Abstract:

Mycotoxins, a diverse group of toxic fungal metabolites, are present as food contaminants worldwide. Of highest concern is dietary exposure to mycotoxins with carcinogenic properties: aflatoxins, fumonisins, and ochratoxin A (OTA). Other contaminants of interest are citrinin, ergot alkaloids, Fusarium mycotoxins (e.g. deoxynivalenol, T-2 toxin, zearalenone) and patulin. Dietary exposure of nursing mothers deserves special attention since some of the mycotoxins ingested are known to be excreted with breast milk. The first studies on mycotoxin occurrence in human milk date back to the mid and late 80's and examined the presence of aflatoxins and OTA in breast milk samples collected in Germany and in some countries of tropical Western Africa. Since then, many more studies have been conducted in other parts of the world. The reported frequencies of detection and average concentrations of aflatoxins (AFB₁, AFM₁) indicate that exposure of infants in Europe is low or negligible, but can reach critical levels in Tropical Africa and some countries of the ‘Middle East’. The other mycotoxin for which levels in human breast milk have been analyzed is OTA: it has been detected in breast milk samples of all countries studied so far, but at rather different levels. In some countries, such as Egypt, Turkey and Sierra Leone, OTA levels in breast milk can be more than 100-fold higher than those measured in Europe. The calculated OTA intake of nursed infants in such countries clearly exceed the tolerable intake values that have been set for adults. Newborns and infants may be more susceptible to adverse effects of these toxins than adults. This and possible co-exposures are briefly discussed. Although animal data (mainly from dairy cattle) provide some orientation on the occurrence of certain mycotoxins in milk, there are major gaps in knowledge on the lactational transfer of several important mycotoxins in humans.