterrey city, Nuevo Leon state, and the need to control the presence of aflatoxins in foods eaten by nursing mothers.

Occurrence of aflatoxin M1 in human breast milk in Bangladesh.

Breast milk is the best, most complete form of nutrition for newborns and infants. However, human milk can contain aflatoxin M1 (AFM1) upon ingestion of dietary mycotoxin contaminants, namely, aflatoxin B1 (AFB1), by lactating mothers. AFB1 and its hydroxylated metabolite AFM1 are potent carcinogens and thus an important issue in food safety and public health. This study is the first to explore the presence of AFM1 in breast milk samples from Bangladesh and assess infant exposure to this toxin, as a consequence of maternal mycotoxin intake. A total of 62 breast milk samples were collected from nursing mothers in Sylhet region of Bangladesh. The milk samples were collected between October 2019 and March 2020 and analyzed by a sensitive enzyme-linked immunosorbent assay. AFM1 was detected in 51.6% of the breast milk samples (colostrum, transitional and mature milk), with a mean concentration of 4.42 ± 0.56 pg/mL, and in the range between LOD (4.0 pg/mL) and 6.66 pg/mL. The frequent detection of AFM1 in breast milk indicates widespread dietary exposure to mycotoxins in our cohort. The estimated average daily intake of AFM1 for all nursed infants was 0.49 ng/kg b.w./day. No significant correlations were observed between AFM1 levels in human milk and food items regularly consumed by nursing women. Overall, AFM1 levels in breast milk samples from the Sylhet region of Bangladesh are moderate, and lower than the permissible levels established for AFM1 in dairy milk or infant formulae (50 and 25 ng/kg, respectively). Yet, this first data for AFM1 breast milk contaminant levels just reflect the recent situation in one cohort, and monitoring should be continued.

Aflatoxin Exposure Among Mothers and Their Infants from the Western Highlands of Guatemala.

We examined breast milk of mothers and urine of infants before and after introduction of supplementary foods for aflatoxin M1 (AFM1) and the association between AFM1 with maternal and infant diet. A prospective cohort study was conducted among mothers and infants ages 0-6months and 7-12months from June-October 2014. Sociodemographic, dietary, birth, and health data were collected. A breast milk sample was collected from each mother and a urine sample from each infant at baseline (time point 1) and monthly for 2 time points thereafter; samples collected at baseline and time point 3 were tested for AFM1. Almost 5% of breast milk and 15.7% of urine samples tested AFM1-positive. The median AFM1 in breast milk was 0.020ng/mL and in urine 0.077ng/mg creatinine. At time point 3, infants of 5 of the 6 mothers in each group who were AFM1-positive in breast milk were also AFM1-positive in urine. Mothers' consumption of cooked maize/maize dough ≥ 3days per week (OR 2.96, 95% CI = 1.19-7.34) and mothers' consumption of tamales made from maize ≥ 3days per week (OR 0.28, 95% CI = 0.10-0.73) were significantly associated with AFM1 in infant urine. This is the first study in Guatemala documenting aflatoxin exposure in both breastmilk of lactating mothers and infants´ urine during the first year of life. This may have important implications in understanding the multicausality of the high rates of stunting among children < 5years old in Guatemala.

Prevalence and associated factors of breastmilk aflatoxin M1 levels in mothers from Banke, Nepal

Aflatoxin M1 (AFM1) is the hydroxylated metabolite of aflatoxin B1 (AFB1) formed in the liver of mammals and subsequently excreted in breastmilk (BM) of mammals. Humans are exposed to AFM1 mainly through the consumption of aflatoxin contaminated milk and foods. Determining levels of AFM1 is of significant public health importance due to the risk of exposure to breastfeeding infants. The objective of this study is to determine the prevalence of AFM1 in BM and assess factors associated with BM AFM1 levels in mothers. Data, collected between July 2015 and July 2017, were derived from the Aflacohort study (n = 1675) in Banke district, of Province 5 in the south-west region of Nepal. AFM1 was analyzed using ultra-high-performance liquid chromatography with a lower limit of detection of 0.04 ng/L (ng/L). Multivariate linear and quantile regression models were used to examine the relationship of factors with AFM1, including mother's age, food consumption and body mass index, as well as, seasonality and wealth quintiles. Approximately 94% of BM samples had detectable levels of AFM1 (geometric mean 0.78 ng/L and range 0.04 ng/L to 315.99 ng/L). The consumption of particular foods such as yogurt, milk, hydrogenated oil and ripe pumpkin was positively associated with BM AFM1 levels (p-value <0.05), while consumption of legumes was associated with lower BM AFM1 levels (p-value <0.05). Seasonal influences were significant, with BM collected in the pre-winter and winter seasons exhibiting significantly higher AFM1 levels compared to the spring (p-value <0.05). These results suggest near-ubiquitous presence of aflatoxin in the food supply of this part of Nepal, and possible exposure of AFM1 to infants through BM of mothers. The findings justify integrated strategies across the value chain and at household level to identify dietary sources of aflatoxin exposure, proper post-harvest management and monitoring for aflatoxin control and mitigation.

Occurrence of and Factors Associated With the Presence of Aflatoxin M1 in Breast Milk of Mothers in Fethiye, Turkey.

Aflatoxins comprise a group of mycotoxins that are found in the environment. Exposure to aflatoxins has been reported to cause serious health problems in humans. Since aflatoxin M1 (AFM1) is secreted in breast milk, the exposure of infants to this toxin is an important concern. The aim of this study was to determine the prevalence, levels of, and factors associated with the presence of AFM1 in breast milk of mothers in Fethiye, Turkey. Breast milk samples were taken from 100 mothers who had given birth over the period of October-November 2017. The AFM1 content of the samples was determined via enzyme-linked immunosorbent assay. The lowest limit for milk samples in the Ridascreen® AFM1 commercial test kit is 5 ng/L. Because of this, AFM1 levels below 5 ng/L in the breast milk samples were assessed as negative. Of the breast milk samples tested, 53 were positive. The average AFM1 amount in the positive samples was 6.36 ng/L (ppt; range 5.10-8.31 ng/L). Mothers who were housewives, lived in damp, humid houses, or ate spices or dried fruits and vegetables had significantly greater prevalence of AFM1 in their breast milk than those who were employed, did not report dampness or mold in the home, or did not eat spices or dried fruits and vegetables. AFM1 in breast milk could be an important risk factor for infant health. Informing the public about food safety could reduce the amount of AFM1 being transferred into breast milk via food channels.

Exposure assessment of Portuguese infants to Aflatoxin M1 in breast milk and maternal social-demographical and food consumption determinants

Mycotoxins are secondary metabolites of fungi that have toxic effects on both humans and animals. Aflatoxin M1 (AFM1) which can be transmitted to newborns via breast milk, is a hydrolyzed metabolite of Aflatoxin B1 (AFB1) that is ingested along with contaminated food. AFM1 is classified as “possibly carcinogenic agent for Human” (group 2B IARC). Despite the potential hazard of AFM1 to breastfed babies, there is a lack of studies of exposure evaluation in Europe and a complete absence of reports in Portugal.The present study aimed to determine the occurrence of AFM1 in maternal milk and the degree of exposure of infants to this toxin. The correlation between the concentration of AFM1 and basic socio-demographic factors and the consumption of certain categories of food was also aimed. Thus 67 milk samples from nursing mothers living in Portugal were collected, between 2015 and 2016, and analyzed using a competitive commercial ELISA kit, in order to determine the presence of AFM1.Twenty-two samples (32.8%) contained levels of AFM1 above the detection limit (5 ng/L), ranging between 5.1 and 10.6 ng/L (7.4 ± 1.9 ng/L). In the observed exposure pattern, AFM1-positive milk samples were associated with summer collection, lower mother's educational level, early lactation phase and the maternal consumption of rice and chocolate. No other studied determinants, whether socio-demographic (age, weight, height, number of children, characteristics of breastfeeding, the infants' weight) or dietary (frequency of food consumption) showed a significant statistical influence. Assessment of AFM1 estimated daily intake (EDI) revealed a higher exposure of younger babies (<7 kg; EDI 1.06 ng/kg b.w./day) in relation to older ones (≥7 kg; 0.86 ng/kg b.w./day), and the proposed value of TDI (0.2 ng/kg b.w.).Thus the results of this study suggest the need to reinforce surveillance of AFB1 occurrence in food, as a protective and control measure, not only for adults, but ultimately for lactating infants exposed through maternal breast milk. Although AFM1 presents an inferior carcinogenic potency, it is noteworthy that when compared with adults, infants feature a lower capacity of carcinogen biotransformation, a fairly restricted diet and a higher consumption in relation to body weight.

Occurrence and dietary factors associated with the presence of aflatoxin B1 and M1 in breast milk of nursing mothers in Iran

Breast milk is recommended as the sole source of nutrition for the first 6 months of life and its purity is essential for the beginning of human life. Aflatoxins, a group of highly toxic metabolites, can be accumulated in breast milk as a result of maternal dietary exposure. Therefore, the objective of this study was to determine the occurrence, levels and dietary factors associated with the presence of aflatoxin B1 and aflatoxin M1 in breast milk samples collected from Kurdish lactating women in Iran.A total of 88 breast milk samples obtained from urban and rural areas were analyzed for the presence of aflatoxin B1 and M1 using Enzyme linked-immunosorbent assay method (ELISA). A Semi-Quantitative Food Frequency Questionnaire was used to determine the daily intake of foods, focused on more probable AFs contaminated foodstuffs.Aflatoxin B1 and aflatoxin M1 were detected in 93.2% and 100% of samples in the range of 10–80 and 0.1–13.6 ng/L respectively. There were no significant differences in the occurrence and levels of aflatoxins in breast milk samples between urban and rural regions (p > 0.05). The presence of aflatoxin B1 was significantly associated to consumption of bread and egg (p < 0.05) and the presence of aflatoxin M1 was associated to consumption of wheat flour and traditional Doogh (p < 0.05). The mean daily intake of aflatoxin B1 by mothers and infant was 0.61 and 3 ng/kg b.w./day, respectively which suggested, for the first time, that breast-fed infants in Kurdish areas in West Azarbaijan province, Iran, are exposed to significant levels of this toxin through mother's breast milk. However, the mean daily intake of aflatoxin M1 by infants (0.33 ng/kg b.w./day) was close to the calculated tolerable daily intake of 0.2 ng/kg b.w./day of AFM1.These findings highlight the high risk of infants’ exposure to aflatoxins and the necessity for developing strategies to reduce exposure to aflatoxins especially aflatoxin B1, involving interventions targeted at decreasing contamination of consumed foods.

Analysis of Aflatoxin M1 in Breast Milk and Its Association with Nutritional and Socioeconomic Status of Lactating Mothers in Lebanon

Aflatoxin B1 (AFB1) is the most potent of the dietary aflatoxins, and its major metabolite, aflatoxin M1 (AFM1), is frequently found in the breast milk of lactating mothers. The aim of this study was to assess the occurrence and factors associated with AFM1 contamination of breast milk collected from lactating mothers in Lebanon. A total of 111 breast milk samples were collected according to the guidelines set by the World Health Organization. Samples were analyzed with a competitive enzyme-linked immunosorbent assay between December 2015 and November 2016. A survey was used to determine the demographic and anthropometric characteristics of participating lactating mothers. Dietary habits were assessed using a semiquantitative food frequency questionnaire. Mean (±standard deviation) concentration of AFM1 in the breast milk samples was 4.31 ± 1.8 ng/L, and 93.8% of samples contained AFM1 at 0.2 to 7.9 ng/L. The mean concentration of AFM1 was significantly lower (P < 0.05) in fall and winter (4.1 ± 1.9 ng/L) than in spring and summer (5.0 ± 1.7 ng/L). None of the samples exceeded the European Commission regulation limit (25 ng/L) for infant milk replacement formula. AFM1 contamination was significantly associated (P < 0.05) with the daily consumption of white cheeses but not with the consumption of meat or cereal products. No significant association (P > 0.05) was observed between AFM1 concentrations in breast milk and anthropometric sociodemographic factors (age and level of education) or the governorate of residence of the nursing mothers. The mean AFM1 estimated daily intake was found to be 0.69 ng/day/kg of body weight. Although the incidence of AFM1 contamination was low, our first-of-its-kind study highlights the importance of conducting investigations on mycotoxin contamination in breast milk and of developing protection strategies to tackle the exposure of infants to this potent chemical hazard.

Aflatoxin M1 in Breast Milk, Cow Milk and Milk Products in Minna, Nigeria and their Predisposing Factors

Herein is a focus on incidence and levels of Aflatoxin M1 (AFM1) in milk of breast feeding mothers, cow milk and vended milk products within Minna, Nigeria obtained by analysis of 140 samples of milk and milk products using high performance liquid chromatography (HPLC). The findings reveal; incidence of 77.5% in human milk, and suggests that diet, socioeconomic status and ethnicity influence exposure. Nomadic cow milk samples had the highest incidence of 80%, cheese had 40% incidence, nono had 35% incidence, commercial cow milk had 25% incidence and yoghurt had 10% incidence. In a total of 69 contaminated samples, 51 were at levels above (0.05 μg/L) the EU and Nigerian legislated limit. Exposure to AFM1 from milk and milk products at concentrations demonstrated in this investigation is of great concern as infants in the country are encouraged to be exclusively breast fed for six months after which alternative milk intake sometimes from animal origin can be sourced. Established carcinogenicity and growth impairing potentials of AFM1 stands as sources of concern and hence the need for enforcement of the legislated limit by regulatory agencies in Nigeria.

Exposure of Infants to Aflatoxin M1 from Mother's Breast Milk in Ilam, Western Iran

ObjectivesAflatoxins as a highly toxic group of mycotoxins are present in the environment and foodstuff. These have been reported to cause serious health problems in humans. Since aflatoxin M1 (AFM1) is excreted into breast milk, investigating the exposure of infants to AFM1 is of special concern. MethodsIn the present study, breast milk samples were collected from 85 lactating mothers in Ilam province, Iran, and the levels of AFM1 were analyzed using the enzyme-linked immunosorbent assay-based technique. AFM1 was detected in breast milk of all lactating women. The mean contamination level was 5.91 ± 2.031 ng/L, ranging from 2 ng/L to 10 ng/L. ResultsMultiple regression analysis indicated no significant associations of consumption of milk and dairy products, meat, fish, legumes, grain products, fruits, and nuts with the concentration of AFM1 in breast milk. Furthermore, no significant association was observed between AFM1 concentration and anthropometric data of infants. ConclusionIn western parts of Iran, lactating mothers and their infants could be at risk of aflatoxin B1 and AFM1 exposure, respectively. Therefore, in Iran, the evaluation of AFM1 in human breast milk as a biomarker for postnatal exposure of infants to this carcinogen requires more attention in different regions and various seasons.

Determination of aflatoxin M1 in breast milk as a biomarker of maternal and infant exposure in Colombia

Chronic exposure to aflatoxins, and especially to aflatoxin B1 (AFB1), causes hepatocellular carcinoma with prevalence 16–32 times higher in developing compared with developed countries. Aflatoxin M1 (AFM1) is a monohydroxylated metabolite from AFB1 that is secreted in milk and which can be used as a biomarker of AFB1 exposure. This study aimed to determine AFM1 levels in human breast milk using immunoaffinity column clean-up with HPLC and fluorescence detection. Breast milk samples were obtained from 50 nursing mothers. Volunteers filled in a questionnaire giving their consent to analyse their samples as well as details of their socioeconomic, demographic and clinical data. The possible dietary sources of aflatoxins were assessed using a food frequency questionnaire. A total of 90% of the samples tested positive for AFM1, with a mean of 5.2 ng l−1 and a range of 0.9–18.5 ng l−1. The study demonstrated a high frequency of exposure of mothers and neonates to AFB1 and AFM1 in Colombia, and it points out the need to regulate and monitor continuously the presence of aflatoxins in human foods. Further research is needed in order to determine the presence of other mycotoxins in foods and in human samples as well as to devise protection strategies in a country where mycotoxins in human foods are commonly found.

Incidence of Aflatoxin M1 in Human and Animal Milk in Jordan

This study was undertaken to determine the presence of aflatoxin M1 (AFM1) in animal milk. In addition, exposure of infants to aflatoxin M1 (AFM1) and lactating mothers to aflatoxin B1 (AFB1) was examined using AFM1 in breast milk as a biomarker for exposure to AFB1. In total, 100 samples of fresh animal milk and fermented milk (buttermilk) and 80 samples of human breast milk were collected during the period 2011–2012. An enzyme-linked immunosorbent assay (ELISA) was used for the analysis of milk samples. AFM1 was detected in all animal fresh and fermented milk samples. The concentrations of AFM1 in 70 samples of fresh and fermented milk were higher than the maximum tolerance limit accepted by the European Union and the United States of 50 ng/kg. In human milk samples the average concentration of AFM1 was higher than the maximum tolerance limit accepted by the European Union and the United States of 25 ng/kg. Logistic regression analysis failed to show a correlation between AFM1 and type and amount of dairy consumption, vegetables, fruits, and meat. However, an association between AFM1 and cereal consumption was detected. This study is the first to report on the occurrence of AFM1 in milk consumed by the Jordanian population.

Aflatoxin M1 in breast milk of nursing Sudanese mothers

The presence of aflatoxin M1 (AFM1) in the breast milk of nursing Sudanese mothers was investigated using AOAC official method 980.21 as the extraction method and HPLC with fluorescence detector for separation and detection. Following informed consent, 94 breast milk samples of mothers were collected, and 51 samples were found to be positive for AFM1, with an average concentration of 0.401 ± 0.525 ng g(-1) and a maximum level of 2.561 ng g(-1). The volunteers completed a questionnaire concerning their dietary preferences. The data collected suggest that peanut butter, vegetable oils and rice are the main sources responsible for the AFM1 burden in breast milk. The toxin levels are alarmingly high, and indicate that Sudanese infants are exposed to high levels of AFM1. A wide range of harmful effects, and consequently health problems, can be expected due AFM1 toxicity.

Incidence of aflatoxin M1 in human breast milk in Tehran, Iran

This study examined the exposure of infants to aflatoxin M1 (AFM1) and of lactating mothers to aflatoxin B1 (AFB1), using AFM1 in breast milk as a biomarker for exposure to AFB1. An enzyme-linked immunosorbent assay (ELISA) was modified for the analysis of AFM1 in breast milk samples from 160 women in Tehran, Iran. AFM1 was detected in 157 samples by average concentration of 8.2 ± 5.1 ng/kg (range 0.3–26.7 ng/kg). The concentration of AFM1 in one sample was higher than the maximum tolerance limit accepted by European Union and USA (25 ng/kg), but in 55 samples was higher than the maximum concentration recommended by Australia and Switzerland (10 ng/kg). Logistic regression Analysis failed to show significant correlation between AFM1 and gestational age, education, postnatal age, gender, nationality, clinical condition, the number of family member, the number of children, type and amount of dairy consumption, vegetable, fruits, oil and meat. But it was significant relation to the cereal consumption, also to the height at birth.

Determinants of aflatoxin M1 in breast milk in a selected group of Egyptian mothers

In Egypt, there is a paucity of biomarker data on aflatoxin (AF) exposure. The study assessed the level and frequency of breast milk AFM1 as a biomarker of maternal exposure. Breast milk samples were collected from a selected group of 388 Egyptian lactating mothers of children attending the New El-Qalyub Hospital, Qalyubiyah governorate, Egypt, during May–September 2003. Following aflatoxin extraction, AFM1 levels were assessed by high-performance liquid chromatography (HPLC) with fluorescence detection. Approximately 36% of mothers tested positive for AFM1 (median 13.5 pg ml−1, interquartile range (IQR) 10.27–21.43). Non-working status (p = 0.018, odds ratio (OR) = 2.87), obesity (p = 0.004, OR = 3.01), high corn oil consumption (p = 0.002, OR = 2.21), number of children (>1) (p = 0.025, OR = 1.99), and early lactation stage (<1 month) (p = 0.028 OR = 3.57), contributed to the occurrence of AF in breast milk. AFM1 contamination of breast milk was frequent, albeit at moderate levels. Growth and development of the infant is rapid and thus it is possible that AF exposure through breast milk has a significant health effect.

Aflatoxin M1 in breast-milk of UAE women.

A study was undertaken to determine whether breast-milk of mothers from the United Arab Emirates (UAE) contained aflatoxins. One hundred and forty lactating mothers, 55 who had delivered premature infants (<2500 g, </=37 wk gestational age) and 85 who had full-term infants, agreed to participate in the study. Breast-milk was collected during regular feeding of infants in the special care baby unit and postnatal wards using an electric breast pump and ten ml of milk was siphoned off into a zinc-free plastic container for analysis. Aflatoxin M(1) concentration in the breast-milk samples was measured by HPLC. Samples were collected between January 1999 and December 2000. Approximately 66% of the mothers were expatriates and 34% were UAE nationals. Babies' weight, postnatal age, sex, birthweight and gestational age, and mothers' nationality, age and parity were recorded. Overall, 92% of the breast-milk samples contained aflatoxin M(1). Both univariate and multivariate logistic regression analysis failed to show significant correlation between aflatoxin M(1) and gestational age, postnatal age, gender, nationality and clinical condition. Levels of lactose, protein and lipids did not correlate significantly with levels of aflatoxin M(1). The public should be educated about storing food and the hazards of aflatoxin ingestion to reduce the unacceptably frequent presence of aflatoxin in breast-milk.

Exposure of infants to aflatoxin M1 from mothers' breast milk in Abu Dhabi, UAE.

During a survey of the occurrence of aflatoxins in mothers' breast milk carried out in Abu Dhabi, involving 445 donors at the Cornich Hospital and the Al Nehyan Clinic for Maternity and Childhood, 99.5% of samples were found to contain aflatoxin M1 at concentrations ranging from 2 pg ml-1 to 3 ng ml-1. The mothers represented a wide range of nationalities, ages and health status and the opportunity was used to seek any correlation between these factors and the concentration of aflatoxin M1 in breast milk. The protein, fat and lactose contents of milk samples were also determined and the possibility of any correlation between any of these and aflatoxin M1 was studied.

Aflatoxin M1 in human breast milk from The Gambia, west Africa, quantified by combined monoclonal antibody immunoaffinity chromatography and HPLC.

Maternal to child exposure of aflatoxin M1 in breast milk is an underevaluated risk factor from dietary exposure to aflatoxin B1. A molecular dosimetry study in The Gambia, West Africa, was initiated to explore the relationships between dietary intake of aflatoxins during a 1 week period and a number of aflatoxin biomarkers including aflatoxin metabolite excretion into breast milk. For the breast milk study, five lactating women were identified and milk samples were collected by hand expression once a day during days 3-7 for three women and during days 3-6 for the two other women. Aflatoxin M1 (AFM1) in human milk was measured in all five subjects by a preparative monoclonal antibody immunoaffinity column/HPLC method. In three of the five women, aflatoxin G1 was found. Estimates of the percentage of aflatoxin in the diet excreted as AFM1 in milk ranged from 0.09 to 0.43%. Thus, these data indicate that a rapid methodology exists to assess the levels of AFM1 excretion in human milk and to use this approach as a biomarker for exposure of children to this carcinogen.