Academic journal article Iranian Journal of Public Health

Infants' Exposure to Aflatoxin M1 fromMother's Breast Milk in Iran

Academic journal article Iranian Journal of Public Health

Infants' Exposure to Aflatoxin M1 fromMother's Breast Milk in Iran

Article excerpt


Background: The occurrence of aflatoxin M1 (AFM1) in milk, especially breast milk, is a valuable biomarker for exposure determination to aflatoxin B1 (AFB1). In the present study, the risk of exposure to AFM1 in infants fed breast milk was investigated.

Methods: An enzyme-linked immunosorbent assay (ELISA) was used for the analysis of AFM1 in breast milk samples from 132 lactating mothers referred to four urban Mothers and Babies Care Unit of Hamadan, western Iran.

Results: AFM1 was detected in eight samples (6.06%) at mean concentration of 9.45 ng/L. The minimum and maximum of concentration was 7.1 to 10.8 ng/L, respectively. Although the concentration of AFM1 in none of the samples was higher than the maximum tolerance limit accepted by USA and European Union (25 ng/kg) however, 25% had a level of AFM1 above the allowable level of Australia and Switzerland legal limit (10 ng/L).

Conclusions: Lactating mothers and infants in western parts of Iran could be at risk for AFB1 and AFM1 exposure, respectively. Considering all this information, the investigation of AFM1 in lactating mothers as a biomarker for postnatal exposure of infants to this carcinogen deserves further studies in various seasons and different parts of Iran.

Keywords: Aflatoxin M1, ELISA, Human breast milk, Mycotoxin, Iran


Mycotoxins are toxic metabolites produced by special fungal strains. Aflatoxins (AFs) are one of the first recognized and vastly researched mycotoxins in the world. They are one of the most potent toxic substances produced by the fungi Aspergillus flavus and A. parasiticus. Humans and animals are generally exposed to AFs via diet. It is proved that AFs are carcinogenic and may cause growth impairment and immune suppression in numerous animal species (1, 2). AFs have been established in human sera and cord blood of women promptly following birth. Therefore, the transplacental transfer of AF by the feto-placental unit has been established (3, 4). The high AF exposure of West African child ren and the effects of this exposure on children's growth have been demonstrated (5). Moreover, the higher level of AFB1 has been correlated with reduced birth weight and jaundice in neonates (6). Immunity and different aspects of children's health may significantly be influenced by exposure to aflatoxins. Turner et al. reported a decrease in salivary IgA in Gambian children exposed to aflatoxin (7).

Aflatoxin M (AFM) is a hydrolyzed metabolite of AFB (8). When feed contaminated with AFB is ingested by dairy cattle, up to 0.3-6.2% will appear in the milk as AFM (9). AFM1 is of special interest because it can be transmitted to a newborn offspring by the human's milk (10). Consumption of AFM1-contaminated milk by human, especially neonates and children, is of substantial concern especially when considering that AFM1 may be secreted in mother's breast milk (11). It has been recognized that children exposed to AFM1 through milk or it's by products may become prone to infectious diseases, underweight, and stunted during infancy and for the rest of the life. (2).

In contrast to the infectious diseases, mycotoxins, because of their chronic effects on human being, have been neglected in most developing countries. However, only limited data are available on mycotoxin contamination of Iranian commodities. According to recent statistics issued by the Iranian Ministry of Health, cancer is the third most common known cause of death in Iran, after cardiovascular diseases and accidents (12). Moreover, there were insufficient data on the contamination of Iranian milk with AFM1 and based on our knowledge there was limited information about the exposure of infants to aflatoxin from mothers' breast milk in Iran.

The aim of this study was to investigate the presence and extent of AFM1 in mothers' breast milk samples by ELISA method.

Materials and Methods

This study was of cross-sectional design. …

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