Micro problems with macro consequences: accumulation of persistent organic pollutants and microplastics in human breast milk and in human milk substitutes.

Industrial activities provide a modern human lifestyle with advances and comforts in every field. However, such scenario has brought several negative issues. Persistent organic pollutants (POPs) and a growing plastic usage together with the degradation byproducts, namely microplastics (MPs), are current environmental problems present in every ecosystem, disturbing all forms of life. POPs and MPs are also found in human consumption products including animal and vegetal derivatives, human milk substitutes, and in human breast milk. To date, it is currently unknown what are the effects of MPs and POPs when ingested during the first and most important stage for health programming of the offspring, the first 1000 days of life. Here, we add epidemiological and clinical evidence supporting major sources of POPs and MPs in the ecosystem; and we will precisely describe the effect of POP and MP accumulation in animal- or plant-based infant formulas and human breast milk, modulating health outcomes in the newborn. This review provides a rational to incentive the POP and MP identification in human breast milk and human milk substitutes for avoiding susceptibility to negative health outcomes for the newborn.

Trends in social inequalities in breastfeeding and infant formulas in Latin American countries between the 1990 and 2010 decades.

OBJECTIVE: To analyse trends of social inequality in breastfeeding and infant formula (IF) use in Latin America between 1990 and 2010 decades. DESIGN: Time-series cross-sectional study with data from Demographic and Health Surveys. We described the prevalence of exclusive breastfeeding (EBF), breastfeeding between 6 and 12 months (BF6-12) and IF for infants under 6 months (IF < 6) and between 6 and 12 months (IF6-12). Social inequalities were assessed using the slope index of inequality (SII) and concentration index (CIX). Trends in the prevalence of breastfeeding, IF and index of social inequality were analysed by a linear regression model with weighted least squares variance. SETTING: Bolivia, Colombia, Dominican Republic, Guatemala, Haiti and Peru. PARTICIPANTS: 51·358 alive infants younger than 12 months. RESULTS: Five countries showed an increasing trend for EBF and BF6-12, four increased for IF < 6 and six for IF6-12. Simultaneous decrease in IF < 6 (Colombia: -0·3/year; Haiti: -0·02/year) and increase in EBF (Colombia: +2·0/year; Haiti: +1·9/year) were observed only in two countries. EBF prevalence was high in the lowest income quintiles in five countries, and IF prevalence was high in the highest income quintiles in all countries and over the decades. For BF6-12, a decrease in inequality (prevalence increased in the highest quintile) was observed in Guatemala (SII1995 = -0·42; SII2015 = -0·28) and the Dominican Republic (SII1996 = -0·54; SII2013 = -0·26). Guatemala was the only country showing a decrease in inequality for BF (SII = -0·005; CIX = -0·0035) and an increase for IF (SII = 0·022; CIX = 0·01). CONCLUSIONS: The inequality in BF and IF remained over time. However, inequality in IF < 6 has decreased because low-income infants have increased use and high-income infants have decreased.

Full Breastfeeding Modifies Anthropometric and Body Composition Indicators in Nursing Mothers.

Background: It has been observed that breastfeeding mobilizes the deposits of fat that accumulate during pregnancy and promotes weight loss through energy expenditure. The purpose of this study was to demonstrate that full breastfeeding (FBF) reduces anthropometric and body composition indicators in women between the 8th and the 16th week postpartum. Methods: In a nonrandom cohort study, 170 mothers at the Hospital Civil de Guadalajara, Guadalajara, México, were enrolled: FBF 74, partial breastfeeding (PBF) 57, and human milk substitutes (HMS) 39. Anthropometric indicators and body composition were measured at the 8th and 16th week postpartum. We performed analysis of variance to compare body composition according to the type of feeding and paired Student's t-test to compare the changes from the 8th to 16th week postpartum. Results: We found that FBF mothers had a trend to lower arm fat area and triceps skinfold than PBF and HMS mothers at 8 and 16 weeks postpartum. We observed a decrease in weight (p = 0.004), weight/age index (p = 0.003), body mass index (p = 0.003), hip circumference (p = 0.037), and lean mass (p = 0.003) from 8 to 16 weeks postpartum in mothers who offered FBF. The mid-upper arm circumference, the arm total area, and their z-score increased in the three feeding groups. Conclusions: Our results show that FBF mothers had some lower adiposity from 8 to 16 weeks postpartum compared with the result observed among PBF mothers and those who utilized HMS.

Concentraciones de los oligoelementos cobre y zinc en leche materna, de vaca y de cabra / Concentrations of trace elements like copper and zinc in breast, cow's and goat's milk

Objetivo: Comparar las concentraciones de los oligoelementos cobre y zinc en la leche materna, de vaca y de cabra. Métodos: Estudio descriptivo de corte transversal. Se recogieron muestras de leche materna de madres lactantes sanas (91 mujeres) que asistieron a un centro materno infantil en la ciudad de Maracaibo-Venezuela. Previo consentimiento informado se seleccionaron madres que cumplieron con los criterios de inclusión. Las concentraciones de los oligoelementos en estudio, se determinaron mediante espectrofotometría de absorción atómica con llama. Resultados: En el análisis de la muestra de leche humana se hallaron concentraciones de cobre de 0,290 ± 0,04 mg/L y concentraciones de zinc de 1,580 ± 0,35 mg/L. Estos valores son considerados aceptables según la ingesta diaria de referencia para estos oligoelementos y fueron más elevada en muestras en leche de cabra según la literatura, mientras que las concentraciones de zinc en ambas leches (cabra y vaca), registradas por otros especialistas, fueron más elevadas que en la leche humana del presente estudio. Conclusiones: Las concentraciones de cobre y zinc halladas en la leche materna en este trabajo son las ingestas recomendadas para el desarrollo y madurez del sistema nervioso central del neonato(AU)

Objective: To compare the concentrations of trace elements like copper and zinc present in breast, cow's and goat's milk. Methods: Descriptive, cross sectional study. Samples of breast milk were collected from healthy lactating mothers (91 women) who attended a maternal and children health center in Maracaibo city, Venezuela. Mothers were selected prior informed consent who met the inclusion criteria. The concentrations of the studied trace elements were determined by atomic absorption spectrophotometry with flame. Results: In the analysis of the human milk´s sample, there were found concentrations of Cu (0.290 ± 0.04 mg/L) and concentrations of Zn (1.580 ± 0.35 mg/L). These levels are considered acceptable according to the permitted intake of trace elements and according to the literature, those are higher in goat milk´s samples, while concentrations of Zn in both milks (goat and cow), registered by other specialists were higher than in the human milk´s of the present study. Conclusions: The concentrations of copper and zinc found in breast milk are the recommended daily intake for the development and maturity of the central nervous system of the newborns(AU)

Consumo de leites em menores de um ano de idade e variáveis associadas ao consumo de leite não materno / Milk consumption in infants under one year of age and variables associated with non-maternal milk consumption

RESUMO Objetivos: Verificar o tipo de leite consumido por crianças menores de um ano de idade e identificar variáveis associadas ao consumo de leite não materno (LNM) - fórmula infantil ou leite de vaca (LV). Métodos: Estudo transversal realizado durante a Campanha Nacional de Vacinação contra Poliomielite 2012. Os acompanhantes de 935 crianças menores de um ano responderam a um questionário estruturado sobre a alimentação da criança nas últimas 24 horas. As estimativas são apresentadas por pontos e intervalo de confiança de 95% (IC95%). Adotou-se a estatística F para verificar diferenças na proporção de consumo dos tipos de leite segundo a faixa etária das crianças (<6 meses e 6-11 meses) e a associação entre o consumo de leite não materno e as variáveis estudadas. Resultados: O consumo de leite materno e fórmula infantil foi maior entre as crianças menores de 6 meses - sendo 82,8% (IC95% 78,5-86,3) e 70,4% (IC95% 61,4-78,0), respectivamente -, enquanto o de leite de vaca foi maior entre as crianças de 6 a 11 meses - 74,2% (IC95% 66,5-80,6) -, com diferenças nas proporções de consumo (p<0,0001). As variáveis associadas ao maior consumo de leite de vaca foram: menor escolaridade materna (p<0,0001), o fato de a mãe não trabalhar fora (p=0,0015), a criança consultar na rede pública de saúde (p<0,0001) e participar do Programa Leite das Crianças - PLC (p<0,0001). Conclusões: As crianças receberam leite de vaca precocemente (antes do primeiro ano de vida), em especial aquelas pertencentes às famílias de menor nível socioeconômico e inseridas em programa social específico para recebimento de leite.

ABSTRACT Objective: To verify the type of milk consumed by children under one year of age and identify variables associated with non-maternal milk consumption (formula or cow milk). Methods: Cross-sectional study developed during the 2012 National Vaccination Campaign against Poliomyelitis. The companions of 935 children under one year of age answered a structured questionnaire on the child's diet in the last 24 hours. The estimates are presented by points, with 95%CI. F-statistics were used to check for differences in the proportion of the types of milk consumption according to the children's age range (<6 months and 6-11 months) and the association between non-maternal milk consumption and the study variables. Results: The consumption of maternal milk and child formula was higher for children under six months of age - corresponding to 82.8% (95%CI 78.5-86.3) and 70.4% (95%CI 61.4-78.0), respectively -, whereas the consumption of cow milk was higher among children between 6 and 11 months of age - 74.2% (95%CI 66.5-80.6) -, with differences in the consumption proportions (p<0.0001). The variables associated with higher cow milk consumption were lower maternal education (p<0.0001), the fact that the mother does not have a paid occupation (p=0.0015), child doctor's appointment in the public health network (p<0.0001) and participation in the Child's Milk Program (p<0.0001). Conclusions: The infants received cow's milk early (before the first year of life), especially children from families with lower socioeconomic levels and children who took part in a specific social program for milk distribuition.

Desarrollo de dos fórmulas infantiles como alternativa económica y saludable para seguridad alimentaria y nutricional de la población lactante / Development of two infant formulas as an economic and healthy alternative for help to food security and nutritional security to the infant population

Introducción: Cuando la lactancia materna no es posible, se recurre a otros alimentos que brinden los nutrientes necesarios a los bebés, como las fórmulas infantiles, con características nutricionales que cumplan con la reglamentación actual y permitan un adecuado crecimiento al lactante. Objetivo: Diseñar dos fórmulas líquidas para lactantes que aporten los requerimientos diarios de macronutrientes y algunos micronutrientes (ácido fólico, zinc, calcio y hierro), con leche de vaca, higienizada por pasteurización, de bajo costo para que sea más asequible para la población lactante vulnerable a la vez que contribuye con su crecimiento. Materiales y métodos: Estudio exploratorio desarrollado en dos fases, formulación y elaboración de los productos y verificación de su eficacia en el crecimiento de lactantes. Resultados: Los productos cumplen con los requisitos de fabricación exigidos, de bajo costo y son capaces de sustentar un crecimiento normal, según clasificación de OMS. Conclusión: Las fórmulas desarrolladas tienen un adecuado aporte de macro y micronutrientes con características sensoriales y microbiológicas bajo los criterios exigidos por la reglamentación internacional y nacional, de bajo costos, permitiendo un adecuado crecimiento al lactante.

Introduction: When breastfeeding is not feasible, other sources to provide the required nutrients to babies are sought, such as infant formulas that comply with current regulation and with the baby's growth requirements. Objective: To design two liquid infant formulas that provide daily macronutrients and some micronutrients (folic acid, zinc, calcium, and iron) requirements, based on low-cost pasteurized cow milk in order to be more affordable for vulnerable babies and to contribute with their growth. Materials and Methods: Exploratory study developed in two phases: Formulation and preparation of the infant formula and verification of its efficacy in terms of babies' growth. Results: The infant formulas comply with all manufacturing requirements, are inexpensive, and appropriate to sustain normal growth, according to WHO. Conclusion: The two infant formulas developed have adequate macronutrient and micronutrient contribution with sensorial and microbiological characteristics that comply with local and foreign regulations, are inexpensive, and appropriate to sustain babies' normal growth.