Probleme mit Fremdstoffen — insbesondere Dioxinen — in der Frauenmilch
polychlorierte Dibenzo-p-dioxine und Dibenzofu-rane
metabolite of DDT (1,1,1,-Trichloro-2,2-bis[p-chlorophenyl] ethane)
Internationale TCDD-Toxizitäts-Äquivalente, Toxizität von PCDDs/PCDFs relativ zu der von TCDD
Man, being situated at the end of the food chain, has been exposed to a variety of persistent and very lipophilic environmental substances that accumulate in the adipose tissue of the general population world-wide. When breast-feeding, many of these substances are released and transferred together with the lipids into the milk. The concentration of such pollutants in the milkfat corresponds to that present in the mother’s adipose tissue or in serum lipids.
The concentration of „dioxins“found in the milk of women in the Federal Republic of Germany averages approximately 3 pg/g TCDD (2,3,7,8-tet-rachlorodibenzo-p-dioxin) in milkfat and about 39 pg I-TE/g milkfat for the sum of PCDDs/PCDFs (I-TE = international-toxic-TCDD-equivalencies for the other congeners, compared with the toxicity of TCDD). One may calculate the average daily uptake of the breast-fed infant to amount to approximately 20 pg TCDD/kg body wt and app. 180 pg I-TE/kg wt for the sum of PCDDs/PCDFs (850 ml/day; 3.5% fat; 5 kg). Assuming an average TCDD body burden of approximately 500 ng in the adult (about 15 kg body fat), about 20% of the mother’s body burden may be eliminated during four months of breast-feeding.
At the end of four months breast-feeding theoretically, the infant could have accumulated a 2- to 3-times higher concentration of „dioxins“in the body as compared to the mother, assuming 100% absorption and no elimination. However, until now, this calculation is not supported by solid data, and the few studies performed so far rather point to a lower rate of accumulation. Prenatally only small concentrations of „dioxins“are transferred through the placenta.
A final assessment of the concentrations remaining in infants and of clinical effects that might possibly be related to breast-feeding must be postponed until data from analytical investigations and clinical long-term follow up studies are available. Such studies are under way, in corresponding clinical investigations in Berlin. However, since no clear adverse health effects have been revealed until now in infants, the well-established benefits of breast-feeding at our present stage of knowledge outweigh possible effects of the pollutants, and breast-feeding is still recommended by all national (e.g. BGA) and international (e.g. WHO) expert committees.
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