Implants linked to disorders in children.

A preliminary study hints that children breast-fed by mothers with silicone gel breast implants may develop symptoms of an autoimmune attack,

Earlier research had indicated that women with these implants may face increased risk of a puzzling array of autoimmune disorders (SN: 12/12/92, p.414). In fact, evidence linking silicone implants to autoimmune disorders prompted the U.S. Food and Drug Administration to restrict access to the implants.

Jeremiah J. Levine and Norman T. Ilowite of the Long Island Jewish Medical Center in New Hyde Park, N.Y., who conducted the study, knew that many women with implants suffer from a skin disorder called scleroderma. They also knew that scleroderma is often accompanied by problems with the esophagus, the muscular tube that leads to the stomach.

The pair evaluated 11 boys and girls who reported gastrointestinal problems such as abdominal pain, vomiting, and difficulty swallowing their food. All had been born to women with silicone implants. Eight of the mothers recalled nursing, and three had bottle,fed their children.

Levine and Ilowite discovered that six of the eight breast-fed children had problems with esophageal peristalsis, the involuntary waves that push food down this digestive tube. Without such waves, gravity is the only force getting nourishment to the stomach, Levine says. Each of the three bottle-fed children had an apparently healthy esophagus.

The team also studied 17 controls, children with stomach pain whose mothers did not have silicone implants. When compared to controls, the breast-fed children in the silicone group had abnormal esophageal function, the team reports in the Jan. 19 JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION.

Although the study is small, the results appear significant, Levine says, noting that this esophageal disorder is rare in the general pediatric population. The researchers don't know whether children with the condition will outgrow their digestive problems; however, the digestive symptoms of three children in the study persisted.

Researchers have yet to uncover a mechanism by which silicone gel implants might cause disease, notes Jonathan A. Flick of Temple University School of Medicine in Philadelphia. Flick, who wrote an editorial accompanying the study, suggests that silicone may leach into breast milk and thus trigger the esophageal difficulties later in a child's life. Alternatively, the condition may result from antibodies that slip past the placenta.

Should women with silicone implants forgo nursing an infant? U.S. physicians remain cautious about such advice, noting that the advantages of breast-feeding are well established. Further research must confirm any hazards associated with milk from a silicone,enhanced breast, Levine points out.