Exclusive breast milk is the recommended nutrition by the World Health Organization (WHO) until six months of age, followed by introducing foods with continual breastfeeding. Lactogenesis, the process of milk production and secretion can be divided into two stages: lactogenesis I and II. Lactogenesis I begins during gestation and is characterized by the development of the breast, while lactogenesis II starts after birth and signifies the start of milk secretion (PREUSTING et al., 2017). The process of breastfeeding is very important to both the breastfeeding mother and the child. During this process, chemicals, microorganisms, and immunity are transferred from mother to child. This has therefore become a major source of infants’ exposure to many chemical agents some of which are of public health importance (BRAUN, 2016).
Bisphenol A (BPA), also called 2,2-bis (4-hydroxyphenyl) propane, is a white crystalline compound with a molecular weight of 228.29 g/mol, a melting point of 156°C, and has low solubility in water. BPA has been widely used as a monomer in plastic polycarbonate and epoxy resin in food packaging, dental sealants, and ducts (HUANG et al., 2012). BPA is a known endocrine disruptor, and its estrogenic and antiandrogenic activities have been described in glucocorticoids and thyroid hormones (SKLEDAR; MAˇ, 2016). The primary source of human exposure to BPA is through the oral route, by eating contaminated food and drinks, although air, dust, and water are other possible sources of exposure. BPA can penetrate food from the internal epoxy resin linings of canned foods and consumer products, such as polycarbonate tableware, food storage containers, water bottles and baby bottles. The degree to which BPA passes from polycarbonate vials to liquid or food depends on the product’s temperature and the container. The greater the temperature change, the greater the release of BPA (DUALDE et al., 2019).
Reports have shown high human exposure to BPA with documentation of the high occurrence of the analyte in biological samples, especially urine samples (AZZOUZ; RASCÓN; BALLESTEROS, 2016). Exposure to BPA can cause numerous adverse health effects such as diabetes, obesity, cardiovascular diseases, reduce basal testosterone secretion, and decrease fertility in males (ROCHESTER, 2013; ELADAK et al., 2015).
It has been shown that a high concentration of urinary BPA during pregnancy increases the possibility of giving birth to children with lower birth weights (HUO et al., 2015). BPA has also been shown to cross the human placenta barrier and present a risk to fetal development (CORBEL et al., 2014). Developmental periods, especially prenatal, birth and childhood, are the most sensitive developmental stages to the toxic effect of BPA, and because it is an endocrine disruptor, it can cause endocrine changes and metabolic disorders (BRAUN, 2016).
Public health concern on infant exposure to BPA is on the increase. According to an expert report by the Food Agriculture Organization (FAO) and WHO, it is estimated that the average exposure of exclusively breastfed babies (0 to 6 months) to BPA is 0.3 µg/kg body weight per day. Exposure estimates are generally higher for babies fed formula in bottles containing polycarbonate compared to bottles without polycarbonate. The most significant exposure occurs in children from 0 to 6 months of age who are formula-fed, suffering an intake of 2.4 µg/kg of body weight per day of BPA. Once solid foods are introduced (at 6–36 months), exposure to BPA decreases proportionally with increasing body weight (WHO, 2010).
In Brazil, Resolution RDC N ° 41, 2011 was enacted to prohibit the use of plastics in infant bottles (MINISTÉRIO DA SAÚDE, 2011), however, lactating mothers may be exposed to BPA due to contact with plastic products and packaging intended for adults thereby exposing their infants to BPA or its metabolites through breastfeeding. Since breastfeeding is a potential source of an infant’s exposure to BPA, there is a need to constantly monitor the exposure of lactating mothers to BPA which can invariably transfer such to the lactating infants.
Despite the high rate of the use of plastic containers by women of reproductive age and lactating mothers in many countries, information about the body burden of BPA in lactating mothers is scarce in the literature and not available in Brazil, hence, no data on infant’s exposure to BPA through breastfeeding. Therefore, this study aimed at determining the concentration of BPA in the colostrum of mothers hospitalized at University Hospital Professor Polydoro Ernani de São Thiago through the ELISA technique and to establish a possible association(s) between the use of plastics by the mother and lactogenesis II.