Prenatal exposure: who cares?

We now know that we live our whole lives under a rain of hazardous chemicals. But there is a period in our lives when this exposure can create even more problems. It is when we are developing in our mothers’ wombs and when we are breastfeeding. Not only can our development be hindered but that exposure can increase the probability that we will contract certain illnesses when we are adults.Unfortunately, toxins are often present in mothers’ blood and milk. In low- and middle-income countries (LMICs), the main problem is malnutrition but often natural toxins, and even pesticides, can be present in dangerous concentrations. In wealthier industrialized countries where natural toxins are better controlled, there are higher levels of environmental contaminants. In the EU, where regulations are the tightest in the world, there are no regulations that protect the baby in the nine months before birth and in the months after where she or he is fed with breast milk. Maximum levels (MLs) are lower for baby food than for adult food but who is considering the fetus or the newborn who is only fed breast milk? What are the consequences of this gap in the EU regulatory system? Where are the data for natural or man-made toxins in mothers’ milk?If you read the FDA advice for pregnant women you will find a lot of information about microbiological risks but nothing about the chemical risks. Recently, I bought a book titled Real Food for Pregnancy: The Science and Wisdom of Optimal Prenatal Nutrition. I decided to get it because in a book of about 300 pages written by a nutritionist (Lily Nichols) I expected to find a comprehensive list of dangerous chemicals that we all are exposed to. The book is interesting, well-written, and contains a lot of interesting information. When I found the chapter about toxins, I was looking forward to seeing how the author would suggest avoiding mycotoxins and plant toxins. Unfortunately, there was no information about genotoxic or teratogenic food contaminants like aflatoxins or ochratoxins. There was a long section dedicated to xenoestrogens and hormone disruptors like BPA and phthalates but not a single word about mycotoxins like zearalenone that have clear estrogenic effects. There are not many publications about the presence of mycotoxins in maternal milk but in one study conducted in Germany ochratoxin A was occurring at several times the maximum tolerable daily intake (TDI).Medicinal teas, herbal infusions, and honey that we all - including pregnant women - like to consume for comfort and health sometimes contain significant amounts of both plant toxins (e.g. pyrrolizidine alkaloids) and mycotoxins. Moreover, as a way to “safely eliminate toxins”, the author of Real food for Pregnancy suggested chlorella- or spirulina-based food supplements. These algae may be able to reduce the adsorptionof toxics like dioxins. Quite an important job. However, if the culture conditions are not well-controlled, or the supplement contains other algae taken from lakes, the product can be contaminated by cyanobacteria that produce microcystins, very toxic compounds.For these reasons, we will soon turn more of our focus to natural toxin exposure biomonitoring, particularly in pregnant woman, and to the safety of food supplements.