Lactating women

The typical U.S. daily diet contains 1.1—3.6 mg of vitamin B, most coming from meats and vegetables. Poor diets may provide less than half of these amounts and less than the RDA. Some populations require higher amounts persons with high protein intakes, pregnant and lactating women, users of oral contraceptives, alcohoHcs, users of dmgs which interfere with vitamin B function, and those afflicted with some diseases. Several reviews have examined the relationship of vitamin B and specific diseases in more detail (4,23). 

Thiamine requirements vary and, with a lack of significant storage capabiHty, a constant intake is needed or deficiency can occur relatively quickly. Human recommended daily allowances (RDAs) in the United States ate based on calorie intake at the level of 0.50 mg/4184 kj (1000 kcal) for healthy individuals (Table 2). As Httle as 0.15—0.20 mg/4184 kJ will prevent deficiency signs but 0.35—0.40 mg/4184 kJ are requited to maintain near normal urinary excretion levels and associated enzyme activities. Pregnant and lactating women requite higher levels of supplementation. Other countries have set different recommended levels (1,37,38). 

Renal excretion is the most important endosulfan elimination route in humans and animals. Biliary excretion has also been demonstrated to be important in animals. Estimated elimination half-lives ranged between approximately 1 and 7 days in adult humans and animals. Endosulfan can also be eliminated via the breast milk in lactating women and animals, although this is probably a relatively minor elimination route. No studies were located regarding known or suspected differences between children and adults with respect to endosulfan excretion. 

Evidence of active pericarditis, endocarditis, septic emboli, current or recent pregnancy, and lactating women... 

Pregnant or lactating women should not take orlistat because no data exist to establish safety. Orlistat is contraindicated in patients with chronic malabsorption syndrome or cholestasis.31... 

A variety of compounds have been evaluated for developmental immunotoxicity. Early work with chlorinated hydrocarbon insecticides revealed that lactating women exposed to the insecticide chlordane, had residues of chlordane in their breast milk.97 A study was performed in mice to determine if chlordane might alter the immune system of mouse pups exposed to chlordane via the dam s milk.98 Female pups displayed... 

Over the past three decades, several studies have assessed neonatal responses to odors naturally emitted from the breasts by lactating women (e.g., Macfar-lane 1975 Russell 1976 Schaal, Montagner, Herding, Bolzoni, Moyse and Qui-chon 1980 Schaal 1986 Makin and Porter 1989). The odour of the whole breast, collected on a cotton pad applied on the areola, reduces arousal in active newborns (Schaal et al. 1980 Schaal 1986 Sullivan and Toubas 1998) and increases it... 

Rabbits excrete 14C-endrin in the urine as sulfates (Bedford et al. 1975b). Studies in lactating cows ingesting endrin in the diet for 21 days show that 14C-endrin is readily excreted as unchanged endrin in the milk, accounting for 2.5-4.3% of the total dose (Baldwin et al. 1976). Similarly, endrin has been detected in the milk of lactating women (Alawi et al. 1992 Bordet et al. 1993). Due to its lipophilic nature (partition coefficient [Logow] 5.6), endrin was contained in the lipid portion of the milk. 

Organochlorine pesticides have been detected in samples of fat tissues. However, endrin was not found in adipose tissue samples of the general population (Stanley 1986 Williams et al. 1988). In pesticide manufacturing workers, endrin was found in the adipose tissue only after very high exposures. Endrin has been detected in the milk of lactating women (0.02-6.24 mg/kg milk fat) (Alawi et al. 1992 Bordet et al. 1993). In conclusion, the quantitation of endrin exposure, via parent compound or metabolite, remains difficult at best. Further studies characterizing the pharmacokinetics of endrin are needed. 

Altemus, M, Deuster, P. A., Galliven, E., Carter, C. S., and Gold, P. W. 1995. Suppression of hypothalamic-pitui-tary-adrenal axis responses to stress in lactating women. Journal of Clinical Endocrinology and Metabolism 80 2954-2959. 

Absorption occurs through the respiratory tract, orai membranes, and skin (Taylor 1996). Absorption from the stomach is iimited, uniess the acidity is reduced, because nicotine is a strong base. Between 80 and 90% of nicotine is metabolized, mainly in the liver but also the kidneys and lungs. Cotinine is the primary metabolite of nicotine, and the half-life of nicotine is about 2 hours. Elimination occurs by the kidneys, but it is also present in the breast milk of lactating women. 

The RDI/RDA for vitamin A for adult males is 900 micrograms/day (0.9 mg/day) and for adult females 700 micrograms/day (0.7 mg/day). Children require significantly less and lactating women significantly more. There are a number of excellent sources of vitamin A fish, dairy products, liver, leafy vegetables, and dark-colored fruits. 

The RDA for thiamine is 1.2 mg/day for adult males and 1.1 mg/day for adult females. Children need less and pregnant or lactating women need more. Whole-grain products, including breads and cereals, are good sources of thiamine, particularly if fortihed or enriched. There are no known toxic effects from thiamine ingestion and there is no specihed UL. 

The RDA for adult males is 16 mg/day and for adult females 14 mg/day. As usual, children require less and pregnant or lactating women a bit more. Niacin is not hard to come by in your diet good sources include eiuiched and whole-grain bread and bread products, fortified cereals, meat, fish, and poultry. 

The RDA for pantothenic acid in adult men and women is 5 mg/day. Pregnant and lactating women need, respectively, 6 and 7 mg/day. As usual, children need less. Organ meats, milk, bread products, and fortified cereals are excellent sources of this vitamin. There are no reports of pantothenic acid toxicity and there is no established... 

Breast milk During lactation human mammary tissue expresses the sodium iodide symporter [260], and thus significant transfer of perchlorate into human milk is likely. The presence of micrograms per liter concentrations of perchlorate in milk collected fi om US women [233] confirms lactation as a relevant perchlorate excretion path. If lactating women are secreting perchlorate in milk, then urine-based estimates of total perchlorate exposure for these individuals are likely to be lower than actual [242]. 

Borjian M, Marcella S, Blount B, Greenberg M, Zhang J, Murphy E, Blasini VE, Robson M (2011) Perchlorate exposure in lactating women in an urban community in New Jersey. Sci Total Environ 409 460 64... 

Breast-fed neonates themselves distinguish breast (Macfarlane, 1975 Russell, 1976 Schaal etal, 1980) and axillary (Cernoch and Porter, 1985) odors of their mother from the same body region odors of other lactating women. 

Although most folic acid products carry the Rx legend, products that provide no more than 0.4 mg (or 0.8 mg for pregnant or lactating women) may be otc items. 

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