A case report describes obstructive icteric liver disease in a breastfed baby after exposure to the volatile organochlorine tetrachloroethene (PER), which is used as a cleaning agent. The mother had visited her husband every day at his workplace, which was apparently strongly contaminated. This also led to neurological symptoms in the mother (Bagneli 1977). A milk sample given an hour after maternal exposure had 10 mg tetrachloroethene/!. After 24 hours, the level was still 3 mg/l. The baby's condition returned to normal after weaning. A follow-up examination aL 10 years of age showed nothing remarkable. Other groups of authors have demonstrated volatile chlorhydrocar-bons - on average 6.2 jig/1 - in the milk of mothers whose exposure was not occupational. It can be 4-8 weeks after exposure before the concentration in milk of the lipophilic tetrachloroethene "normalizes" (Schreiber 1993). However, this should in no way be a basis for recommending weaning after "trivial" exposure. Ongoing exposure at the workplace, on the other hand, should be looked at critically during breastfeeding.
Various other contaminants, such as the organic solvents benzene and toluene (Fabietti 2004), and the bactericide triclosan (Adolfsson-Erici 2002), have been detected in breast milk.
Synthetic musk compounds, such as musk xylol, musk ketone, musk ambrette, and others, are among the nitroaromatics. These substances have a limited acute toxicity, but, like the organochlorine compounds, they seem to accumulate in the fatty tissue and persist in the environment. Current analyses of mothers' milk have indicated a mean of about 0.1 mg/kg milk fat for musk xylol. The other compounds have levels two to three times lower. Synthetic musk compounds arc added to detergents and cosmetics because of their fragrance, and thus dermal absorption is a likely path for their intake. There are no indications of toxic effects as a result of intake via mothers' milk. The studies to date on genera! toxicity and on mutagenic and carcinogenic potential do not permit a conclusive judgment (Liebl 2000, Rimkus 1994). Since 1993, contamination of mother's milk with musk xylol has declined in Germany to about 0.02 mg/kg milk fat, following a recommendation that this substance be avoided in detergents and other cleaning agents. Since the beginning of the 1990s, musk ketone levels have remained relatively constant at 0,02 mg/kg milk fat.
4.18.6 Breastfeeding despite environmental contaminants?
There are insufficient data on the polycyclic musk compounds such as galaxolide and tonalide. These substances are also added to detergents and other cleaning agents.
In addition to these aromatics, UV-filtering substances (sunlight protection factors anc! sun block) are detectable in the milk (BgVV 2000).
According to a small study, silicon from breast implants was said to lead to disturbances of motility in the lower esophageal tract of breastfed infants, caused by scleroderma-likc changes (Levine 1994). A definitive judgment on this hypothesis is not yet possible. A corresponding suspicion that silicon implants could cause col-lagenoses in the women themselves has not been confirmed in a meta-analysis (Janowsky 2000). Silicon compounds are used in many common medications, and exposure from these is more common than from implants.
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For many years, scientists have been playing out the ingredients that make breast milk the perfect food for babies. They've discovered to day over 200 close compounds to fight infection, help the immune system mature, aid in digestion, and support brain growth - nature made properties that science simply cannot copy. The important long term benefits of breast feeding include reduced risk of asthma, allergies, obesity, and some forms of childhood cancer. The more that scientists continue to learn, the better breast milk looks.