Sclerodermalike esophageal disease in children breast-fed by mothers

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http://jama.ama-assn.org/cgi/content/abstract/271/3/213

Sclerodermalike esophageal disease in children

breast-fed by mothers with silicone breast implants

J. J. Levine and N. T. Ilowite

Division of Pediatric Gastroenterology, Schneider

Children's Hospital, Long Island Jewish Medical

Center, Albert Einstein College of Medicine, New Hyde

Park, NY 11042.

OBJECTIVE--To determine whether breast-fed children of

mothers with silicone implants are at increased risk

for the development of sclerodermalike esophageal

involvement compared with children not exposed to

silicone implants.

DESIGN--Case-series [corrected].

SETTING--Referral-based pediatric gastroenterology

clinic.

PATIENTS--Eleven children (mean age, 6.0 years; range,

1.5 to 13 years; six boys and five girls) referred for

abdominal pain who were born to mothers who had

silicone breast implants (eight breast-fed children

and three bottle-fed) were compared with 17 patients

(mean age, 10.7 years; range, 2 to 18 years; 11 boys

and six girls) with abdominal pain who were not

exposed to silicone implants.

METHODS--All children underwent esophageal manometry

and upper intestinal endoscopy with esophageal biopsy

and were tested for antinuclear antibody and

autoantibodies to Scl-70, centromere,

ribonucleoprotein, Sm, Ro, La, and phospholipid.

RESULTS--Six of the eight breast-fed children from

mothers with silicone implants had significantly

abnormal esophageal motility with nearly absent

peristalsis in the distal two thirds of the esophagus

and decreased lower sphincter pressure. Upper

esophageal pressures and motility were normal.

Compared with controls, the breast-fed children had

significantly decreased lower sphincter pressure and

abnormal esophageal wave propagation. These manometric

abnormalities were not seen in the three bottle-fed

children. There was no difference in the expression of

autoantibodies in the breast-fed children compared

with the bottle-fed children or controls.

CONCLUSIONS--A relationship appears to exist between

breast-feeding by mothers with silicone implants and

abnormal esophageal motility. Studies evaluating

larger numbers of children are needed to determine the

extent of the risk.

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

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J Hum Lact 2003;19:70-71.

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The Transfer of Drugs and Other Chemicals Into Human

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Pediatrics 2001;108:776-789.

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Pediatrics 1998;102:1112-1115.

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BMJ 1998;316:477-477.

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