Am J Perinatol 2006; 23(5): 305-312
DOI: 10.1055/s-2006-946720
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

Maternal Exposure to Endocrine-Active Substances and Breastfeeding

Jose G. Dorea1
  • 1Department of Nutrition, Universidade de Brasília, and Post-Graduate Division, School of Medicine, SESC-FEPECS, Brasília, Brazil
Further Information

Publication History

Publication Date:
23 June 2006 (online)

ABSTRACT

Women pass on low levels of hazardous environmental contaminants and naturally occurring substances during pregnancy and nursing. In addition to estrogenic activity, these substances exhibit antiestrogenic, antiandrogenic, and androgenic actions, and because they can affect thyroid metabolism, they are described as endocrine-active substances (EAS). Specific topics related to EAS metabolism by mothers, fetuses, and infants are discussed. There is strong evidence that the assumed risk of EAS in early human development is exacerbated by interrupting neonatal priming provided by breastfeeding. The benefits of breastfeeding are fundamental to attenuate possible EAS effects on infants due to long-term intrauterine exposure. Breastfeeding is a guarantor of health benefits, whereas its alternative (infant formula) is a predictor of some health limitations. Mothers concerned with exposure to environmental contaminants should be advised of the proven benefits of breastfeeding and the possible health limitations of formula feeding.

REFERENCES

  • 1 Massart F, Harrell J C, Federico G, Saggese G. Human breast milk and xenoestrogen exposure: a possible impact on human health.  J Perinatol. 2005;  25 282-288
  • 2 Laurberg P, Andersen S, Knudsen N, Ovesen L, Nøhr S B, Pedersen I B. Thiocyanate in food and iodine in milk: from domestic animal feeding to improved understanding of cretinism.  Thyroid. 2002;  12 897-902
  • 3 Raloff J. That feminine touch. Sci News 1994.  http://Available at: www.sciencenews.org/pages/sn_edpik/ls_8.htm Accessed May 24, 2006; 
  • 4 Clarkson T W. The three modern faces of mercury.  Environ Health Perspect. 2002;  110(suppl 1) 11-23
  • 5 Borgert C J, LaKind J S, Witorsch R J. A critical review of methods for comparing estrogenic activity of endogenous and exogenous chemicals in human milk and infant formula.  Environ Health Perspect. 2003;  111 1020-1036
  • 6 Watanabe S, Yamaguchi M, Sobue T et al.. Pharmacokinetics of soybean isoflavones in plasma, urine and feces of men after ingestion of 60 g baked soybean powder (kinako).  J Nutr. 1998;  128 1710-1715
  • 7 Safe S. Endocrine disruptors and human health: is there a problem.  Toxicology. 2004;  205 3-10
  • 8 Todaka E, Sakurai K, Fukata H et al.. Fetal exposure to phytoestrogens: the difference in phytoestrogen status between mother and fetus.  Environ Res. 2005;  99 195-203
  • 9 Merritt R J, Jenks B H. Safety of soy-based infant formulas containing isoflavones: the clinical evidence.  J Nutr. 2004;  134 1220S-1224S
  • 10 Woodruff T, Wolff M S, Davis D L, Hayward D. Organochlorine exposure estimation in the study of cancer etiology.  Environ Res. 1994;  65 132-144
  • 11 Herrera E, Gomez-Coronado D, Lasuncion M A. Lipid metabolism in pregnancy.  Biol Neonate. 1987;  51 70-77
  • 12 Dorea J G. Changes in body weight and adiposity during lactation.  Nutr Res. 1997;  17 379-389
  • 13 Winkvist A, Rasmussen K M. Impact of lactation on maternal body weight and body composition.  J Mammary Gland Biol Neoplasia. 1999;  4 309-318
  • 14 Hartmann P, Sherriff J, Kent J. Maternal nutrition and the regulation of milk synthesis.  Proc Nutr Soc. 1995;  54 379-389
  • 15 Bjerregaard P, Hansen J C. Organochlorines and heavy metals in pregnant women from the Disko Bay area in Greenland.  Sci Total Environ. 2000;  245 195-202
  • 16 Dorea J G, Cruz-Granja A C, Lacayo-Romero M L, Cuadra-Leal J. Perinatal metabolism of dichlorodiphenyldichloroethylene in Nicaraguan mothers.  Environ Res. 2001;  86 229-237
  • 17 Bosse U, Bannert N, Niessen K H, Teufel M, Rose I. Chlorinated carbohydrate content of fetal and pediatric organs and tissues.  Zentralbl Hyg Umweltmed. 1996;  198 331-339
  • 18 DeKoning E P, Karmaus W. PCB exposure in utero and via breast milk. A review.  J Expo Anal Environ Epidemiol. 2000;  10 285-293
  • 19 Wang S L, Lin C Y, Guo Y LL, Lin L Y, Chou W L, Chang L W. Infant exposure to polychlorinated dibenzo-p-dioxins, dibenzofurans and biphenyls (PCDD/Fs, PCBs)-correlation between prenatal and postnatal exposure.  Chemosphere. 2004;  54 1459-1473
  • 20 McLaren D S. A fresh look at some perinatal growth and nutritional standards.  World Rev Nutr Diet. 1987;  49 87-120
  • 21 Niessen K H, Ramolla J, Binder M, Brugmann G, Hofman U. Chlorinated hydrocarbons in adipose tissue of infants and toddlers: inventory and studies on their association with intake of mothers' milk.  Eur J Pediatr. 1984;  142 238-243
  • 22 Amarowicz R, Sulik M, Korczakowska B, Brykalska A. Residues of chlorinated hydrocarbons in livers of newborns, infants and children.  Rocz Panstw Zakl Hig. 1993;  44 379-382
  • 23 Link B, Gabrio T, Zoellner I et al.. Biomonitoring of persistent organochlorine pesticides, PCDD/PCDFs and dioxin-like PCBs in blood of children from South West Germany (Baden-Wuerttemberg) from 1993 to 2003.  Chemosphere. 2005;  58 1185-1201
  • 24 Cattaneo A, Lehners M. Comment on “Breast milk: an optimal food”.  Environ Health Perspect. 2005;  113 A18-A19
  • 25 Takser L, Mergler D, Baldwin M, de Grosbois S, Smargiassi A, Lafond J. Thyroid hormones in pregnancy in relation to environmental exposure to organochlorine compounds and mercury.  Environ Health Perspect. 2005;  113 1039-1045
  • 26 Koopman-Esseboom C, Morse D C, Weisglas-Kuperus N et al.. Effects of dioxins and polychlorinated biphenyls on thyroid hormone status of pregnant women and their infants.  Pediatr Res. 1994;  36 468-473
  • 27 Longnecker M P, Gladen B C, Patterson Jr D G, Rogan W J. Polychlorinated biphenyl (PCB) exposure in relation to thyroid hormone levels in neonates.  Epidemiology. 2000;  11 249-254
  • 28 Matsuura N, Uchiyama T, Tada H et al.. Effects of dioxins and polychlorinated biphenyls (PCBs) on thyroid function in infants born in Japan-the second report from research on environmental health.  Chemosphere. 2001;  45 1167-1171
  • 29 Dorea J G. Maternal thiocyanate and thyroid status during breast-feeding.  J Am Coll Nutr. 2004;  23 97-101
  • 30 Vanderpas J, Bourdoux P, Lagasse R et al.. Endemic infantile hypothyroidism in a severe endemic goitre area of central Africa.  Clin Endocrinol (Oxf). 1984;  20 327-340
  • 31 Thilly C H, Vanderpas J B, Bebe N et al.. Iodine deficiency, other trace elements, and goitrogenic factors in the etiopathogeny of iodine deficiency disorders (IDD).  Biol Trace Elem Res. 1992;  32 229-243
  • 32 Rasmussen T H, Nielsen F, Andersen H R, Nielsen J B, Weihe P, Grandjean P. Assessment of xenoestrogenic exposure by a biomarker approach: application of the E-Screen bioassay to determine estrogenic response of serum extracts.  Environ Health. 2003;  2 12
  • 33 Rogan W J, Gladen B C, McKinney J D et al.. Polychlorinated biphenyls (PCBs) and dichlorodiphenyl dichloroethane (DDE) in human milk: effects on growth, morbidity, and duration of lactation.  Am J Public Health. 1987;  77 1294-1297
  • 34 Gladen B C, Ragan N B, Rogan W J. Pubertal growth and development and prenatal and lactational exposure to polychlorinated biphenyls and dichlorodiphenyl dichloroethene.  J Pediatr. 2000;  136 490-496
  • 35 Gladen B C, Klebanoff M A, Hediger M L et al.. Prenatal DDT exposure in relation to anthropometric and pubertal measures in adolescent males.  Environ Health Perspect. 2004;  112 1761-1767
  • 36 Massart F, Seppia P, Pardi D et al.. High incidence of central precocious puberty in a bounded geographic area of northwest Tuscany: an estrogen disrupter epidemic?.  Gynecol Endocrinol. 2005;  20 92-98
  • 37 Boisen K A, Kaleva M, Main K M et al.. Difference in prevalence of congenital cryptorchidism in infants between two Nordic countries.  Lancet. 2004;  363 1264-1269
  • 38 Mendola P, Robinson L K, Buck G M et al.. Birth defects risk associated with maternal sport fish consumption: potential effect modification by sex of offspring.  Environ Res. 2005;  97 134-141
  • 39 Vasiliu O, Muttineni J, Karmaus W. In utero exposure to organochlorines and age at menarche.  Hum Reprod. 2004;  19 1506-1512
  • 40 Davis D L, Gottlieb M B, Stampnitzky J R. Reduced ratio of male to female births in several industrial countries: a sentinel health indicator?.  JAMA. 1998;  279 1018-1023
  • 41 Safe S H. Endocrine disruptors and human health-is there a problem? An update.  Environ Health Perspect. 2000;  108 487-493
  • 42 Karmaus W, Huang S, Cameron L. Parental concentration of dichlorodiphenyl dichloroethane and polychlorinated biphenyls in Michigan fish eaters and sex ratio in offspring.  J Occup Environ Med. 2002;  44 8-13
  • 43 Weisskopf M G, Anderson H A, Hanrahan L P. Great Lakes Consortium . Decreased sex ratio following maternal exposure to polychlorinated biphenyls from contaminated Great Lakes sport-caught fish: a retrospective cohort study.  Environ Health. 2003;  2 2
  • 44 Vreugdenhil H J, Slijper F M, Mulder P G, Weisglas-Kuperus N. Effects of perinatal exposure to PCBs and dioxins on play behavior in Dutch children at school age.  Environ Health Perspect. 2002;  110 A593-A598
  • 45 Sandberg D E, Vena J E, Weiner J, Beehler G P, Swanson M, Meyer-Bahlburg H F. Hormonally active agents in the environment and children's behavior: assessing effects on children's gender-dimorphic outcomes.  Epidemiology. 2003;  14 148-154
  • 46 Udry J R. Putting prenatal effects on sex-dimorphic behavior in perspective.  Epidemiology. 2003;  14 135-136
  • 47 Kaufman A S. Critique of Vreugdenhil et al.'s study linking PCBs to the play behaviors of Dutch girls and boys.  Environ Health Perspect. 2003;  111 A380
  • 48 Erwin P C. To use or not use combined hormonal oral contraceptives during lactation.  Fam Plann Perspect. 1994;  26 26-30
  • 49 Betrabet S S, Shikary Z K, Toddywalla V S, Toddywalla S P, Patel D, Saxena B N. ICMR Task Force Study on hormonal contraception. Transfer of norethisterone (NET) and levonorgestrel (LNG) from a single tablet into the infant's circulation through the mother's milk.  Contraception. 1987;  35 517-522
  • 50 Madhavapeddi R, Ramachandran P. Side effects of oral contraceptive use in lactating women: enlargement of breast in a breast-fed child.  Contraception. 1985;  32 437-443
  • 51 Pardthaisong T, Yenchit C, Gray R. The long-term growth and development of children exposed to Depo-Provera during pregnancy or lactation.  Contraception. 1992;  45 313-324
  • 52 Costa T H, Dorea J G. Concentration of fat, protein, lactose and energy in milk of mothers using hormonal contraceptives.  Ann Trop Paediatr. 1992;  12 203-209
  • 53 Dorea J G. The effects of oral contraceptive use on iron and copper concentrations in breast milk.  Fertil Steril. 1999;  72 297-301
  • 54 Dorea J G. Oral contraceptives do not affect magnesium in breast milk.  Int J Gynaecol Obstet. 2000;  71 25-31
  • 55 Dorea J G, Miazaki E S. Calcium and phosphorus in milk of Brazilian mothers using oral contraceptives.  J Am Coll Nutr. 1998;  17 642-646
  • 56 Sas M, Gellen J J, Dusitsin N et al.. An investigation on the influence of steroidal contraceptives on milk lipid and fatty acids in Hungary and Thailand. WHO Special Programme of Research, Development and Research Training in Human Reproduction. Task Force on Oral Contraceptives.  Contraception. 1986;  33 159-178
  • 57 Xu R J. Development of the newborn GI tract and its relation to colostrum/milk intake: a review.  Reprod Fertil Dev. 1996;  8 35-48
  • 58 Liu J, Qiao X, Qian W, Hou X, Hayes J, Chen J D. Motilin in human milk and its elevated plasma concentration in lactating women.  J Gastroenterol Hepatol. 2004;  19 1187-1191
  • 59 Takeda T, Sakata M, Minekawa R et al.. Human milk induces fetal small intestinal cell proliferation-involvement of a different tyrosine kinase signaling pathway from epidermal growth factor receptor.  J Endocrinol. 2004;  181 449-457
  • 60 Xiao X, Xiong A, Chen X, Mao X, Zhou X. Epidermal growth factor concentrations in human milk, cow's milk and cow's milk-based infant formulas.  Chin Med J (Engl). 2002;  115 451-454
  • 61 Howie P W, Mcneilly A S. Breast-feeding and postpartum ovulation.  IPPF Med Bull. 1982;  16 1-3
  • 62 Spencer N A, McClintock M K, Sellergren S A, Bullivant S, Jacob S, Mennella J A. Social chemosignals from breastfeeding women increase sexual motivation.  Horm Behav. 2004;  46 362-370
  • 63 Dorea J G. Mercury and lead during breast-feeding.  Br J Nutr. 2004;  92 21-40
  • 64 Bohles H, Aschenbrenner M, Roth M, von Loewenich V, Ball F, Usadel K H. Development of thyroid gland volume during the first 3 months of life in breast-fed versus iodine-supplemented and iodine-free formula-fed infants.  Clin Investig. 1993;  71 13-20
  • 65 Hahn H B, Spiekerman A M, Otto W R, Hossalla D E. Thyroid function tests in neonates fed human milk.  Am J Dis Child. 1983;  137 220-222
  • 66 Mizuta H, Amino N, Ichihara K et al.. Thyroid hormones in human milk and their influence on thyroid function of breast-fed babies.  Pediatr Res. 1983;  17 468-471
  • 67 Strbak V, Skultetyova M, Michalickova J et al.. Effect of breast-feeding on infant thyroid activity: 3 year follow up-longitudinal study.  Endocrinol Exp. 1986;  20 257-266
  • 68 Phillips D I, Barker D J, Osmond C. Infant feeding, fetal growth and adult thyroid function.  Acta Endocrinol (Copenh). 1993;  129 134-138
  • 69 Dundar N O, Anal O, Dundar B, Ozkan H, Caliskan S, Buyukgebiz A. Longitudinal investigation of the relationship between breast milk leptin levels and growth in breast-fed infants.  J Pediatr Endocrinol Metab. 2005;  18 181-187
  • 70 Resto M, O'Connor D, Leef K, Funanage V, Spear M, Locke R. Leptin levels in preterm human breast milk and infant formula.  Pediatrics. 2001;  108 E15
  • 71 Savino F, Nanni G E, Maccario S, Costamagna M, Oggero R, Silvestro L. Breast-fed infants have higher leptin values than formula-fed infants in the first four months of life.  J Pediatr Endocrinol Metab. 2004;  17 1527-1532
  • 72 Singhal A, Farooqi I S, O'Rahilly S, Cole T J, Fewtrell M, Lucas A. Early nutrition and leptin concentrations in later life.  Am J Clin Nutr. 2002;  75 993-999
  • 73 Sadauskaite-Kuehne V, Ludvigsson J, Padaiga Z, Jasinskiene E, Samuelsson U. Longer breastfeeding is an independent protective factor against development of type-1 diabetes mellitus in childhood.  Diabetes Metab Res Rev. 2004;  20 150-157
  • 74 Shehadeh N, Gelertner L, Blazer S, Perlman R, Solovachik L, Etzioni A. Importance of insulin content in infant diet: suggestion for a new infant formula.  Acta Paediatr. 2001;  90 93-95

Jose G Dorea

C.P. 04322, Universidade de Brasilia

70919-970 Brasília, DF, Brazil

    >