Pikounis, Amann, Jackson, Punshon, Gilbert-Diamond, Korrick, Karagas, Cottingham — Urinary biomarkers of exposure to toxic and essential elements in infants by feeding mode
This Environmental Epidemiology original-research paper from the Dartmouth + Brigham/Harvard infant-environmental-health collaboration (Pikounis, Amann, Jackson, Punshon, Gilbert-Diamond, Korrick, Karagas, Cottingham) compares urinary biomarkers of exposure to toxic and essential trace elements in infants fed with human milk versus infant formula. The paper is the most direct U.S. infant-cohort comparison of feeding-mode-stratified biomarker exposure for both toxic (As, Pb, Cd, Hg) and essential (Mn) elements, complementing the dietary-intake-estimate approach used in Carignan 2015 with biomarker-validated exposure measurements. Together with the broader Dartmouth infant-As cluster (Jackson 2012, Carignan 2015, Carignan 2016 cohort), this paper establishes the U.S. evidence base for the infant-formula-versus-human-milk biomarker case.
Key conclusions
Formula-fed infants have higher urinary biomarker levels for several toxic elements (notably As, Mn) than breastfed infants, consistent with the higher concentration of these elements in formula and reconstitution water versus human milk. Essential-element biomarkers also differ by feeding mode in patterns consistent with formula composition versus human milk composition. The paper reinforces the central case that infant feeding mode is a major determinant of infant trace-element exposure.
Implications
- Certification: Biomarker-validated evidence for the per-feeding-mode infant exposure case. Useful as a citing reference for HMTc infant-formula heavy-metal-load concern.
- Courses: Standard reference for biomarker-based infant feeding-mode comparison.