Dahlström A, Ebersjö C, Lundell B
Department of Paediatrics at Stockholm Söder Hospital, Karolinska Institute, Stockholm, Sweden.
Acta Paediatr. 2004 Jun;93(6):810-6.
To study exposure to nicotine in breastfed infants in relation to parental smoking habits.
Forty mother-infant pairs were studied. Twenty non-smoking mothers, 18 smoking (2-20 cigarettes per day) and two snuff-taking mothers were included. All infants were healthy, exclusively breastfed and their postnatal age was 6 wk. During a home visit, parental smoking habits were recorded, and the time of mothers' last smoke or taking of snuff and breastfeeding were recorded. Breast milk and infant urine samples were collected. Concentrations of nicotine and cotinine were analysed with gas chromatography. The amount of milk ingested during the home visit was calculated by weighing the infants.
Two non-smoking and non-snuff-taking women had milk containing nicotine (28 and 13 microg/l, respectively). Both had smoking spouses. In the smoking and snuff-taking group, the mean (SD) milk nicotine concentration was 44 (38) microg/l (n = 36). When milk samples taken 7 h and 0.6 h after smoking were compared, the concentration of milk nicotine increased from 21 to 51 microg/l (p < 0.01). The two snuff-taking mothers exposed their children to higher milk nicotine concentrations than all but two of the smokers. The concentrations of the metabolite cotinine in infant urine correlated with the dose of nicotine ingested during the home visit (r = 0.84, p < 0.01).
Breastfed infants with a smoking or snuff-taking mother are exposed to nicotine in breast milk. The mean intake of nicotine via milk is 7 microg/kg/d. With a shorter time between the mothers' smoking and breastfeeding, the milk nicotine concentration will increase. Both passive smoking at home and snuff-taking were associated with measurable nicotine levels in milk. Healthcare personnel promoting breastfeeding should be aware of these factors influencing exposure to nicotine in the breastfed infant.
研究母乳喂养婴儿接触尼古丁的情况与父母吸烟习惯的关系。
对40对母婴进行了研究。其中包括20名不吸烟的母亲、18名吸烟母亲（每天吸2 - 20支香烟）和2名使用鼻烟的母亲。所有婴儿均健康，完全母乳喂养，出生后6周。在一次家访中，记录了父母的吸烟习惯，以及母亲最后一次吸烟或使用鼻烟的时间和母乳喂养的时间。收集了母乳和婴儿尿液样本。用气相色谱法分析尼古丁和可替宁的浓度。通过称量婴儿体重计算家访期间摄入的奶量。
两名不吸烟且不使用鼻烟的女性的母乳中含有尼古丁（分别为28和13微克/升）。两人的配偶均吸烟。在吸烟和使用鼻烟组中，母乳尼古丁浓度的均值（标准差）为44（38）微克/升（n = 36）。比较吸烟后7小时和0.6小时采集的母乳样本，母乳尼古丁浓度从21微克/升增至51微克/升（p < 0.01）。两名使用鼻烟的母亲使孩子接触到的母乳尼古丁浓度高于除两名吸烟者外的所有其他吸烟者。婴儿尿液中代谢物可替宁的浓度与家访期间摄入的尼古丁剂量相关（r = 0.84，p < 0.01）。
母亲吸烟或使用鼻烟的母乳喂养婴儿会接触到母乳中的尼古丁。通过母乳摄入尼古丁的平均量为7微克/千克/天。母亲吸烟与母乳喂养之间的时间间隔越短，母乳尼古丁浓度就会越高。在家中被动吸烟和使用鼻烟均与母乳中可检测到的尼古丁水平相关。促进母乳喂养的医护人员应意识到这些影响母乳喂养婴儿接触尼古丁的因素。
