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Aflatoxin Exposure Among Mothers and Their Infants from the Western Highlands of Guatemala

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Abstract

Objectives

We examined breast milk of mothers and urine of infants before and after introduction of supplementary foods for aflatoxin M1 (AFM1) and the association between AFM1 with maternal and infant diet.

Methods

A prospective cohort study was conducted among mothers and infants ages 0–6 months and 7–12 months from June-October 2014. Sociodemographic, dietary, birth, and health data were collected. A breast milk sample was collected from each mother and a urine sample from each infant at baseline (time point 1) and monthly for 2 time points thereafter; samples collected at baseline and time point 3 were tested for AFM1.

Results

Almost 5% of breast milk and 15.7% of urine samples tested AFM1-positive. The median AFM1 in breast milk was 0.020 ng/mL and in urine 0.077 ng/mg creatinine. At time point 3, infants of 5 of the 6 mothers in each group who were AFM1-positive in breast milk were also AFM1-positive in urine. Mothers’ consumption of cooked maize/maize dough ≥ 3 days per week (OR 2.96, 95% CI = 1.19–7.34) and mothers' consumption of tamales made from maize ≥ 3 days per week (OR 0.28, 95% CI = 0.10–0.73) were significantly associated with AFM1 in infant urine.

Conclusion

This is the first study in Guatemala documenting aflatoxin exposure in both breast milk of lactating mothers and infants´ urine during the first year of life. This may have important implications in understanding the multicausality of the high rates of stunting among children < 5 years old in Guatemala.

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Acknowledgements

We thank the mothers who participated in this study and the clinic staff who helped to facilitate the study. This study was supported by the Minority Health International Research Training (MHIRT), grant no. T37-MD001448, from the National Institute on Minority Health and Health Disparities, National Institutes of Health (NIH), Bethesda, MD, USA.

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Authors and Affiliations

  1. Department of Epidemiology, School of Public Health, University of Alabama At Birmingham, 1665 University Blvd, Birmingham, AL, 35233, USA

    Pauline E. Jolly, Haglaeeh Contreras, Nora Balas, Anna Junkins, Ibironke O. Aina & Selina Minott

  2. Section of Nutrition and Micronutrients, Institute of Nutrition for Central America and Panamá (INCAP), Guatemala City, Guatemala

    Manolo Mazariegos

  3. College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843, USA

    Meichen Wang & Timothy D. Phillips

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  1. Pauline E. Jolly
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Correspondence to Pauline E. Jolly.

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The authors declare that they have no conflict of interest.

Ethical Approval

The study protocol was reviewed and approved by the Institutional Review Board of the University of Alabama at Birmingham and the Ethics Committee of the Institute of Nutrition for Central America and Panamá, Guatemala. Written informed consent was obtained from each mother.

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Jolly, P.E., Mazariegos, M., Contreras, H. et al. Aflatoxin Exposure Among Mothers and Their Infants from the Western Highlands of Guatemala. Matern Child Health J 25, 1316–1325 (2021). https://doi.org/10.1007/s10995-021-03151-1

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