Turkish Adaptation, Reliability, and Validity Study of the Vaccine Acceptance Instrument.

This research study aimed to assess the reliability and validity of the Turkish version of the Vaccine Acceptance Instrument (VAI). The VAI is a 20-item Likert-type scale, with responses ranging across seven points. A systematic approach was followed to translate the scale into Turkish, involving translation, expert panel evaluation, back-translation, and pilot testing. The Vaccine Acceptance Instrument and a sociodemographic data form were used for data collection. The reliability of the scale was tested by test-retest analysis, and its internal reliability was examined by Cronbach's alpha test. The factor structure was examined using Exploratory Factor Analysis (EFA). Confirmatory Factor Analysis (CFA) was employed to assess the scale's fit. Overall, 229 participants were included in the study. In test-retest reliability analysis, the intraclass correlation coefficient of the scale was 0.992 (95% CI: 0.987-0.996). The Cronbach's alpha value of the scale was 0.824. A four-factor structure was determined. The model had an acceptable fit [χ2/df = 380.04/164 (2,317) p < 0.001, CFI = 0.91, GFI = 0.90, AGFI = 0.906, NFI = 0.90, RMSEA = 0.076]. The mean total VAI score was 112.71 ± 17.02. The low education level of the mother, being a housewife, and parents not having the COVID-19 vaccine were statistically significantly associated with a low scale score and low vaccine acceptance (p < 0.05). The Turkish adaptation of the VAI demonstrated satisfactory levels of validity and reliability following rigorous testing.

Social-emotional and behavioural problems in young children of healthcare worker mothers during the COVID-19 outbreak: a case-control study.

BACKGROUND: The pandemic has had a significant impact on the daily lives of children and their families, particularly the children of health care workers, due to changes in family routines as a result of their parents' work schedules. We aimed to explore the socioemotional and behavioural (SEB) problems of children of healthcare worker mothers (HCWM) during the COVID-19 pandemic and compare them with age-matched children and their mothers from other occupations. METHOD: A case-control study design was applied, and a snowball approach was used to enrol volunteered participants aged between 6 and 36 months of age, through a Google survey. We used the Brief Infant-Toddler Social and Emotional Assessment (BITSEA) questionnaire to assess children's SEB problems and a Brief Symptom Inventory (BSI) to evaluate the psychological distress of mothers. Differences in BITSEA, BSI and MSPSS scores were examined using chi-square and Mann-Whitney U tests, as appropriate. A logistic regression model was used to identify independent predictors of children's behavioural and emotional problems. RESULTS: In total, 600 questionnaires were analysed. It was observed that children in the HCWM group were separated from their mothers more often and for longer periods of time than their counterparts (p < 0.010, p = 0.002). Changes in the child's structured outdoor activities during the pandemic period were more likely to be observed in the HCWM group (p < 0.05). The percentage of children with the BITSEA problem subscale above the subclinical cut-off, externalizing and dysregulation scores were significantly higher in the HCWM group (p = 0.044, p = 0.031, and p = 0.016). Moreover, each point increase in BSI global index scores (p < 0.001, RR:3.34, 95%CI:1.91-5.82) was found as a risk factor for clinically significant SEB problems. CONCLUSION: Overall, the current study suggests HCWM's have experienced occupational inequality, and young children of HCWM's were at increased risk for externalizing and dysregulation problems during the pandemic. Maternal psychological stress had a significant impact on their children's socio-emotional well-being.

Exploring the interplay: Maternal electronic health literacy and its impact on early childhood development and parenting practices.

BACKGROUND: Mothers need a competent electronic health literacy (eHL) skill for beneficial gains for the health of their children in the virtual environment, which is a new health platform. We predict that a competent eHL of mothers who play a central role in early childhood will positively affect the health of their children. This study aimed to determine the level of eHL of mothers of young children and investigate the relationship between mothers' eHL and early childhood development (ECD) and early parenting practices (EPP). METHODS: This cross-sectional study was conducted on mothers with children aged 36-59 months using eHealth. Sociodemographic and personal characteristics form, Early Childhood Development Module and eHealth Literacy Scale were administered to the participating mothers. RESULTS: The data from 440 mother-child pairs were analysed. Children of mothers with sufficient eHL levels were more likely to be Early Childhood Development Index (ECDI)-on-track, adjusted odds ratio (AOR), 95% confidence interval (CI): 2.16 (1.29-3.61); have adequate support in learning, AOR (%95 CI): 3.23 (1.69-6.18); and have adequate daily meals and snacks, AOR (%95 CI): 2.43 (1.56-3.78). CONCLUSION: These results revealed that there is a need for interventions that will contribute to child health by improving mothers' eHL levels.

Which factors accompany maternal acceptance-rejection in children with specific learning disabilities?

BACKGROUND: Children with specific learning disabilities (SLDs) and their parents experience many problems that may influence their interactions. The study aimed to evaluate the maternal acceptance/rejection status of children with SLDs and their associations with sociodemographic characteristics, and problem behaviors. METHODS: The Parental Acceptance-Rejection/Control Questionnaire (PARQ/C) and Strengths and Difficulties Questionnaire (SDQ) were applied to the mothers with children aged 7-17 years with a diagnosis of SLD. RESULTS: Among 266 children enrolled, the mean age was 10.2 years, and 61.7% were male, the mean score was 30.4 for warmth/affection, 25.8 for hostility/aggression, 22.9 for indifference/neglect, 16.3 for undifferentiated rejection, 95.4 for the total PARQ, and 40.8 for the control scales. Generalized linear models revealed that maternal depression, poor family income, parental smoking, and presence of dysgraphia, and poor total difficulties and prosocial scores of SDQ subscales were associated with the maternal acceptance-rejection. There was an interaction between the maternal control subscale and the school success of the child. CONCLUSION: Mothers of children with SLDs had high maternal rejection scores which were associated with unfavorable characteristics of child and family. Early detection and giving appropriate support of these cases could improve the mother's relationship with her SLD child.

Investigation of infant deaths associated with critical congenital heart diseases; 2018-2021, Türkiye.

BACKGROUND: The aim of this study was to examine the characteristics of infant mortality associated with critical congenital heart disease (CCHD). METHODS: In a cross-sectional study, data for the study were obtained through Death Notification System, Birth Notification System and Turkish Statistical Institute birth statistics. RESULTS: Of all infant deaths, 9.8% (4083) were associated with CCHD, and the infant mortality rate specific to CCHD was 8.8 per 10,000 live births. CCHD-related infant deaths accounted for 8.0% of all neonatal deaths, while the CCHD specific neonatal death rate was 4.6 per 10,000 live births. Of the deaths 21.7% occurred in the early neonatal, 30.3% in the late neonatal and 48.0% in the post neonatal period. Group 1 diseases accounted for 59.1% (n = 2415) of CCHD related infant deaths, 40.5% (n = 1652) were in Group 2 and 0.4% (n = 16) were in the unspecified group. Hypoplastic left heart syndrome was the most common CCHD among infant deaths (n = 1012; 24.8%). The highest CCHD related mortality rate was found in infants with preterm birth and low birth-weight while multiparity, maternal age ≥ 35 years, twin/triplet pregnancy, male gender, maternal education in secondary school and below, and cesarean delivery were also associated with higher CCHD related infant mortality rate. There was at least one non-cardiac congenital anomaly/genetic disorder in 26.1% of all cases. CONCLUSION: CCHD holds a significant role in neonatal and infant mortality in Türkiye. To mitigate CCHD-related mortality rates, it is crucial to enhance prenatal diagnosis rates and promote widespread screening for neonatal CCHD.

Comorbidity of behavioral problems and parental acceptance-rejection in children diagnosed with chest discomfort, palpitations, vasovagal syncope, and underlying heart disease: a multiple case-control study.

BACKGROUND: Children who experience chest discomfort, palpitations, vasovagal syncope, and underlying heart disease often present a complex clinical picture. Not only are they dealing with potential cardiac issues, but they may also exhibit behavioral problems that can complicate the diagnostic and treatment process. Moreover, parental acceptance or rejection can significantly influence the child's well-being and medical outcomes in such cases. This study aims to explore the comorbidity of behavioral problems and parental acceptance-rejection in children diagnosed with these cardiac symptoms and underlying heart disease. METHODS: In a case-control study, the Parental Acceptance - Rejection Questionnaire and Parental version of Strengths and Difficulties Questionnaire (SDQ) was filled by parents of 314 patients from pediatric cardiology clinic. RESULTS: The control group scored substantially lower overall according to SDQ. The vasovagal syncope subgroup was found to have considerably lower scores on the subscale. The group with chest discomfort scored highly in hostility and aggression in the PARQ. In comparison to the other groups, the vasovagal syncope and chest pain group demonstrated higher scores in undifferentiated rejection and total score. CONCLUSION: This study showed a correlation between children's behavioral and emotional problems and cardiac symptoms. This states that children's relationship with their parents has an impact on their symptoms. It will be necessary to conduct further studies to determine a causal association and devise preventative measures.

Mother-child pairs' eating and feeding behaviours in two different nutritional status from two distinct provinces.

Nutrition plays a crucial role for the bio-psycho-social growth and development of children. Mother-child pairs' eating-feeding problems can be hypothesized to relate to the child's nutritional status and living area. Our focus was to assess maternal attitudes and children's eating habits in thin and normal-weight children across two cities characterized by distinct socioeconomic and demographic profiles: Ankara and Sanliurfa. This double case-control study included the mothers whose children are aged between 2 and 7 years old in both cities. Figure Rating Scale, Child Feeding Questionnaire and Behavioral Pediatrics Feeding Assessment Scale were filled by mothers of children. The mothers of thin children were concerned more about the weight of their children, felt more responsible for feeding their children, and use of pressured them to eat more frequently compared to normal-weight children's mothers in both cities. In Ankara, the duration of breastfeeding is longer, using formula is rarer and starting complementary food on time is more common, mother had higher scores on perceived responsibility, perceived child weight, and concern about child weight subscales; lower score on the restriction subscale compared to Sanliurfa. Mothers of both thin and normal weight children in Sanliurfa rated their children as weaker compared to those in Ankara. In conclusion, child eating behaviors and parental feeding practices were associated with the weight of children depending on demographic and sociocultural differences. Implementing customized, location-specific preventive educational initiatives on child feeding will not only foster behavioral changes but also yield valuable insights for shaping future interventions.

Trends and associated factors of bottle-feeding in Turkey: dramatic change over the last three decades under the limited implemented code.

The study aimed to examine the trends and associated factors of bottle-feeding among children aged 0-35 months. Data covering 11,205 mother-child pairs, from six recent Turkey Demographic and Health Surveys (TDHSs) were analyzed by using complex sample crosstabs and logistic regression. Bottle-feeding was on an upward trend from 33.0% to 51.5% from 1993 to 2013 and fell slightly 47.9% in 2018. Increasing trends of bottle-feeding were found in children aged 6-35 months, the East region, lower wealth index, maternal education under 5 years, Kurdish mothers, and the low antenatal care attendance. Multivariate analysis using data from TDHS-2018 showed that young maternal age, low birth weight and being 6-23 months of age were associated with higher rates of bottle-feeding. The prolonged bottle-feeding became widespread, and the bottle-feeding was common even in 35-month-old children. Interventions by the Government and stakeholders to minimize low rates of bottle-feeding should focus on high-risk groups.

Change in screen time of preschool children according to parental attitudes during the COVID-19 pandemic with an online survey.

The relationship between the change in the screen time of preschool children according to both parent-child characteristics and parental attitudes was investigated in an online study involving 403 mothers. Mothers completed a questionnaire on baseline characteristics and Parent Attitude Scale. Multiple logistic regression and generalized linear models revealed the associations. Change in screen time was grouped as "increase" and "no increase". 70% stated an increase in the screen time during the pandemic period. The overprotective score was low in the group with increased screen time after adjusting parental age, education, and working status, family type, number of the children, the enrolled child's age, gender, daily screen time before the pandemic, and caregiver of the child. The child having longer screen time also had higher risk for the history of an increase in screen time in the lockdown period. This situation shows a need for parental guidance for healthy screen use.

Mother's psychopathological conditions and parenting characteristics according to smoke exposure.

The study aims to investigate the relationship between maternal smoking and smoke exposure with the mother's parenting attitude and psychopathological conditions in the absence of any health problems in the mother-child pairs. A descriptive form consisting of 27 questions, a "Parental Attitude Scale", and a "Depression, Anxiety, and Stress Scale" was applied by mothers with children aged 2 to 6 years. Of the 450 voluntary mothers included in the study, 107 (23.8%) had environmental smoke exposure and 69 (15.0%) were smokers. The highest quartile of democratic subscores was associated with maternal smoking and smoke exposure when confounding factors were controlled. Compared to non-smokers and unexposed, the adjusted odds ratio of having abnormal anxiety scale subscores was 3.90 [95% CI: 1.69-8.97] for smokers. When parenting types were included, mothers' smoking status and overprotective subscores were found to be associated with anxiety. There is an interaction among mothers' smoking, parenting types, and anxiety scores.

Father's reading beliefs and child's media usage habits.

The aim of the study is to examine the relationship between fathers' reading beliefs and father's and child's media habits and book reading status in the preschool period. In total, 520 fathers with children aged 2-5 years were included in the study. "z score above+1" were defined as the High Parental Reading Scale Score (HPRSS). Moreover, 72.3% of fathers spent 3 hours or more with their children on a day, and 32.9% of fathers used the screen as a reward and 35% as a punishment. Multivariable analysis showed that spending more than 3 hours with their children, not using the screen as a reward, not using it as a punishment, knowing smart signs, getting information from a book, having a screen time less than 1 hour, not using screen alone, doing another activity when not allowed were associated with the HPRSS. The father's reading belief is related to the child's media usage habits.

Relations of maternal health literacy and parenting practices with early childhood development: a cross-sectional study.

This study aimed to examine the relations of early childhood development with maternal health literacy and mothers' early parenting practices. This cross-sectional study was conducted on mothers with children aged 36-59 months (n = 503) with a survey form, Early Childhood Development Index (ECDI) and Turkish Health Literacy Scale-32. Children of mothers with sufficient/excellent health literacy levels, children who are breastfed for 12 months and longer, and children with a screen time of 2 h or less were more likely to be ECDI-on-track (AOR (CI) = 2.52 (1.53-4.15); 2.28 (1.41-3.70); 2.04 (1.18-3.50); respectively). In conclusion, children whose mothers were adequately health literate, who were breastfed longer and who had less screen time were better on ECDI indicators. Increasing the knowledge and skills of mothers on early parenting practices and supporting them to be good health literacy will contribute positively to the early development of children.

Evaluation of critical congenital heart disease from 2018 to 2020 in Turkey: a retrospective cohort study.

BACKGROUND: The aim of this study is to examine the features of critical congenital heart disease (CCHD). METHODS: The study was planned as a retrospective cohort study. Data for the study were obtained through national data collection systems and 2018-2020 CCHD cohort was established. In this study, we divided the patients into two groups: Group 1 included seven primary target diseases of the newborn CCHD screening program and Group 2 included secondary target diseases. RESULTS: There were 9884 CCHD cases, with a prevalence of 27.8 per 10,000 live births. Of the cases 44.4% were in Group 1 (12.3 per 10,000) and 54.8% were in Group 2 (15.2 per 10,000). Of all cases 55.5% were male and the female/male ratio was 1/1.2. While 21.8% of the cases were premature, 23.0% were babies with low birth weight (LBW), 4.8% were born from multiple pregnancies. The highest prevalence of CCHD was found in LBW (84.8 per 10,000), premature infants (57.8 per 10,000) (p < 0.001). The fatality rate in the cohort was 16.6% in the neonatal period, 31.6% in the first year of life respectively. The mean estimated survival time in the birth cohort was 40.0 months (95% CI: 39.5-40.6). The mean survival time for Group 1 diseases was 33.4 months (95% CI: 32.5-34.2), while it was 45.4 months (95% CI: 44.7-46.0) for Group 2 diseases (p < 0.001). Preterm birth, LBW, maternal age and region were evaluated as factors associated with mortality risk. CONCLUSION: This study showed that CCHDs are common in Turkey and mortality rates are high. There are regional differences in CCHD both prevalence and survival. Improving prenatal diagnosis rates and expanding neonatal CCHD screening are of key importance.

Changes in anthropometry in full-term breastfed newborns and associated factors for the first month.

OBJECTIVE: We aim to assess the changes and associated factors in newborn anthropometry in the first month for full-term, healthy, and exclusive-breastfed infants. METHODS: Neonatal anthropometric measurements were taken on day 5, day 15, and day 30 after delivery. Generalized estimating equations (GEE) analyzed the changes. RESULTS: From 169 mother-newborn pairs, GEE showed that weight gain during the first month was influenced by maternal body mass index (BMI), delivery type, birth weight, and jaundice after adjusting confounding factors (p < .05). The neonatal length was affected by the smoking status of parents, gestational maternal health problems, maternal height, birth weight, and jaundice (p < .05). Neonatal head circumference was influenced by the smoking status of parents, gestational maternal health problems, maternal BMI, delivery type, maternal height, and birth weight. CONCLUSION: Adverse perinatal factors including mother's smoke exposure, maternal obesity and diabetes, cesarean birth, and neonatal hyperbilirubinemia influence anthropometry in the first months of life.

Mother's knowledge for environmental risks and self-awareness for the presence of pollutants in her living area in West and Central Anatolia: a cross-sectional survey.

BACKGROUND: Environmental risk awareness is a key concept to raise awareness and plan future programs for environmental protection. A cross-sectional household survey aimed to find out the presence of environmental hazards next to living area and the mother's knowledge levels about environmental risk factors with their related factors according to district development ranking, and Western and Central Anatolian regions with sampling from rural and urban residence. METHOD: The study was designed with household sampling weighted according to population density in 2008. Data on the demography and health status, dwelling characteristics of the residents are also collected in 2009. In addition, open-ended questions "What does environmental risk/hazard mean?" and "Which environmental risks/hazards are present in your environment?" were asked. The data collected from the survey were analyzed using multivariate binary logistic regression. RESULTS: The sample included 3489 mothers living either in urban or rural areas. Of the mothers, 19.3% did not know what an environmental risk is and 75.7% stated that there was at least one environmental pollutant in their environment. The most commonly perceived risk factor was air pollution (23.0%), which was reported to be present in their living areas by 12.4%. Regions, residence, settlement features of the house, and health status of family members were associated with the perception of environmental risk at a statistically significant level. CONCLUSION: The neighborhood conditions and health status of family associated with the mother's awareness for environmental risk factors. Communication and cooperation between local governments, health institutions, non-governmental organizations and other stakeholders should be strengthened to increase risk awareness.

AI-ASSISTED emotion analysis during complementary feeding in infants aged 6-11 months.

This study aims to explore AI-assisted emotion assessment in infants aged 6-11 months during complementary feeding using OpenFace to analyze the Actions Units (AUs) within the Facial Action Coding system. When infants (n = 98) were exposed to a diverse range of food groups; meat, cow-milk, vegetable, grain, and dessert products, favorite, and disliked food, then video recordings were analyzed for emotional responses to these food groups, including surprise, sadness, happiness, fear, anger, and disgust. Time-averaged filtering was performed for the intensity of AUs. Facial expression to different food groups were compared with neutral states by Wilcoxon Singed test. The majority of the food groups did not significantly differ from the neutral emotional state. Infants exhibited high disgust responses to meat and anger reactions to yogurt compared to neutral. Emotional responses also varied between breastfed and non-breastfed infants. Breastfed infants showed heightened negative emotions, including fear, anger, and disgust, when exposed to certain food groups while non-breastfed infants displayed lower surprise and sadness reactions to their favorite foods and desserts. Further longitudinal research is needed to gain a comprehensive understanding of infants' emotional experiences and their associations with feeding behaviors and food acceptance.

Association of bisphenol A with 25(OH)D, 1,25(OH)2D levels and 1,25(OH)2D/25(OH)D ratio in cord blood.

The aim was to investigate the association between bisphenol A (BPA), 25-hydroxy vitamin D [25(OH)D], and 1α,25 dihydroxy vitamin D [1,25(OH)2D] levels in the cord blood of newborn babies. BPA was measured by high pressure liquid chromatography (HPLC) and vitamin D levels by commercial ELISA or ECLIA kits. BPA and Vitamin D levels were grouped according to tertile values. In the cord blood, the median 25(OH)D level was 14.9 ng/mL (IQR: 8.5-20.8) and median 1,25(OH)2D level was 53.3 pg/dL (IQR: 42.3-98.4). 25(OH)D levels were < 20 ng/mL in 76.5% of the babies. BPA was detectable in 72.4% of the cord blood samples; median BPA level was 1.57 ng/mL (IQR: < DL-4.05 ng/mL). Frequencies of vitamin D deficiency and frequencies of cases having the highest tertile active vitamin D levels were similar in groups of BPA tertiles in both univariate and multivariate analysis. In conclusion, both BPA exposure and insufficient vitamin D transfer via cord blood are common in newborns. Bisphenol A levels were not correlated with vitamin D levels in cord blood of healthy mother-fetus pairs.

Evaluation of breastfeeding and infant feeding attitudes among syrian refugees in Turkey: observations of Syrian healthcare workers.

BACKGROUND: The influx of Syrian refugees into Turkey has highlighted the importance of supporting breastfeeding practices among this vulnerable population. We aimed to evaluate the breastfeeding and infant feeding attitudes of Syrian mothers based on the observations of Syrian healthcare workers (HCWs). METHODS: An online form including 31 questions was prepared in Turkish, Arabic, and English languages and distributed to HCWs, working in refugee health centers via e-mail, WhatsApp, or text message with the help of Ministry of Health in Turkey between January 2020 and March 2020. The questions were about HCWs' characteristics (occupation, region of employment, duration of employment, participation in breastfeeding counseling course) and about HCWs' observations of Syrian mothers' breastfeeding and infant feeding practices. RESULTS: A total of 876 HCWs were included in the study; about 37.3% were physicians. Only 40.0% of HCWs reported that babies were predominantly fed with breast milk in the first three days after birth, 45.2% of HCWs indicated that mothers typically used sugary water as a prelacteal food, and 30.5% believed that breastfeeding was discontinued before 12 months. The main barriers to breastfeeding identified by HCWs included the lack of education, mental and physical health issues in the mother, food insecurity, low income, inadequate housing, lack of family planning, sociocultural environment, and limited access to quality health services. For complementary feeding, 28.0% of HCWs stated early introduction and 7.4% remarked delayed. HCWs believed grains, fruits and vegetables, and dairy products as top three foods for starting complementary food (59.5%, 47.8%, and 30.3% respectively). Healthcare challenges of Syrian pregnant and lactating mothers were reported to be associated primarily with "food, finance, and housing difficulties", low maternal education, and cultural and environmental issues. HCWs recommended various solutions, such as supporting breastfeeding, offering nutrition and health support, promoting family planning, improving healthcare systems through legislation, and addressing cultural barriers. CONCLUSIONS: To address breastfeeding issues among Syrian mothers, it is crucial to provide breastfeeding training to both HCWs and mothers. Expanding interventions that support breastfeeding-friendly practices, including community support and food aid for breastfeeding mothers, should also be considered to address the social determinants of breastfeeding.

Accuracy of Syrain Refugee Mothers' Perceptions of Newborn's Birth Size: Insights from a National Survey in Turkey.

This study aims to assess the accuracy of maternally perceived birth size and its associated factors among the Syrian refugees in Turkey, using the data from 2018 Turkey Demographic and Health Survey Syrian Migrant Sample (TDHS-SM-18). The study includes information on the last-born child, singleton pregnancies, births in healthcare facilities, children under 5 living with their mothers, with recorded birth weight (n = 969). The study categorizes the mother's perception of size into three groups : compatible, overestimated, and underestimated. Various factors, including sociodemographic characteristics, financial aspects, maternal characteristics, and child characteristics, are considered as explanatory variables. The analysis employs a complex sample multiple logistic regression model. The findings reveal that the majority of mothers accurately perceive the birth size, but 17.1% of them do not. Maternal factors such as region of residence, literacy, occupation, age at birth, and child factors such as birth order, birth interval, gender, and birth weight are identified as associated factors with maternal misperception. This study provides valuable insights into the accuracy of maternally perceived birth size and sheds light on the factors influencing this perception among Syrian refugee mothers in Turkey.

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

OBJECTIVES: 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. METHODS: Voluntary lactating mothers having infants with gestational length ≥ 37 weeks were enrolled between August 2017 and June 2018 in Sanliurfa. 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. RESULTS: 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). CONCLUSIONS: Breast milk monitoring study revealed that ZEN and DON mycotoxins were present in the mother-infant environment. Contamination levels changed during the lactation period.