Systematic review on Endocrine Disrupting Chemicals in breastmilk and neuro-behavioral development: Insight into the early ages of life

Abstract

Breast milk (BM) is the main nutrition source for infants that plays a key role on growth and development. Human milk composition includes endogenous and exogenous substances, including endocrine disrupting chemicals (EDCs). EDCs are man-made environmental chemicals present in everyday environment and food that can disrupt the programming of endocrine signalling pathways during development, resulting in adverse effects that may not be apparent until much later in life. The presence of single and/or mixtures of EDCs in BM has been shown to be associated with impairment of reproductive, metabolic, immunologic system and neurobehavioral developmental outcomes. This systematic review discusses the current knowledge about the presence of EDCs in BM, and their potential effects on infant outcomes during the first six years of life. Following PRISMA guidelines, we made a systematic evaluation of the literature on the effects of single and mixtures EDC on (i) mental and psychomotor development; (ii) socio-communicative and behavioral development. Negative association between EDC exposure and developmental areas considered emerged highlighting: (i) BM as a potential key matrix for the monitoring of EDC exposure (ii) the short- and long-term negative effect on infant neuro-behavioral outcomes, and (iii) the importance of public health efforts to reduce maternal and infant EDC exposure. However, heterogeneous results found emphasizes the need to further longitudinal studies to consider factors that can lower EDC exposure or exert a protective role on infant neurodevelopment, and to better understand the mechanism behind the EDCs and its effects on infant development.