American Journal of Epidemiology Advance Access originally published online on November 9, 2005
American Journal of Epidemiology 2006 163(1):48-56; doi:10.1093/aje/kwj010
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Original Contribution |
Influence of Maternal Bone Lead Burden and Calcium Intake on Levels of Lead in Breast Milk over the Course of Lactation
1 Department of Environmental Health, Harvard School of Public Health, Boston, MA
2 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
3 Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México
4 Department of Nutrition, Harvard School of Public Health, Boston, MA
5 Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA
Reprint requests to Dr. Adrienne S. Ettinger, Harvard School of Public Health, Landmark Center West, Room 421, 401 Park Drive, Boston, MA 02215 (e-mail: aettinge{at}hsph.harvard.edu).
The authors studied 367 women who were breastfeeding their infants in Mexico City, Mexico, between 1994 and 1995 to evaluate the effect of cumulative lead exposure, breastfeeding practices, and calcium intake on breast milk lead levels over the course of lactation. Maternal blood and breast milk lead levels were measured at 1, 4, and 7 months postpartum. Bone lead measurements were obtained at 1 month postpartum. At 1, 4, and 7 months postpartum, respectively, the mean breast milk lead levels were 1.4 (standard deviation (SD), 1.1), 1.2 (SD, 1.0), and 0.9 (SD, 0.8) µg/liter and showed a significant decreasing trend over the course of lactation (p < 0.00001). The relations of bone lead and blood lead to breast milk lead were modified by breastfeeding practice, with the highest breast milk lead levels among women with a high level of patella lead who were exclusively breastfeeding. Dietary calcium supplementation increased the rate of decline in breast milk lead by 5–10%, in comparison with a placebo, over the course of lactation, suggesting that calcium supplementation may constitute an important intervention strategy, albeit with a modest effect, for reducing lead in breast milk and thus the potential for exposure by infants.
bone and bones; breast feeding; calcium; lactation; lead; longitudinal studies; milk, human
Abbreviations: K-XRF, K x-ray fluorescence; SD, standard deviation
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