Skip to main content

Longitudinal follow-up of zearalenone and deoxynivalenol mycotoxins in breast milk in the first five months of life



There is a possibility for exposed lactating mammalians to transfer some contaminants to their milk. This study aimed to determine the levels and changes of Zearalenone (ZEN), Deoxynivalenol (DON) mycotoxins for the first five months in human milk.


Voluntary lactating mothers having infants with gestational length ≥ 37 weeks were enrolled between August 2017 and June 2018 in Şanlıurfa. Mothers and infants with chronic health problems were not included in the study. Human milk samples were taken at three different times; on enrollment (Day 6–10, visit 1), between 4 and 6 weeks postpartum (visit 2), and between 14 and 19 weeks postpartum (visit 3). Mycotoxin levels in human milk were measured utilizing Helica brand commercial kit.


Nineteen voluntary mothers and their breastfed infants with three human milk samples completed the study. The mean ages of mothers and infant (± SD) were 27.4 (± 5.4) years and 7.6 (± 0.9) days on enrollment. Median levels of ZEN and DON in human milk samples were 0.39 and 16.7 ng/mL, respectively. None of the cases had a ZEN daily intake higher than 250 ng/kg bw per day. However, three fourth of the cases had DON intake higher than > 1000 ng/kg bw per day. When adjusted for infant weight for age and sex, both ZEN levels and daily intake were decreased progressively from visit 1 to visit 3 (p < 0.001). DON levels and daily intake at visit 2 were found to be significantly lower in samples of visit 3 than that taken in visit 2 (p = 0.004 and p < 0.001, respectively).


Breast milk monitoring study revealed that ZEN and DON mycotoxins were present in the mother-infant environment. Contamination levels changed during the lactation period.

Peer Review reports


Mycotoxins are toxic metabolites produced by certain species of fungi and continue to attract global attention because of their impact on animal and human health. The most common mycotoxins in foods include aflatoxins; fumonisins; patulin; ochratoxin A; deoxynivalenol (DON); and zearalenone (ZEN) [1, 2].

Previous studies have addressed the toxic effects of ZEN and DON mycotoxin contaminants in animal models, including piglets, sheep, and rats. ZEN, as an estrogenic pollutant in mammalians, may cause several reproductive problems; impairment of folliculogenesis with impairment of primordial follicle formation in the ovaries, reduce sperm quality, delay in reproductive period, epigenetic changes, fetal reabsorption, increasing the frequency of stillbirths, low birth weights, and feminization of immature males [3,4,5,6]. ZEN produces vulvar dilatation, redness, and rectal prolapse. Additionally, ZEN is suggested to be a risk factor for precocious puberty and breast cancer in humans [7]. It was reported that DON may lead to vomiting and failure to thrive, immune dysregulation, leukopenia, and skin necrosis [8].

Mammalians are exposed to ZEN and DON by consuming different foodstuffs [9,10,11,12]. ZEN and DON are the most frequently detected mycotoxins in barley, sorghum, maize, wheat, rye, and other grains. Mycotoxins are metabolized after being taken into the body, the original forms or biotransformed structures of mycotoxins can be excreted in the urine. [13, 14]. Lactating mammals can transfer a small amount of exposed pollutants to their offspring through their milk [15]. Breast milk is one of the best matrices for biomonitoring studies because sufficient quantities of samples from the required sample size can be collected non-invasively. However, there are limited studies on the presence and levels of ZEN and DON mycotoxins in human milk [15,16,17,18,19,20,21,22,23]. Indeed, there is only one published study evaluating the presence of ZEN and DON in a longitudinal study [19] and this study included only one lactating woman.

Breastfeeding women can come into contact with ZEN and DON mycotoxins from foods they consume [24]. This study was performed to determine the presence and levels of ZEN and DON in human milk for the first five months in a cohort study. If mycotoxin carry-over is detected in breast milk in our study, both the mother’s diet and the choice of complementary foods for the baby can be controlled.


For this cohort study, mothers with 6-10-day-old babies who applied to Private Şan Med Hospital Pediatrics Department in Şanlıurfa, Turkey between August 2017 and June 2018 were informed about the study.

Inclusion criteria for mother-infant pairs were: (a) Voluntary mothers without any known health problems including hypertension, diabetes mellitus, hypo/hyperthyroidism, (b) Infants whose gestational age ≥ 37 weeks, exclusively breastfeed (c) Mothers who planned to breastfeed for at least 6 months; (d) mothers enrolling to the hospital and giving milk samples at all the visits.

Exclusion criteria were (a) infants having congenital anomaly, (b) infants having mixed feeding, (c) infants from multiple pregnancies-twins, (d) mothers who stopped breastfeeding during the follow-up period.

The study protocol was approved by the Ethics Committee of Hacettepe University Faculty of Medicine for non-interventional studies. The mothers were informed and signed the consent form before the study.

On admission, characteristics of the mother (age, education, health problems, weight gain during pregnancy, weight, and height at birth) and infant (birth order, gestational length, birth type, sex, birth weight) were taken from the hospital file. Breast milk samples were taken on admission (visit 1; 6–10 days). They were invited for follow-up between 4 and 6 weeks (visit 2) and 14–19 weeks (visit 3). Maternal weight and infant weight, height, and head circumference were measured at all visits. Maternal body mass index was calculated. For infants z-scores of weight for age, height for age, weight for height, and head circumference for age (WAZ, HAZ, WHZ, and HCZ, respectively) were obtained from WHO Anthro software 3.2.

Dependent variables are levels of ZEN and DON in human milk.

To initiate the oxytocin reflex, the baby was breastfed for 5 min, then the milk sample was manually expressed and put into polypropylene tubes. They were stored at-20oC till the analysis was performed. Before analysis, 10 ml of milk was centrifuged at 3500 rpm for 10 min. After the fat layer was removed, the skim milk fraction were shifted to new tubes. Levels of ZEN and DON in human milk were determined using commercially available enzyme-linked immunosorbent assay (ELISA) kits (Helica, Catalog no 941DON01M-96, Catalog no 951ZEN01G-96). The assay was performed by manufacturer’s instructions.

The level to which the nursed infant (µg/kg bw per day) is exposed was calculated by multiplying the concentration in the milk (ng/mL) with the volume of milk consumed per day (L/kg bw per day) [25,26,27]. The amount of milk consumed by babies was estimated from EFSA data and 50% values were taken according to the baby’s age, gender, and body weight at the visit [25]. There is no published data for volume consumed by infants 6–7 days old and infants aged 112–140. Therefore, for these periods, the closest age range for which data was available in EFSA was taken (8–13 days for 6–7 and 84–111 days for 112–140) [25].

Statistical analyses were performed by SPSS 23.0 (SPSS INC., Chicago, IL) package program. Normality of data was controlled by Shapiro-Wilk test, kurtosis, skewness values and histogram. Normally distributed data were given as mean and standard deviations. Non-parametric tests were adopted because the distribution of the mycotoxin contamination data did not follow normality. The mean, quartiles, and 10 and 90 percentile values were identified for mycotoxins. The relationship between mycotoxin levels and continuous parameters of mother-infant pairs was examined by Spearman correlation analysis. Mycotoxin differences according to categorical mother-infant parameters were analyzed with Generalized Linear Models. Parameters showing p value < 0.2 in univariate analyses were taken for further analysis. Given the interaction among birth weight, WAZ, and HAZ we selected WAZ for binary analysis. Generalized estimating equations evaluated longitudinal changes in mycotoxin levels in milk with infants’ sex, birth order, and weight for age. Pairwise contrast was performed with the least significant difference (LSD). P < 0.05 was considered significant.


Twenty-six mother-infant pairs were enrolled, 2 mothers stopped breastfeeding and 5 mothers did not admit to control visits. Nineteen mothers meeting the study criteria and giving milk samples were included in the study.

The mean ages of mothers and infants were 27.4 years and 7.6 days on admission (Table 1). All mothers were housewives. Of all 2/3 of them had undergone cesarean delivery and 42.1% of them were primipara. 72.2% of babies were male.

Table 1 Characteristics of mother-infant pairs on admission and during follow-up period, n = 19*

Median levels of ZEN and DON in all studied human milk samples were 0.39 ng/mL and 15.0 ng/mL, respectively (Table 2). The estimated intake was 0.189 µg/kg-bw per day for ZEN and 2.94 µg/kg-bw per day for DON. All ZEN levels were below 0.25 µg/kg bw per day (Table 1). However, more than three-fourths of samples had DON more than 1.0 µg/kg bw per day.

Table 2 Zearalenone and Deoxynivalenol concentrations and estimated intakes for 57 breast milk samples from 19 mothers

When all milk samples were taken for analysis, there is no correlation between ZEN and DON (n = 57, r = 0.32, p = 0.17). Among mother-infant parameters, birth weight, infants’ WAZ and HAZ were found to be positively correlated with ZEN on admission (Table 3; Fig. 1). However, no interactions were detected at visit 2 and visit 3. Female infants had higher mean ZEN levels than male infants (Table 4). During follow-up period, ZEN levels decreased statistically. DON level was similar in the first two visits but decreased in the last visit. There were no differences in ZEN and DON levels according to other studied parameters (Tables 3 and 4).

Table 3 Correlations between mycotoxins and mother-infant parameters at visits*
Fig. 1
figure 1

Scatterplot of Zearalenone (ZEN) with z score of weight for age (WAZ) at visits

Table 4 Differences in Zearalenone and Deoxynivalenol levels in all studied breast milk by some mother-infant parameters*

When sex, birth order, and WAZ were analyzed with visit time, generalized estimating equations revealed an interaction for ZEN with sampling visit time and WAZ of infants. However, DON is associated with only sampling time (Table 5).

Table 5 Determinants of changes in Zearalenone and Deoxynivalenol levels in breast milk during lactational period*


We found detectable levels of ZEN and DON mycotoxins in breastmilk. Previous studies in two provinces from Turkey reported that median ZEN and DON levels were 0.36 ng/mL and 8.55 ng/mL in Ankara [18], and 0.17 ng/mL (0.04 and 0.68 ng/mL) and 3.92 ng/mL (0.40-14.99 ng/mL) in Eskişehir, respectively [17]. Similarly, the ZEN level in human milk of 47 primipara mothers was between 0.26 and 1.78 ng/mL in Italy [28]. These studies were performed with ELISA. One study in Spain evaluated 35 breast milk samples (postpartum 30 days) with QuEChERS/UHPLCHRMS and reported the mycoestrogen ZEN and some of its metabolites in 13–67% with levels varied from 2.1 to 14.3 ng/mL and only one case having DON metabolite, DOM [21]. In another study, ZEN levels in the milk were 2.0–17.0 ng/mL in only 4% of 275 mothers having coeliac and 2.5–21.9 ng/mL in 8% of 178 healthy mothers [29]. A trace amount of ZEN was detected in pooled breast milk sample taken from the Austria milk bank [19]. An Iranian study reported that ZEN levels in none of the breast milk samples from 90 mothers were above the detection limit (≥ 0.005 ng/mL) with the HPLC method [23]. DON was not detected in breast milk in India [30]. The ZEN and DON detection in breast milk is found to be quite variable. One reason may be that climatic conditions of the studied environment or the region differently affect the fungal species and mycotoxin production [1, 22, 31]. Another reason might be related to food processing and the type of food eaten by the mother [1]. Besides, sampling methods, differences in analytical methods, and assay limits make it difficult to compare with other results [15]. Cross-reactivity reactions (ELISA) or interfering peaks (LC-FD) may be interpreted as positive signals [28]. In addition, postpartum day of milk sampling could affect mycotoxin levels. We detected changes in ZEN and DON levels with lactational duration.

Positive associations for ZEN with both birth weight and infant weight on Days 6–10 were detected in Şanlıurfa. This could be explained by the mycoestrogenic characteristics of ZEN. The interaction was observed in the early postnatal period. Similarly, infants (aged 0.5-4 months) with breast milk greater than 0.50 ng/mL had higher WAZ than their counterparts [32].

In our study in Şanlıurfa, a very weak correlation was found between ZEN and DON, no correlation was found in Ankara, and a strong correlation was found in Eskişehir (r = 0.622, p < 0.001) [17, 18]. This indicates that the exposure sources for ZEN and DON differ according to regions and climates.

To date, food regulatory authorities around the globe have not set permissible limits for the ZEN, and DON in any milk [33]. The EFSA Panel on Contaminants in the Food Chain derived a Tolerable Daily Intake (TDI) for ZEN of 0.25 µg/kg-bw based on a NOEL of 10 µg/kg-bw per day for estrogenic effects in female pigs with an uncertainty factor of 40 [2, 34]. The provisional group TDI value for DON plus 3-ADON and 15-ADON was 1.0 µg/kg bw/day [34]. Similar to previous studies in Turkey and Italy [17, 28], we calculated estimated intake of ZEN in human milk as 0.189 µg /kg/day, which is below 0.25 mg/kg-bw/day. The median estimated TDI value for DON was 2.94 µg /kg/day in human milk from Şanlıurfa, which is higher than Eskişehir study (0.75 µg/kg/day). In addition, 78.9% of 57 milk samples in the current study in Şanlıurfa were higher than 1.0 µg/kg bw/day. However, this is 36% in Eskişehir [17].

Strengths and limitations

Although limited by small sample size (n = 19), ZEN and DON level changes in the first six months, consisting of 3 periods, were analyzed for the first time. The longitudinal cohort study in breast milk samples showed changes in exposure to mycotoxins during lactation. Due to the small number of cases, its generalizability is limited. However, previously, only one mother followed for one year [19]. Male predominance was a selection bias in the study as a limitation. Other limitation is that the toxin concentration determinations were performed with EFSA data [25]. There, whereas, due to the absence of estimated data for food intake for the enrolled age groups, we calculated intakes for closest age range. The potential errors in the intake estimates might be occurred. In the evaluations, the error was tried to be minimized by using body weight and gender. Another limitation is that ELISA was used for toxin detection when already better methods like HPLC/LCMS are available, which are more accurate and reliable with better sensitivity and specificity [1].

Previous studies have highlighted the high mycotoxin exposure of weaned infants compared to breastfed infants [9, 12, 35]. Similarly, the detection frequency and median concentrations were found to be greater in urine of non-exclusively breastfed compared to exclusively breastfed infants (83 vs. 57% for ZEN; 55 vs. 30% for DON; 0.10 vs. 0.08 ng/mL for ZEN, 2.13 vs. 0.44 ng/mL for DON) [16]. In addition, the maternal dietary habits and the consumption of contaminated foods, and the presence of mycotoxin around mother and infant environment might influence the contamination of breast milk. Therefore, breast milk is significantly less harmful to infants as compared with other dietary sources that may be contaminated at higher concentrations. Moreover, new benefits of breast milk for the development and health of babies are being discovered every day.

In conclusion, mycotoxins including ZEN and DON may pass from some pollutants which are present around mothers and babies to breast milk. However, their levels decreased during lactation age. The fact that we determined the change in the mycotoxin amount in different lactation stages shows that infant age should be taken into consideration when organizing a new study. Detection of ZEN and DON mycotoxins in breast milk, even in small amounts, indicates its presence in the foods consumed by the lactating mother. This situation requires attention in the selection and preparation of food for both the lactating mother and the infant during the complementary feeding stage. There is a need for studies that take into consideration the mother’s food choice and that include different regions, which will provide information about the prevalence of mycotoxin.

Data Availability

Data can be requested from corresponding author (


  1. Nji QN, Babalola OO, Ekwomadu TI, Nleya N, Mwanza M. Six main contributing factors to high levels of mycotoxin contamination in African Foods. Toxins. 2022;14(5):318.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. EFSA Panel on Contaminants in the Food Chain. Scientific opinion on the risks for public health related to the presence of zearalenone in food. EFSA J. 2011;9(6):2197.

    Article  Google Scholar 

  3. Čonková E, Laciakova A, Kováč G, Seidel H. Fusarial toxins and their role in animal diseases. Vet J. 2003;165(3):214–20.

    Article  PubMed  Google Scholar 

  4. Feng YQ, Wang JJ, Li MH, Tian Y, Zhao AH, Li L, De Felici M, Shen W. Impaired primordial follicle assembly in offspring ovaries from zearalenone-exposed mothers involves reduced mitochondrial activity and altered epigenetics in oocytes. Cell Mol Life Sci. 2022;79(5).

    Article  CAS  PubMed  Google Scholar 

  5. Schoevers EJ, Santos RR, Colenbrander B, Fink-Gremmels J, Roelen BA. Transgenerational toxicity of Zearalenone in pigs. Reprod Toxicol. 2012;34(1):110–9.

    Article  CAS  PubMed  Google Scholar 

  6. Kinkade CW, Rivera-Núñez Z, Gorcyzca L, Aleksunes LM, Barrett ES. Impact of fusarium-derived mycoestrogens on female reproduction: a systematic review. Toxins (Basel) 2021, 13(6).

  7. Gray JM, Rasanayagam S, Engel C, Rizzo J. State of the evidence 2017: an update on the connection between breast cancer and the environment. Environ Health. 2017;16(1):94.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Wu L, Liao P, He L, Ren W, Yin J, Duan J, Li T. Growth performance, serum biochemical profile, jejunal morphology, and the expression of nutrients transporter genes in deoxynivalenol (DON)-challenged growing pigs. BMC Vet Res. 2015;11.

    Article  Google Scholar 

  9. Hernández M, Juan-García A, Moltó JC, Mañes J, Juan C. Evaluation of mycotoxins in infant breast milk and infant food, reviewing the literature data. Toxins (Basel) 2021, 13(8)

  10. Meucci V, Soldani G, Razzuoli E, Saggese G, Massart F. Mycoestrogen pollution of Italian infant food. J Pediatr. 2011;159(2):278–283.e1.

    Article  CAS  PubMed  Google Scholar 

  11. Seo H, Jang S, Jo H, Kim H, Lee S, Yun H, Jeong M, Moon J, Na T, Cho H. Optimization of the QuEChERS-based analytical method for investigation of 11 mycotoxin residues in feed ingredients and compound feeds. Toxins (Basel) 2021, 13(11).

  12. Sengling Cebin Coppa CF, Mousavi Khaneghah A, Alvito P, Assunção R, Martins C, Eş I, Gonçalves BL, de Valganon D, Sant’Ana AS, Corassin CH, et al. The occurrence of mycotoxins in breast milk, fruit products and cereal-based infant formula: a review. Trends Food Sci Technol. 2019;92:81–93.

    Article  CAS  Google Scholar 

  13. Franco LT, Petta T, Rottinghaus GE, Bordin K, Gomes GA, Alvito P, Assunção R, Oliveira CAF. Assessment of mycotoxin exposure and risk characterization using occurrence data in foods and urinary biomarkers in Brazil. Food Chem Toxicol. 2019;128:21–34.

    Article  CAS  PubMed  Google Scholar 

  14. Tolosa J, Rodríguez-Carrasco Y, Ruiz MJ, Vila-Donat P. Multi-mycotoxin occurrence in feed, metabolism and carry-over to animal-derived food products: a review. Food Chem Toxicol. 2021;158:112661.

    Article  CAS  PubMed  Google Scholar 

  15. Adaku Chilaka C, Mally A. Mycotoxin occurrence, exposure and health implications in infants and young children in Sub-Saharan Africa: a review. Foods 2020, 9(11).

  16. Ezekiel CN, Abia WA, Braun D, Šarkanj B, Ayeni KI, Oyedele OA, Michael-Chikezie EC, Ezekiel VC, Mark BN, Ahuchaogu CP, et al. Mycotoxin exposure biomonitoring in breastfed and non-exclusively breastfed Nigerian children. Environ Int. 2022;158:106996.

    Article  CAS  PubMed  Google Scholar 

  17. Dinleyici M, Aydemir O, Yildirim GK, Kaya TB, Carman KB. Human mature milk zearalenone and deoxynivalenol levels in Turkey. Neuro Endocrinol Lett. 2018;39(4):325–30.

    CAS  PubMed  Google Scholar 

  18. Memiş EY, Yalçın SS. Human milk mycotoxin contamination: smoking exposure and breastfeeding problems. J Matern Fetal Neonatal Med. 2021;34(1):31–40.

    Article  PubMed  Google Scholar 

  19. Braun D, Ezekiel CN, Marko D, Warth B. Exposure to Mycotoxin-Mixtures via Breast Milk: An Ultra-Sensitive LC-MS/MS Biomonitoring Approach. Front Chem. 2020 May 19;8:423.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Duarte S, Silva LJG, Pereira A, Gimbi M, Cesar C, Vidal V, Basílio R, Almeida A, Lino C, Pena A. Mycotoxins exposure in Cabinda, Angola-A Pilot Biomonitoring Survey of Breastmilk. Toxins (Basel) 2022, 14(3).

  21. Rubert J, León N, Sáez C, Martins CP, Godula M, Yusà V, Mañes J, Soriano JM, Soler C. Evaluation of mycotoxins and their metabolites in human breast milk using liquid chromatography coupled to high resolution mass spectrometry. Anal Chim Acta. 2014;820:39–46.

    Article  CAS  PubMed  Google Scholar 

  22. Coppa C, Cirelli AC, Goncalves BL, Barnabe EMB, Petta T, Franco LT, Javanmardi F, Khaneghah AM, Lee SHI, Corassin CH, et al. Mycotoxin occurrence in breast milk and exposure estimation of lactating mothers using urinary biomarkers in Sao Paulo, Brazil. Environ Pollut. 2021;279:116938.

    Article  CAS  PubMed  Google Scholar 

  23. Samiee F, Kharazi A, Elaridi J, Taravati Javad M, Leili M. An assessment of the occurrence and nutritional factors associated with aflatoxin M1, ochratoxin A, and zearalenone in the breast milk of nursing mothers in Hamadan, Iran. Toxicon. 2020;187:209–13.

    Article  CAS  PubMed  Google Scholar 

  24. Mousavi Khaneghah A, Fakhri Y, Raeisi S, Armoon B, Sant’Ana AS. Prevalence and concentration of ochratoxin A, zearalenone, deoxynivalenol and total aflatoxin in cereal-based products: a systematic review and meta-analysis. Food Chem Toxicol. 2018;118:830–48.

    Article  CAS  PubMed  Google Scholar 

  25. Hardy A, Benford D, Halldorsson T, Jeger MJ, Knutsen HK, More S, Naegeli H, Noteborn H, Ockleford C, Ricci A, et al. Guidance on the risk assessment of substances present in food intended for infants below 16 weeks of age. EFSA J. 2017;15(5):e04849.

    PubMed  PubMed Central  Google Scholar 

  26. EPA. Exposure Factors Handbook. U.S. Environmental Protection Agency, Washington, DC, EPA/600/R-09/052F, 2011.

  27. Degen GH, Partosch F, Muñoz K, Gundert-Remy U. Daily uptake of mycotoxins - TDI might not be protective for nursed infants. Toxicol Lett. 2017;277:69–75.

    Article  CAS  PubMed  Google Scholar 

  28. Massart F, Micillo F, Rivezzi G, Perrone L, Baggiani A, Miccoli M, Meucci V. Zearalenone screening of human breast milk from the Naples area. Toxicol Environ Chem. 2016;98(1):128–36.

    Article  CAS  Google Scholar 

  29. Valitutti F, De Santis B, Trovato CM, Montuori M, Gatti S, Oliva S, Brera C, Catassi C. Assessment of mycotoxin exposure in breastfeeding mothers with celiac disease. Nutrients. 2018;10(3):336.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Mehta RV, Wenndt AJ, Girard AW, Taneja S, Ranjan S, Ramakrishnan U, Martorell R, Ryan PB, Rangiah K, Young MF. Risk of dietary and breastmilk exposure to mycotoxins among lactating women and infants 2–4 months in northern India. Matern Child Nutr. 2021;17(2):e13100.

    Article  PubMed  Google Scholar 

  31. Cherkani-Hassani A, Mojemmi B, Mouane N. Occurrence and levels of mycotoxins and their metabolites in human breast milk associated to dietary habits and other factors: a systematic literature review, 1984–2015. Trends Food Sci Technol. 2016;50:56–69.

    Article  CAS  Google Scholar 

  32. Memiş EY, Yalçın SS, Yalçın S. Mycotoxin carry-over in breast milk and weight of infant in exclusively-breastfed infants. Arch Environ Occup Health. 2021;76(6):313–8.

    Article  PubMed  Google Scholar 

  33. Zeidan R, Ul Hassan Z, Al-Naimi N, Al-Thani R, Jaoua S. Detection of multimycotoxins in camel feed and milk samples and their comparison with the levels in cow milk. Food Sci Nutr. 2022;10(2):609–16.

    Article  CAS  PubMed  Google Scholar 

  34. European Food Safety Authority. Deoxynivalenol in food and feed: occurrence and exposure. EFSA J. 2013;11(10):3379.

    Article  Google Scholar 

  35. Rebellato AP, dos Santos Caramês ET, Pallone JAL, de Oliveira Rocha L. Mycotoxin bioaccessibility in baby food through in vitro digestion: an overview focusing on risk assessment. Curr Opin Food Sci. 2021;41:107–15.

    Article  CAS  Google Scholar 

Download references


Not applicable.


This research received no specific grant from any funding agency, commercial or not-for-profit sectors.

Author information

Authors and Affiliations



SSY designed the study. BG applied the surveys and collected data. SSY and SY wrote the first draft. SSY and SY conducted the analyses. All authors contributed to writing, revising, and approved the final manuscript.

Corresponding author

Correspondence to Sıddika Songül Yalçın.

Ethics declarations

Ethics approval

Hacettepe University Ethics Committee approved the study protocol (GO-17-687). All methods were carried out in accordance with relevant guidelines and regulations along with ethical approval statement and informed consent to participation. The procedures used in this study adhere to the tenets of the Declaration of Helsinki. All mothers were informed of the research and an informed written consent to participate was obtained from all of the participants.

Competing interests

The authors declare no competing interests.

Consent for publication

Not applicable.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Güneş, B., Yalçın, S. & Yalçın, S.S. Longitudinal follow-up of zearalenone and deoxynivalenol mycotoxins in breast milk in the first five months of life. BMC Pharmacol Toxicol 24, 37 (2023).

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: