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Stable Isotope Technique to Assess Human Milk Intake in Infants Living in Contaminated Areas
Closed for proposals
Project Type
Project Code
E41015CRP
1518Approved Date
Status
Start Date
Expected End Date
Completed Date
9 April 2015Description
The World Health Organization (WHO) recommends that infants should be exclusively breastfed for the first six months of life, followed by the introduction of appropriate complementary foods and continued breastfeeding for up to two years to achieve optimal growth, development and health. Paediatricians and policy makers agree that protection, promotion and support of breastfeeding are a public health priority. WHO classifies exclusively breastfed infants as receiving human milk and nothing else. Predominantly breastfed infants receive human milk and small amounts of other fluids (teas, water or juice) on at least three days a week. Many infants are predominantly breastfed until 9 months of age, especially in developing countries. Human milk is used in human biomonitoring as an indicator for accumulation of environmental chemicals. Evidence about toxic and potentially toxic chemicals in human milk can be used to promote environmental protection issues, but this can have an adverse effect on the public health messages issued by WHO. Breastfeeding is safer and cheaper than formula feeding and has significant advantages for the mother and her baby. Breastfed infants score significantly higher than formula-fed infants in studies of mental development. In addition, breastfeeding improves the bonding between mother and baby and has positive effects on the baby’s immune function including fewer incidents of gastrointestinal infections. There is currently no information available on the effect of environmental contamination from mining activities and natural sources on lactation performance of women living in contaminated areas. Young infants are particularly vulnerable since human milk is their primary or sole source of nutrition. Human milk intake and thus lactation performance can be accurately assessed using stable isotope technique. The CRP will use a longitudinal study design to focus on assessing human milk intake and lactation performance of nursing mothers using the deuterium oxide dose-to-mother technique. Repeated measures will be performed in infants aged 3, 6 and 9 months. Depending on the study location, the infants’ intake of lead (Pb), mercury (Hg), arsenic (As), cadmium (Cd), selenium (Se) and manganese (Mn) though human milk will be assessed by combining accurate data on human milk intake with measures of concentration. The infants’ growth will be monitored with reference to the new WHO growth standards and they will be monitored for incidence of infectious diseases.
The overall objective of the proposed CRP is to assess lactation performance of women living in contaminated areas and to provide better estimates of transfer of toxic and potentially toxic elements from mother to child via human milk.
The results generated within this CRP will contribute new data towards the evidence base supporting public health messages regarding breastfeeding.
Objectives
The overall objective of the CRP is to assess lactation performance of women living in contaminated areas and to provide better estimates of transfer of toxic and potentially toxic elements from mother to child via human milk.
Specific objectives
Assess the intake of human milk by exclusively or predominantly breastfed babies, and to assess intake of water from other sources, using the deuterium oxide dose-to-mother technique.
Evaluate the intake of toxic and potentially toxic elements though human milk by combining data on the concentration with data on the volume of human milk consumed by the baby.
Measure total element concentration (and speciation when applicable) of lead (Pb), mercury (Hg), arsenic (As), cadmium (Cd), selenium (Se) and manganese (Mn) in human milk, depending on the study location.
Impact
1) A new network of scientists has been established among the CRP partners. In particular, new collaborations were developed between the University of Chile and Karolinska Institute, Sweden; between The University of Brasilia, Brazil and JSI, Slovenia; The University of Newcastle, Australia, Centre for Health and Development, Bangladesh and St. John’s Research Institute, Bangalore, India; Nutrition Research Centre, Ghana Atomic Energy Commission and JSI, Slovenia; The Obafemi Awolowo University, Ile-Ife, Nigeria and Ghana Atomic Energy Commission.
2) The CRP improved the perceived value of stable isotope techniques to use in population based studies among the CRP participants and stimulated ideas for new international research projects.
3) The CRP raised awareness among the CRP participants about the need for continuous quality assurance to secure comparability of results for determining trace elements in biological samples.
4) New data has been produced about transfer of toxic elements from lactating mothers to the infants living in contaminated areas.
5) Assessment of the quantity of trace elements consumed by breast-fed babies by combining concentration measured by the conventional techniques and volume of human milk intake measured by the deuterium technique provides more accurate information about the ingestion of potentially toxic elements through breast milk. This protocol has a potential to improve the human bio monitoring programs of vulnerable population such as lactating mothers and their infants.
6) The CRP has contributed to building of human capacity, particularly transfer of knowledge and skills in partner institutes.
7) The data this CRP generated will be shared with the Public Health sectors in participating countries.
8) New collaborations have been established within the participating countries between health professionals and scientist working in the field of public health and environmental monitoring.
Relevance
This CRP created a unique set of data with standardised protocols within the same time frame (2010- 2013).
The CRP data confirms the WHO recommendations to practice exclusive breastfeeding even in the contaminated areas.
Protocols used in this CRP could be applied for human biomonitoring programmes.