RELATION BETWEEN BREAST MILK CONTENT OF TOTAL AFLATOXIN AND SOCIODEMOGRAPHIC AND NUTRITIONAL STATUS OF LACTATING MOTHERS IN QATAR

Abstract

Background: Human milk is the ideal nourishment for neonates, as its unique nutritional composition supports adequate growth and development. On the other hand, human milk might contain contaminants including aflatoxins with negative health effects on the infant. Objectives: In this study, we aimed to:1) determine the presence and quantification of total aflatoxins in human milk of mothers of infants admitted to the neonatal intensive care unit (NICU) at the Women Wellness and Research Center (WWRC) in Qatar, and 2) explore the associations of the sociodemographic, lifestyle and nutritional variables of mothers with the concentrations of aflatoxins in their milk. Methods and Results: A total of 71 lactating mothers were enrolled in this study. Human milk samples were collected and tested using ELISA for total aflatoxins. Validated questionnaires to assess socio-demographical, lifestyle, clinical data, and dietary intake (food frequency questionnaire FFQ) were collected from the mothers in person. Findings showed that two-thirds (73%) of milk samples were contaminated with aflatoxin levels above the acceptable limit of 25 ng/l set by the European Union (EU), and with a mean 90 ng/l. Three maternal dietary patterns were identified; the healthy, the traditional, and the processed patterns. The traditional pattern showed significant inverse association with milk aflatoxin level of (-19 ng/l) with a 95% CI of -37.38 to -2.23 (P-value 0.028). Analysis of individual food items in the traditional pattern showed that, coffee and tea, and sweets were the only items that showed significant inverse relations (P-value for trend 0.021 and 0.035, respectively) after adjusting for age, education, and obesity. There was no significant association between maternal socio-demographic, lifestyle and clinical variables and milk aflatoxin levels. Conclusion: This is the first study that investigated human milk content in aflatoxins and suggests that maternal traditional dietary pattern, especially coffee and tea consumption, may be inversely associated with milk contamination. Additional studies with larger sample size are required to assess human milk aflatoxin M1, the major toxic metabolite, and its determinants in the mothers' characteristics. These findings will set the stage for national programs to develop regulations for safe importation, agricultural and environmental practices and raise awareness that would improve the well-being of mothers, infants, and the generations to come.