母乳中全氟化合物的污染水平与婴儿暴露评估

为探索北京市产妇母乳中典型全氟化合物的污染水平及婴儿经母乳的外暴露水平及风险.于2011~2012年通过征集母乳捐献志愿者方式采集95份母乳样本,并填写调查表,记录母乳捐献者的人口学特征及居住环境等信息.采用固相萃取结合超高效液相色谱-串联质谱法测定母乳中全氟辛酸及全氟辛烷磺酸的含量,估算婴儿经母乳的每日摄入量并与参考剂量进行比较.结果显示北京市产妇母乳中全氟辛酸含量均值和中位数分别为42和37.4pg/m L,范围在13.4~181.3pg/m L之间.全氟辛烷磺酸含量高于全氟辛酸,均值、中位数和范围分别为66.6、54.5和14~390.3pg/m L,统计分析发现全氟辛酸与体重指数呈正相关但与母乳产出时间呈负相关,而全氟辛烷磺酸则与产妇年龄呈正相关.婴儿经母乳全氟辛酸和全氟辛烷磺酸每日摄入量中值分别为4.67和6.81ng/(kg bw·d),最高值分别为22.66和48.79ng/(kg bw·d),显示部分婴儿经母乳摄入的全氟辛烷磺酸水平超过了参考剂量,健康风险值得关注.     

From Policy to Practice: Challenges in Infant Feeding in Emergencies During the Balkan Crisis

The preparation and dissemination of policy statements are necessary but insufficient to prevent the inappropriate use of infant-feeding products in emergencies. The widespread failure of humanitarian agencies operating in the Balkan crisis to act in accordance with international policies and recommendations provides a recent example of the failure to translate infant-feeding policies into practice. This article explores the underlying reasons behind the failures which include: (1) the weak institutionalisation of policies; (2) the massive quantities of unsolicited donations of infant-feeding products: (3) the absence of monitoring systems; (4) inadequate co-ordination mechanisms; (5) the high costs of correcting mistakes; and (6) the cumulative effects of poor practice. Efforts to uphold best practice during the crisis are also documented. Finally, the article identifies actions that could be undertaken in advance of and during future emergencies to enhance the application of infant feeding policies in emergencies.     

Mother's body mass index as a predictor of infant's nutritional status in the post-emergency phase of a flood

Maternal nutritional status is a determinant of child health. This paper studies the association between a mother's body mass index (BMI) and her infant's nutritional status over a one year time frame after the 1998 flood crisis in Bangladesh. The paper uses secondary analysis of data collected from 757 households in seven rural areas of Bangladesh affected by the 1998 flood using multiple-stage probability sampling techniques (n = 143). Logistic regression models were employed to investigate the predictive impact of maternal BMI on infant's nutritional status after controlling for a range of child and maternal factors. An underweight mother was a significant factor with regard to the risk of infants suffering stunting (odds ratio (OR) = 4.45, 95 per cent confidence interval (CI) = 1.04-18.94) and being underweight (OR = 3.51, 95 per cent CI = 1.02-12.05) a year later, but not wasting (OR = 2.09, 95 per cent CI = 0.51-8.67). The findings suggest that there is a post-emergency link between maternal and infant nutritional health.     

Infant and Under-five Mortality in Bangladesh: Discriminant Analysis

Bangladesh is on target for achieving the Millennium Development Goal 4 relating to infant and under-five mortality because of very rapid reduction in mortality in recent years. But this rate of reduction may be difficult to sustain and may hamper the achievement of Millennium Development Goal 4. Therefore,the main objective of this paper is to discuss and compare the different covariates of infant and under-five mortality in the context of overall country, urban and rural levels of Bangladesh using discriminant analysis. For this, the data are taken from Bangladesh Demographic and Health Survey, 2004. In discriminant analysis,the stepwise procedure has been picked up and only the significant variables are ranked according to the rank of Wilk's Lambda values. The canonical discriminant function coefficients (unstandardized and standardized) for the predictor variables have also been calculated. Both the results show that breastfeeding is the most important variable in discriminating the two groups of mothers,i.e., mothers experiencing to infant mortality or not and mothers experiencing to under-five mortality or not. The related results of discriminant function also indicate that the discriminant function is statistically significant and discriminates well. Therefore, improvements in the health system are essential for promoting the breastfeeding practices (both inclusive and exclusive), which may be the effective strategies to reach families and communities with targeted messages and information.     

Levels of synthetic musk fragrances in human milk from three cities in the Yangtze River Delta in Eastern China

Synthetic musks are used as additives in many household products. After absorption into the human body, they accumulate and their concentrations in human milk reflect both the mother and her infant’s exposure level. Concentrations of four synthetic musks, musk xylene (1-tert-butyl-2,6-dimethyl-2,4,6-trinitrobenzene, MX), musk ketone (4-tert-butyl-2,6-dimethyl-3,5-dinitroacetophenone, MK), 1,3,4,6,7,8-hexahydro-4,6,6,7,8,8-hexamethylcyclopenta[ ]-2-benzopyran (HHCB) and 7-acetyl-1,1,3,4,4,6-hexamethyl-1,2,3,4- tetrahydronaphthalene (AHTN), were determined in human milk samples collected from Shanghai, Wuxi, and Shaoxing in Eastern China. The four synthetic musks were found in most samples analyzed, with HHCB the dominant component followed by MX. The median (mean) values for HHCB, AHTN, MX and MK concentrations were 63 (82), 5 (12), 17 (24) and 4 (9) ng/g lipid weight, respectively. These data suggested the total synthetic musk contamination was low, and the distribution percentage was HHCB > MX > AHTN MK. The relative high ratio of nitro to polycylic musk indicated that nitro musks were still widely used. The musk concentrations in these cities were not significantly different from each other (p > 0.05). Principal components score plots were obtained, which showed similar exposure sources. The amount of total synthetic musks in human milk were not associated with mother’s age, although HHCB was significantly correlated with AHTN (p < 0.05). Daily ingestion of HHCB, AHTN, MX and MK for infants from human milk were estimated as (2526 2926), (370 524), (7391 832), and (277 462) ng/day, respectively. Those doses were 1–2 orders of magnitude below the provisional tolerable daily intakes.     

New insights into the determinants of the total fertility rate,infant mortality rate and life expectancy

SUMMARY

Data on 127 countries from the World Development Report (1993) are examined with respect to associations between the total fertility rate (TFR), infant mortality rate, life expectancy, female primary education, GNP and domestic water supply. A marked negative association between quantity of domestic water and the total fertility rate, independent of infant mortality, GNP and women's education, was found. However, water was not significantly associated with infant mortality, after controlling for CNP, female education and TFR. Further research at the micro- (community and individual) and macro-level is suggested to understand why and how water plays such an important role in TFR. At the same time, development policies and programmes need to give high priority to the domestic water supply at community as well as national levels.     

Application of a LC–MS/MS method for multi-mycotoxin analysis in infant formula and milk-based products for young children commercialized in Southern Brazil

ABSTRACT

An analytical method based on liquid chromatography–tandem mass spectrometry (LC–MS/MS) was validated and applied for the analysis of aflatoxin M₁ (AFM₁), ochratoxin A (OTA) and deoxynivalenol (DON) in infant formula and milk-based products for young children commercialized in Brazil. A total of 38 samples were evaluated, including 12 infant formula, 14 follow-on formula and 12 samples of milk-based products. AFM₁ was detected in 12 (32%) samples, and seven (18%) samples contained AFM₁ levels above the method limit of quantification in a concentration range between 0.013 and 0.067 ng mL^?1 (0.026 ± 0.019). Two samples of milk-based products exceeded the maximum level (ML) fixed by the European Union for AFM₁ in baby foods, however, all samples were in agreement with the levels established by the Brazilian regulation. OTA and DON were not detected in any of the analyzed samples.     

Umbilical cord blood mercury levels in China

Mercury (Hg) is a well-known neurotoxicant. Hg exposure at high levels can harm individuals of all ages. Even low level exposure to Hg can damage the brain of fetuses and young children, and affect their central nervous system and cognitive development. The aims of our study were to measure total Hg levels in infant umbilical cord blood and to investigate the risk factors associated with total Hg cord blood levels in various cities in China. Our goal was to provide clues for the prevention of Hg exposure in utero. The results indicated that the average cord blood mercury levels (CBMLs) were (1.81 ± 1.93) μg/L, which were lower than those found in most previous studies. The concentrations also differed according to geographic region. The CBMLs were not only associated with family economic and living conditions, but also with diet in pregnant women, especially the intake of marine fish, shellfish, poultry, formula milk and fruits.     

Absorption of polychlorinated biphenyls, dibenzo-p-dioxins and dibenzofurans by breast-fed infants

The absorption of polychlorinated biphenyls, dibenzo-p-dioxins and dibenzofurans was studied in four breast-fed infants. The absorption was measured by comparing the estimated total intake and the excretion in faeces, during 48 hours, at three different time points; 1, 2 and 3 months post parta. The levels of the analysed compounds in the human milk are typical for Sweden, i.e 20 ppt toxic equivalents for the dibenzo-p-dioxins and dibenzofurans and for the polychlorinated biphenyls 16 ppt toxic equivalents. For most of the congeners the absorption is found to be over 95%. Higher excretion is noticed for heptachlorinated and octachlorinated dioxins.     

Follow-up of pregnancies complicated by placental mosaicism diagnosed by chorionic villus sampling

Thirty-nine (2.3 per cent) of 1724 chromosome studies from diagnostic chorionic villus samplings (CVS) done between 1983 and 1990 showed either level III (true) mosaicism (1.2 per cent) or level II (pseudo-) mosaicism (1.1 per cent) for chromosomal aneuploidy. Follow-up information on these 39 pregnancies was collected from questionnaires to families, paediatricians, and obstetricians. For all cases in which the pregnancy was continued and further testing was accomplished, the mosaicism was felt to be confined to the placenta. As compared with a control group of pregnancies evaluated by CVS with normal karyotypes, there was no increased incidence of pregnancy loss, congenital malformations, or developmental delay in the infants. Although intrauterine growth retardation occurred in several of the level III mosaic cases, adequate catch-up growth has been demonstrated.