Current issues in lactation: advantages, environment, silicone.

The physiological process of breast-feeding should be encouraged under most circumstances despite the presence of trace amounts of environmental toxins. The decision for the initiation and continuation of lactation must involve the expectant father, especially in the provision of knowledge by clinicians of the beneficial effects to infant and mother. Awareness that growth patterns of breast-fed infants differ from formula-feeding is essential in the interpretation of toxicity and not an indicator to terminate lactation. Numerous studies demonstrate the importance of breast-feeding in providing protection against various diseases and decreasing the incidence of infant morbidity and mortality. Inert material such as silicone or environmental toxins including organophosphate pesticides, chlorinated hydrocarbons, solvents, and heavy metals have been identified in human milk. Toxic manifestations were reported in suckling infants exposed to mammary chemicals. The observed adverse reactions were suggested to be due to either (1) a direct action of the chemical without any maternal dietary deficiency, (2) a combination of essential mother nutrient deficiency and excess toxicant in breast milk; or (3) the presence of several toxicants in human milk acting in conjunction as bioactivators or promoters of toxicity. In weighing the risks vs benefits of lactation there is a clear consensus that even in the presence of mammary toxicants, breast-feeding should be promoted and maintained.