Aflatoxin M1 exposure and nutritional status of breastfeeding children 0-6 months in Makueni County, Kenya

Aflatoxin exposure in breastfeeding children has yet to be extensively explored in the southeastern region of Kenya, which is prone to aflatoxin outbreaks, and the assessment of potential risks may be underestimated. We determined the aflatoxin exposure of children 0-6 months and the outcome of weight-for-age z-scores as part of a larger cross-sectional study involving 170 randomly selected mother-child dyads. A semi-structured questionnaire was used to collect information on breastfeeding practices. Childrens weights were also measured. Breast milk samples of 48 lactating mothers and their childrens urine were collected from households whose food samples were collected for aflatoxin analysis. Aflatoxin levels were determined using enzyme-linked immunosorbent assays. The Statistical Package Software for Social Sciences (version 27) and Palisades @Risk software were used for analysis. Exclusively breastfeeding children were 44.1% (75/170). The prevalence of aflatoxin M1 in breast milk was 77.1% (37/48) (concentration 35 ng/l; SD, 0.0), and the mean intake was 0.47 mg/kg b.w.t/day. All urine (100%) had aflatoxin M1 (mean 0.39 ng/ml (SD, 0.16). The exposure levels through breast milk were alarmingly high (margin of exposure < 10000) regardless of breastfeeding status, with complementary feeding potentially increasing the risks. Mothers diets significantly contributed to aflatoxin M1 in breast milk and urine (p = 0.01). Socioeconomic status, household size, and age of lactating mothers were not significant predictors of aflatoxin M1 exposure (p > 0.05). Aflatoxin M1 exposure did not influence the weight-for-age z-scores (pall > 0.05). The results indicate high exposure levels among children 0-6 months, and breastfeeding practices could be one of the under-evaluated risk factors.