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Does Increased Nitrate Ingestion Elevate Nitrate Levels in Human Milk?

Does Increased Nitrate Ingestion Elevate Nitrate Levels in Human Milk? Abstract Objective: To determine whether the nitrate content of human milk is influenced by maternal ingestion of water containing elevated nitrate levels. Design: Prospective, nonrandomized, volunteer study. Setting: Clinical Research Center at the University of Iowa Hospitals and Clinics, Iowa City. Patients: Twenty healthy lactating women with infants older than 6 months. Interventions: The mothers were asked to consume a minimum of 1500 mL of water containing 0 mg of nitrate per liter on day 1, 45 mg on day 2, and 100 mg on day 3 in addition to consuming and recording their dietary intake. Breast-feeding was permitted during days 1 and 2, but milk was expressed on day 3 and the infants were given alternate food sources. After each 24-hour study day, maternal urine and milk samples were collected and frozen. A modified cadmium column reduction method was used to determine spot urinary and milk nitrate content. Results: The mean total nitrate intake from diet and water on days 1, 2, and 3, respectively, was 46.6, 168.1, and 272.0 mg. Spot urine nitrate content on days 1, 2, and 3, respectively, was 36.0, 66.0, and 84.0 mg. Nitrate concentration of human milk on days 1, 2, and 3, respectively, was 4.4, 5.1, and 5.2 mg/L. Conclusion: Women who consume water with a nitrate concentration of 100 mg/L or less do not produce milk with elevated nitrate levels.(Arch Pediatr Adolesc Med. 1996;150:311-314) References 1. Comly HH. Cyanosis in infants caused by nitrates in well water . JAMA . 1945; 129:112-117.Crossref 2. Kross BC, Hallberg GR, Bruner R, Cherryholmes K, Kent Johnson J. The nitrate contamination of private well water in Iowa . Am J Public Health . 1993; 83:270-272.Crossref 3. McKee JE, Wolf HW, eds. Water Quality Criteria . 2nd ed. Sacramento, Calif: State Water Resources Control Board; 1963. 4. Johnson CJ, Kross BC. Continuing importance of nitrate contamination of ground-water and wells in rural areas . Am J Ind Med . 1990;18:449-456.Crossref 5. Fan AM, Willhite CC, Book SA. Evaluation of the nitrate drinking water standard with reference to infant methemoglobinemia and potential reproductive toxicity . Regul Toxicol Pharmacol . 1987;7:135-148.Crossref 6. Mack RB. Methemoglobinemia—it isn't easy being blue . Contemp Pediatr . 1987; 4:111-117. 7. Committee on Nutrition. Infant methemoglobinemia: the role of dietary nitrate . Pediatrics . 1970;46:475-478. 8. Craun GF, Greathouse DG, Gunderson DH. Methemoglobin levels in young children consuming high nitrate well water in the United States . Int J Epidemiol . 1981;10:309-317.Crossref 9. Donahoe WE. Cyanosis in infants with nitrates in drinking water as cause . Pediatrics . 1949;3:308-311. 10. Centers for Disease Control and Prevention. Methemoglobinemia in an infant—Wisconsin, 1992 . MMWR Morb Mortal Wkly Rep . 1993;42:217-219. 11. Johnson CJ, Bonrud PA, Dosch TL, et al. Fatal outcomes of methemoglobinemia in an infant . JAMA . 1987;257:2796-2797.Crossref 12. Environmental Protection Agency. Nitrate/Nitrite Health Advisory . Washington, DC: US Environmental Protection Agency, Office of Drinking Water; 1987. 13. Skrivan J. Methemoglobin in pregnancy . Acta Univ Carol Med . 1971;17:123-161. 14. Kross BC, Ayebo A. Case Studies in Environmental Medicine: Nitrate/Nitrite Toxicity . Atlanta, Ga: US Dept of Health and Human Services, Agency for Toxic Substances and Disease Registry; (October) 1991. 15. American Public Health Association, American Water Works Association, and Water Pollution Control Federation. Standard Methods for Examination of Water and Waste Water . 18th ed. Washington, DC: American Public Health Association; 1992. 16. Stahr HM. Nitrates in plasma and ocular fluid: cadmium column reduction method . In: Stahr HM, ed. Analytical Methods in Toxicology . New York, NY: John Wiley & Sons Inc; 1991:23-25. 17. Knight TM, Forman D, Al-Dabbah SA, et al. Estimation of dietary intake of nitrate and nitrite in Great Britain . J Chem Toxicol . 1987;25:277-285.Crossref 18. White JW Jr. Relative significance of dietary sources of nitrate and nitrite . J Agric Food Chem . 1975;23:886-891.Crossref 19. Pennington JAT. Bowes and Church's Food Values of Portions Commonly Used . New York, NY: Harper & Row; 1983. 20. Consalter A, Rigato A, Clamor L, et al. Determination of nitrate in vegetables using an ion-selective electrode . J Food Comp Anal . 1992;5:252-256.Crossref 21. Committee on Drugs. Transfer of drugs and other chemicals into human milk . Pediatrics . 1989;84:924-936. 22. Wilson JT, Brown RD, Cherek DR, et al. Drug excretion in human breast milk: principles, pharmacokinetics, and projected consequences . Clin Pharmacokinet . 1980;5:1-66.Crossref 23. Davidson K. Nitrate toxicity in dairy heifers . Dairy Sci . 1964;47:1065-1073.Crossref 24. Green LC, Tannebaum SR, Fox JG. Nitrate in human and canine milk . N Engl J Med . 1982;306:1367-1368.Crossref 25. Hartman PE. Nitrates and nitrites: ingestion, pharmacodynamics and toxicology . In: de Serres FJ, Hollaender A, eds. Chemical Mutagens: Principles and Methods for Their Detection . New York, NY: Plenum Press; 1982:211-294. 26. Lawrence RA. Breastfeeding—A Guide for the Medical Profession . St Louis, Mo: CV Mosby Co; 1989. 27. Packer PJ, Leach SA, Duncan SN, et al. The effect of different sources of hitrate exposure on urinary nitrate recovery in humans and its relevance to the methods of estimating nitrate exposure in epidemiological studies . Carcinogenesis . 1989;10:1989-1996.Crossref 28. Radomski JL, Palmiri C, Hearn WL. Concentrations of nitrate in normal human urine and the effect of nitrate ingestion . Toxicol Appl Pharmacol . 1978:45:63-68.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Pediatrics & Adolescent Medicine American Medical Association

Does Increased Nitrate Ingestion Elevate Nitrate Levels in Human Milk?

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Publisher
American Medical Association
Copyright
Copyright © 1996 American Medical Association. All Rights Reserved.
ISSN
1072-4710
eISSN
1538-3628
DOI
10.1001/archpedi.1996.02170280081015
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Abstract

Abstract Objective: To determine whether the nitrate content of human milk is influenced by maternal ingestion of water containing elevated nitrate levels. Design: Prospective, nonrandomized, volunteer study. Setting: Clinical Research Center at the University of Iowa Hospitals and Clinics, Iowa City. Patients: Twenty healthy lactating women with infants older than 6 months. Interventions: The mothers were asked to consume a minimum of 1500 mL of water containing 0 mg of nitrate per liter on day 1, 45 mg on day 2, and 100 mg on day 3 in addition to consuming and recording their dietary intake. Breast-feeding was permitted during days 1 and 2, but milk was expressed on day 3 and the infants were given alternate food sources. After each 24-hour study day, maternal urine and milk samples were collected and frozen. A modified cadmium column reduction method was used to determine spot urinary and milk nitrate content. Results: The mean total nitrate intake from diet and water on days 1, 2, and 3, respectively, was 46.6, 168.1, and 272.0 mg. Spot urine nitrate content on days 1, 2, and 3, respectively, was 36.0, 66.0, and 84.0 mg. Nitrate concentration of human milk on days 1, 2, and 3, respectively, was 4.4, 5.1, and 5.2 mg/L. Conclusion: Women who consume water with a nitrate concentration of 100 mg/L or less do not produce milk with elevated nitrate levels.(Arch Pediatr Adolesc Med. 1996;150:311-314) References 1. Comly HH. Cyanosis in infants caused by nitrates in well water . JAMA . 1945; 129:112-117.Crossref 2. Kross BC, Hallberg GR, Bruner R, Cherryholmes K, Kent Johnson J. The nitrate contamination of private well water in Iowa . Am J Public Health . 1993; 83:270-272.Crossref 3. McKee JE, Wolf HW, eds. Water Quality Criteria . 2nd ed. Sacramento, Calif: State Water Resources Control Board; 1963. 4. Johnson CJ, Kross BC. Continuing importance of nitrate contamination of ground-water and wells in rural areas . Am J Ind Med . 1990;18:449-456.Crossref 5. Fan AM, Willhite CC, Book SA. Evaluation of the nitrate drinking water standard with reference to infant methemoglobinemia and potential reproductive toxicity . Regul Toxicol Pharmacol . 1987;7:135-148.Crossref 6. Mack RB. Methemoglobinemia—it isn't easy being blue . Contemp Pediatr . 1987; 4:111-117. 7. Committee on Nutrition. Infant methemoglobinemia: the role of dietary nitrate . Pediatrics . 1970;46:475-478. 8. Craun GF, Greathouse DG, Gunderson DH. Methemoglobin levels in young children consuming high nitrate well water in the United States . Int J Epidemiol . 1981;10:309-317.Crossref 9. Donahoe WE. Cyanosis in infants with nitrates in drinking water as cause . Pediatrics . 1949;3:308-311. 10. Centers for Disease Control and Prevention. Methemoglobinemia in an infant—Wisconsin, 1992 . MMWR Morb Mortal Wkly Rep . 1993;42:217-219. 11. Johnson CJ, Bonrud PA, Dosch TL, et al. Fatal outcomes of methemoglobinemia in an infant . JAMA . 1987;257:2796-2797.Crossref 12. Environmental Protection Agency. Nitrate/Nitrite Health Advisory . Washington, DC: US Environmental Protection Agency, Office of Drinking Water; 1987. 13. Skrivan J. Methemoglobin in pregnancy . Acta Univ Carol Med . 1971;17:123-161. 14. Kross BC, Ayebo A. Case Studies in Environmental Medicine: Nitrate/Nitrite Toxicity . Atlanta, Ga: US Dept of Health and Human Services, Agency for Toxic Substances and Disease Registry; (October) 1991. 15. American Public Health Association, American Water Works Association, and Water Pollution Control Federation. Standard Methods for Examination of Water and Waste Water . 18th ed. Washington, DC: American Public Health Association; 1992. 16. Stahr HM. Nitrates in plasma and ocular fluid: cadmium column reduction method . In: Stahr HM, ed. Analytical Methods in Toxicology . New York, NY: John Wiley & Sons Inc; 1991:23-25. 17. Knight TM, Forman D, Al-Dabbah SA, et al. Estimation of dietary intake of nitrate and nitrite in Great Britain . J Chem Toxicol . 1987;25:277-285.Crossref 18. White JW Jr. Relative significance of dietary sources of nitrate and nitrite . J Agric Food Chem . 1975;23:886-891.Crossref 19. Pennington JAT. Bowes and Church's Food Values of Portions Commonly Used . New York, NY: Harper & Row; 1983. 20. Consalter A, Rigato A, Clamor L, et al. Determination of nitrate in vegetables using an ion-selective electrode . J Food Comp Anal . 1992;5:252-256.Crossref 21. Committee on Drugs. Transfer of drugs and other chemicals into human milk . Pediatrics . 1989;84:924-936. 22. Wilson JT, Brown RD, Cherek DR, et al. Drug excretion in human breast milk: principles, pharmacokinetics, and projected consequences . Clin Pharmacokinet . 1980;5:1-66.Crossref 23. Davidson K. Nitrate toxicity in dairy heifers . Dairy Sci . 1964;47:1065-1073.Crossref 24. Green LC, Tannebaum SR, Fox JG. Nitrate in human and canine milk . N Engl J Med . 1982;306:1367-1368.Crossref 25. Hartman PE. Nitrates and nitrites: ingestion, pharmacodynamics and toxicology . In: de Serres FJ, Hollaender A, eds. Chemical Mutagens: Principles and Methods for Their Detection . New York, NY: Plenum Press; 1982:211-294. 26. Lawrence RA. Breastfeeding—A Guide for the Medical Profession . St Louis, Mo: CV Mosby Co; 1989. 27. Packer PJ, Leach SA, Duncan SN, et al. The effect of different sources of hitrate exposure on urinary nitrate recovery in humans and its relevance to the methods of estimating nitrate exposure in epidemiological studies . Carcinogenesis . 1989;10:1989-1996.Crossref 28. Radomski JL, Palmiri C, Hearn WL. Concentrations of nitrate in normal human urine and the effect of nitrate ingestion . Toxicol Appl Pharmacol . 1978:45:63-68.Crossref

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Archives of Pediatrics & Adolescent Medicine – American Medical Association

Published: Mar 1, 1996

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