Correspondence

Smoking and the Flavor of Breast Milk

N Engl J Med 1998; 339:1559-1560November 19, 1998

Article

To the Editor:

Children whose mothers smoke have an increased risk of smoking during adolescence.1 One mechanism underlying this relation may involve early learning of flavors, since a variety of flavored substances that are transmitted from the mother's diet to her breast milk can be detected by the nursling.2 In view of the vast array of inherent and added flavors found in cigarettes,3 we tested whether the odor and, consequently, the flavor of human milk is altered by smoking.

After refraining from smoking for at least 12 hours, five lactating women each expressed a base-line sample of approximately 15 ml of milk. Each woman in turn then donned a disposable laboratory coat and gloves, entered a 700-ft³ stainless-steel environmental chamber (airflow rate, 450 ft per minute [Acoustic Systems, Austin, Tex.]), and smoked one or two cigarettes of her regular brand within a 20-minute period. After removing the coat and gloves, she washed her hands with unscented soap and returned to the testing room, where she provided additional milk samples (15 ml) 30 minutes and 1, 2, 3, and 4 hours after smoking. Shortly after the last sample was collected, a sensory panel of seven adults evaluated the odor of the milk samples to determine whether they could detect a difference in the odor as a function of smoking.4 In brief, all possible pairs of samples (6 samples yield 15 possible pairs) from each woman were presented twice, 1 pair at a time in random order, to each panelist in a blinded fashion. The nicotine content of the milk samples was also analyzed by gas chromatography (National Medical Services, Willow Grove, Pa.), with measurement of nitrogen phosphorus.

The results were unambiguous (Figure 1Figure 1Nicotine Content of Milk Samples Obtained at Base Line and 30 Minutes and 1, 2, 3, and 4 Hours after the Women Smoked One or Two Cigarettes and the Percentage of Time Panelists Chose Each Sample as Smelling “More Like Cigarettes” or “Stronger” Than the Other Samples.). The panelists were more likely to identify samples collected from the women 30 minutes to 1 hour after smoking as smelling “stronger” or “more like cigarettes” than the other samples (P<0.001). These data clearly confirm previous reports that breast milk can be a source of exposure to nicotine5 and demonstrate that changes in the odor of milk parallel the changing concentrations of nicotine. These findings raise the possibility that in addition to the effects of nicotine on the developing brain, early experiences with the flavor of tobacco in breast milk (and perhaps even in amniotic fluid) influence the likelihood that exposed children will find these flavors appealing later in life. We do not suggest that lactating women who smoke occasionally should stop nursing. However, the knowledge that the milk of mothers who smoke smells and may taste like cigarettes provides an additional reason to avoid smoking.

Julie A. Mennella, Ph.D.
Gary K. Beauchamp, Ph.D.
Monell Chemical Senses Center, Philadelphia, PA 19104-3308

5 References

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   Mennella JA, Beauchamp GK. The transfer of alcohol to human milk -- effects on flavor and the infant's behavior. N Engl J Med 1991;325:981-985
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   Perlman HH, Dannenberg AM, Sokoloff N. The excretion of nicotine in breast milk and urine from cigarette smoking. JAMA 1942;120:1003-1009
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Citing Articles (10)

Citing Articles

1. 1

   L. Cooke, A. Fildes. (2011) The impact of flavour exposure in utero and during milk feeding on food acceptance at weaning and beyond. Appetite 57:3, 808-811
   CrossRef

2. 2

   Gary K. Beauchamp, Julie A. Mennella. (2011) Flavor Perception in Human Infants: Development and Functional Significance. Digestion 83:s1, 1-6
   CrossRef

3. 3

   Gary K Beauchamp, Julie A Mennella. (2009) Early Flavor Learning and Its Impact on Later Feeding Behavior. Journal of Pediatric Gastroenterology and Nutrition 48:Suppl 1, S25-S30
   CrossRef

4. 4

   Juan Carlos Molina, Norman E. Spear, Linda P. Spear, Julie A. Mennella, Michael J. Lewis. (2007) The International Society for Developmental Psychobiology 39th Annual Meeting Symposium: Alcohol and Development: Beyond fetal alcohol syndrome. Developmental Psychobiology 49:3, 227-242
   CrossRef

5. 5

   Anteo Napoli, Domenico Lallo, Patrizio Pezzotti, Francesco Forastiere, Daniela Porta. (2006) Effects of parental smoking and level of education on initiation and duration of breastfeeding. Acta Paediatrica 95:6, 678-685
   CrossRef

6. 6

   Madhu Page-Sharp, Thomas W Hale, L.Peter Hackett, Judith H Kristensen, Kenneth F Ilett. (2003) Measurement of nicotine and cotinine in human milk by high-performance liquid chromatography with ultraviolet absorbance detection. Journal of Chromatography B 796:1, 173-180
   CrossRef

7. 7

   Irvin E. Liener. (2002) Toxins in Cow's Milk and Human Milk. Journal of Nutritional and Environmental Medicine 12:3, 175-186
   CrossRef

8. 8

   Lisa Helen Amir. (2001) Maternal smoking and reduced duration of breastfeeding: a review of possible mechanisms. Early Human Development 64:1, 45-67
   CrossRef

9. 9

   Rune Lindqvist, Hans Åberg. (2001) Who stops smoking during pregnancy?. Acta Obstetricia et Gynecologica Scandinavica 80:2, 137-141
   CrossRef

10. 10

    Kenneth Perkins, Eric Donny, Anthony Caggiula. (1999) Sex differences in nicotine effects and self-administration: Review of human and animal evidence. Nicotine & Tobacco Research 1:4, 301-315
    CrossRef