Aluminum exposure and toxicity in neonates: a practical guide to halt aluminum overload in the prenatal and perinatal periods

Daniela Fanni, Rossano Ambu, Clara Gerosa, Sonia Nemolato, Nicoletta Iacovidou, Peter Van Eyken, Vassilios Fanos, Marco Zaffanello, Gavino Faa

Cagliari, Italy

Author Affiliations: Department of Pathology, University Hospital San Giovanni di Dio, AOU Cagliari and University of Cagliari, Italy (Fanni D, Ambu R, Gerosa C, Nemolato S, Faa G); National and Kapodistrian University of Athens, Medical School, Athens, Greece (Iacovidou N); Department of Pathology, K.U. Leuven, Leuven, Belgium (Van Eyken P); Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, AOU Cagliari and University of Cagliari, Italy (Fanos V); Department of Pediatrics, University of Verona, Italy (Zaffanello M)

Corresponding Author: Vassilios Fanos, Neonatal Intensive Care Unit, Puericulture Institute and Neonatal Section, AOU Cagliari and University of Cagliari, Strada Statale 554, Monserrato (CA) 09042, Italy (Tel: +397051093403; Fax: +39706753107; Email: vafanos@tiscali.it)

doi: 10.1007/s12519-014-0477-x

Background: During the last years, human newborns have been overexposed to biologically reactive aluminum, with possible relevant consequences on their future health and on their susceptibility to a variety of diseases. Children, newborns and particularly preterm neonates are at an increased risk of aluminum toxicity because of their relative immaturity.

Data sources: Based on recent original publications and classical data of the literatures, we reviewed the aluminum content in mother's food during the intrauterine life as well as in breast milk and infant formula during lactation. We also determined the possible role of aluminum in parenteral nutrition solutions, in adjuvants of vaccines and in pharmaceutical products. A special focus is placed on the relationship between aluminum overexposure and the insurgence of bone diseases.

Results: Practical points of management and prevention are suggested. Aluminum sources that infants may receive during the first 6 months of life are presented. In the context of prevention of possible adverse effects of aluminum overload in fetal tissues during development, simple suggestions to pregnant women are described.Finally, practical points of management and prevention are suggested.

Conclusions: Pediatricians and neonatologists must be more concerned about aluminum content in all products our newborns are exposed to, starting from monitoring aluminum concentrations in milk- and soy-based formulas in which, on the basis of recent studies, there is still too much aluminum.

Key words: aluminum; fetus; newborn; toxicity

World J Pediatr 2014;10(2):101-107