Anne Sütü Mikotoksin Düzeyinin Belirlenmesi ve Bebek Uyku ile Ağlama Özellikleri Üzerine Etkisi

Abstract

Memiş E. Y. Determination of breast milk mycotoxin levels and effects on baby sleep and crying characteristics Hacettepe University Faculty of Medicine Department of Family Medicine, Ankara, 2018. The unique and the most important source of nutrition for babies is breast milk. Pollutants can be found around the mother-baby pairs and also negatively affects both, it may be passed into breast milk, though less well. The purpose of the study is to determine the levels of aflatoxin M1 (AFM1), ochratoxin A (OTA), zearalenone (ZEA), deoxynivalenol (DON) in breast milk. At the same time, the effects of maternal-infant characteristics, anthropometric measurements, breastfeeding problems, maternal nutrient consumption characteristics on the risk of having mycotoxin levels at the highest quartile was analyzed. From 15 days to 4 months postpartum, 122 breastfeeding mother-baby pairs who applied for monitoring of children's health were taken to study. Maternal height and weight measurements were taken, the information form that consist of maternal-infant characteristics, maternal nutrition characteristics and baby crying and sleep characteristics were filled by asking to mothers and maternal milk sample was taken. Breast milk mycotoxin levels were measured with Helica brand kit. Statistical analyzes were done with SPSS 23.0 package program. The breastmilk AFM1 median level was 3.07 pg / ml, the maximum value was 5.54 pg/ml, and only one of the samples was below the detection limit level of AFM1 2 pg/ml. The breast milk OTA median level was 1,38 ng/ml and the maximum value was 2,72 ng/ml. It was observed that the ZEA level in the breast milk was above 0.3 ng/ml in 59% of cases, the DON level was above 10 ng/ml in 37.7% cases. In the assessment of smoking exposure of the mothers, it was determined that there was an increased risk of OTA levels above 75p in smokers. In addition, when the infant’s age, gender, maternal age, mother education level, sibling presence, gestational lenght, mother’s BMI, postpartum change in BMI, mother's accompanying disease, smoking exposure were controlled, the risk of breast milk OTA level exceeding 75p was 6.28 times higher at those consuming egg daily and the risk of having the highest ¼ slice of the ZEA level was 8.04 times higher at those consuming ayran-kefir-yogurt daily. The effects of mycotoxin levels on baby sleep and crying duration were not seen, however, the risk of inconsolable crying was detected 4.35 higher in infants with breast milk having the highest quartile of ZEA. When infants who receiving only breastfeeding were controlled according to birth weight, gender and age, the head circumference, height, and weight z-scores were found higher than others. As a result, mycotoxin can be transmitted in the breast milk and the mother's nutritional choice may affect this situation. Mycotoxin exposure may affect infants’ growth rates. Maternal and infant health can be maintained by ensuring safe food consumption. Keywords: breastmilk, mycotoxins, crying, sleeping, frequency of food consumption, growth