Prevalence and Concentration of Aflatoxin M1 in Mother Milk: A Meta-analysis, Meta-regression, and Infants' Health Risk Assessment.

Breast milk is a complete and nutritious food for newborns and infants, but it may be contaminated with Aflatoxin M1 (AFM1), which endangers consumers' health. Several studies from various regions have determined the concentration and prevalence of AFM1 in mother milk. In this study, an attempt was made to meta-analyze the concentration and prevalence of AFM1 and estimate the health risk of infants. The concentration and prevalence of AFM1 in the countries subgroup were meta-analyzed in the random effects model (REM), and also the effect over time on the prevalence of AFM1 was determined by meta-regression. Finally, the human risk in infants was estimated via the margin of exposure (MOES) in different countries. The five countries with the highest prevalence of AFM1 in mother milk were observed in Jordan (100.00), Tanzania (100.00), Mexico (97.00%), Lebanon (93.69%), and Colombia (90.00%). The pooled prevalence of AFM1 in mother milk was 54.48%, 95% CI (42.99-65.73). The five countries with the highest concentration of AFM1 in mother milk were observed: Egypt (570 µg/l), Sudan (413 µg/l), Cameroon (315.00 µg/l), Serbia (175 µg/l), and Tanzania (70 µg/l). The pooled prevalence of AFM1 in mother milk was 6.00, 95% CI (5.80-6.90(. Except for Egypt, infants in other countries are at an acceptable health risk (MOEs > 10,000). Considering the unacceptable risk due to the consumption of milk containing AFM1 in Egypt, it is suggested that programs be carried out to control the quality of mother milk.